title: The Stressometer: A Simple, Valid, and Responsive Measure of Psychological Stress in Inflammatory Bowel Disease Patients.
abstract: OBJECTIVE
  Psychological stress is associated with inflammatory bowel disease [IBD], but the nature of this relationship is complex. At present, there is no simple tool to screen for stress in IBD clinical practice or assess stress repeatedly in longitudinal studies. Our aim was to design a single-question 'stressometer' to rapidly measure stress and validate this in IBD patients.
  
  
  METHODS
  In all, 304 IBD patients completed a single-question 'stressometer'. This was correlated with stress as measured by the Depression Anxiety Stress Scales [DASS-21], quality of life, and disease activity. Test-retest reliability was assessed in 31 patients who completed the stressometer and the DASS-21 on two occasions 4 weeks apart.
  
  
  RESULTS
  Stressometer levels correlated with the DASS-21 stress dimension in both Crohn's disease [CD] (Spearman's rank correlation coefficient [rs] 0.54; p < 0.001) and ulcerative colitis [UC] [rs 0.59; p < 0.001]. Stressometer levels were less closely associated with depression and anxiety [rs range 0.36 to 0.49; all p-values < 0.001]. Stressometer scores correlated with all four Short Health Scale quality of life dimensions in both CD and UC [rs range 0.35 to 0.48; all p-values < 0.001] and with disease activity in Crohn's disease [rs 0.46; p < 0.001] and ulcerative colitis [rs 0.20; p = 0.02]. Responsiveness was confirmed with a test-retest correlation of 0.43 [p = 0.02].
  
  
  CONCLUSIONS
  The stressometer is a simple, valid, and responsive measure of psychological stress in IBD patients and may be a useful patient-reported outcome measure in future IBD clinical and research assessments.
authors.affiliation: Centre for Colorectal Disease, St Vincent's University Hospital/University College Dublin, Dublin, Ireland.
authors.forename: Denise
authors.initials: D
authors.lastname: Keegan
authors.affiliation: Centre for Colorectal Disease, St Vincent's University Hospital/University College Dublin, Dublin, Ireland.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Byrne
authors.affiliation: Centre for Colorectal Disease, St Vincent's University Hospital/University College Dublin, Dublin, Ireland.
authors.forename: Garret
authors.initials: G
authors.lastname: Cullen
authors.affiliation: Centre for Colorectal Disease, St Vincent's University Hospital/University College Dublin, Dublin, Ireland.
authors.forename: Glen A
authors.initials: GA
authors.lastname: Doherty
authors.affiliation: Centre for Colorectal Disease, St Vincent's University Hospital/University College Dublin, Dublin, Ireland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Dooley
authors.affiliation: Centre for Colorectal Disease, St Vincent's University Hospital/University College Dublin, Dublin, Ireland hemulc@hotmail.com.
authors.forename: Hugh E
authors.initials: HE
authors.lastname: Mulcahy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003093:Colitis, Ulcerative / Q000523:psychology*; D003424:Crohn Disease / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Crohn’s disease; Inflammatory bowel disease; psychological stress; ulcerative colitis