title: Coping strategies and irrational beliefs as mediators of the health-related quality of life impairments in irritable bowel syndrome.
abstract: OBJECTIVE
  Irritable bowel syndrome (IBS) is a chronic and disabling gastrointestinal disorder. Although considerable research has underlined the influence of coping mechanisms as the determinants of the quality of life (QOL), only limited data are available regarding the specific coping mechanisms used by IBS patients to manage illness in daily life. Irrational cognitions are known to emerge in stressful situations such as chronic diseases, and it has been proposed to have implications in the QOL. The aim of this study was to explore the relationship between coping styles and irrational beliefs in predicting the effects of IBS symptoms on the health-related QOL (HRQOL).
  
  
  METHODS
  A cross-sectional study was performed at two tertiary gastroenterology centers. A sample of 70 consecutive IBS patients and 55 healthy controls was studied. All participants completed the Brief Cope Inventory, the Dysfunctional Attitudes Scale, the Short-Form Health Survey and a demographic questionnaire.
  
  
  RESULTS
  All the HRQOL scores of the group with IBS were significantly lower than the HRQOL scores of the healthy group [Pillai's trace V = 0.404, F(8, 116) = 9.833, p < 0.001]. Irritable bowel syndrome patients used more problem-focused coping and avoidant-oriented coping than healthy subjects. The impact of IBS symptoms on HRQOL distress is mediated by irrational beliefs and avoidant oriented coping.
  
  
  CONCLUSIONS
  Our findings highlight the role of irrational cognition and coping mechanisms in patients with IBS. The results underline the importance of the evaluation of psychological aspects of IBS with the possibility of having more tailored treatments for these patients.
authors.affiliation: Dept. Neurosciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. mihaelastanculete@yahoo.com.
authors.forename: Mihaela Fadgyas
authors.initials: MF
authors.lastname: Stanculete
authors.affiliation: Dept of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania.
authors.forename: Silviu
authors.initials: S
authors.lastname: Matu
authors.affiliation: Dept of Clinical Psychology and Psychotherapy, Babes-Bolyai University; Octavian Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania.
authors.forename: Cristina
authors.initials: C
authors.lastname: Pojoga
authors.affiliation: 2nd Dept. of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Dan L
authors.initials: DL
authors.lastname: Dumitrascu
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D016022:Case-Control Studies; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012383:Romania; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers