title: Substantial impact of illness perceptions on quality of life in patients with Crohn's disease.
abstract: OBJECTIVE
  Crohn's disease (CD) negatively impact patients' health-related quality of life (HRQOL). We used the common sense model to examine the contribution of illness perceptions and coping to HRQOL, in addition to clinical and socio-demographic characteristics. This provides insight into potential targets for psychological interventions aimed at improving HRQOL.
  
  
  METHODS
  Consecutive CD patients undergoing colonoscopy were included. Disease activity was assessed by a clinical and an endoscopic index. Patients completed questionnaires assessing illness perceptions (IPQ-R), coping (Utrecht Coping List), self-perceived health, neuroticism, and HRQOL. Hierarchical multiple regression analyses were performed to assess the contribution of illness perceptions and coping to HRQOL. Illness perceptions were compared to patients with rheumatoid arthritis, myocardial infarction (MI), and head and neck cancer (HNC).
  
  
  RESULTS
  Of 82 CD patients, mean age was 42±14years. Clinical and endoscopic active disease was present in 42 (52%) and 49 (60%) patients, respectively. HRQOL was strongly impaired by clinical active disease (r=-0.79), self-perceived health (r=-0.60), and perceived consequences of CD (r=-0.54), but correlated poorly with endoscopic disease activity (r=-0.29). Illness perceptions significantly contributed 3-27% to HRQOL. Coping had no contributory role. CD patients perceived similarly strong consequences of their illness as patients with MI and HNC and had the strongest thoughts about the chronic nature of their illness.
  
  
  CONCLUSIONS
  CD has a similar impact on patients' daily lives as was observed in patients with MI and HNC. Illness perceptions contribute to HRQOL and should therefore be incorporated in clinical practice, thereby improving HRQOL.
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center Utrecht, The Netherlands. M.vanderhave@umcutrecht.nl
authors.forename: Mike
authors.initials: M
authors.lastname: van der Have
authors.forename: Itta M
authors.initials: IM
authors.lastname: Minderhoud
authors.forename: Adrian A
authors.initials: AA
authors.lastname: Kaptein
authors.forename: Max
authors.initials: M
authors.lastname: Leenders
authors.forename: Peter D
authors.initials: PD
authors.lastname: Siersema
authors.forename: Herma H
authors.initials: HH
authors.lastname: Fidder
authors.forename: Bas
authors.initials: B
authors.lastname: Oldenburg
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology; D001172:Arthritis, Rheumatoid / Q000523:psychology; D003424:Crohn Disease / Q000150:complications / Q000523:psychology*; D059026:Diagnostic Self Evaluation; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology; D000075384:Neuroticism; D010465:Perception; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires