title: [Assessing complex health problems of patients with IBD--first step to patient activation].
abstract: BACKGROUND
  Health care for inflammatory bowel diseases (IBD), to be comprehensive, takes a broad range of patients' somatic and psychosocial problems into account. Patients should be actively involved in health-care planning and organisation.
  
  
  METHODS
  431 adult patients with Crohn's disease (50 %) or ulcerative colitis participated in a postal questionnaire survey; 6 months apart it twice assessed the patients' individual problem profiles. The results of the assessment were back-reported to each patient combined with targeted (though standardised) recommendations for future care. This publication is the first of a series. It presents the basic study design, describes the prevalence of 16 psychosocial problem domains and analyses their association with socio-demographic and disease variables.
  
  
  RESULTS
  Participants had a mean age of 46 years; 61 % were female; 57 % in remission (GIBDI ≤ 3). The most prevalent problems reported addressed sexual impairments (27 %), high stress (26 %) and depression (21 %). 27 % of the respondents did not report any psychosocial problem. One in five (21 %) described highly complex problem profiles (≥ 5 "active" problems) combined with a mean of 28 disability days within the past 3 months. Complex psychosocial profiles were associated with active disease, Crohn's disease and low educational level.
  
  
  CONCLUSIONS
  IBD patients show a highly variable spectrum of psychosocial problems. Their number is closely associated with disease activity and a social status variable (school education). The gradient could complicate efforts to increase patient participation in care and to enhance self-management.
authors.affiliation: Institut für Sozialmedizin, Universität zu Lübeck, Lübeck, Germany. angelika.hueppe@uksh.de
authors.forename: A
authors.initials: A
authors.lastname: Hüppe
authors.forename: J
authors.initials: J
authors.lastname: Langbrandtner
authors.forename: H
authors.initials: H
authors.lastname: Raspe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D004522:Educational Status; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011584:Psychology; D018570:Risk Assessment; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology / Q000523:psychology*; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult