title: Religious coping and its influence on psychological distress, medication adherence, and quality of life in inflammatory bowel disease.
abstract: OBJECTIVE
  Inflammatory bowel disease (IBD) is associated with elevated levels of anxiety and depression and a reduction in health-related quality of life (HRQoL). Nonadherence to treatment is also frequent in IBD and compromises outcomes. Religious coping plays a role in the adaptation to several chronic diseases. However, the influence of religious coping on IBD-related psychological distress, HRQoL, and treatment adherence remains unknown.
  
  
  METHODS
  This cross-sectional study recruited 147 consecutive patients with either Crohn's disease or ulcerative colitis. Sociodemographic data, disease-related variables, psychological distress (Hospital Anxiety and Depression Scale), religious coping (Brief RCOPE Scale), HRQoL (WHOQOL-Bref), and adherence (8-item Morisky Medication Adherence Scale) were assessed. Hierarchical multiple regression models were used to evaluate the effects of religious coping on IBD-related psychological distress, treatment adherence, and HRQoL.
  
  
  RESULTS
  Positive RCOPE was negatively associated with anxiety (b = 0.256; p = 0.007) as well as with overall, physical, and mental health HRQoL. Religious struggle was significantly associated with depression (b = 0.307; p < 0.001) and self-reported adherence (b = 0.258; p = 0.009). Finally, anxiety symptoms fully mediated the effect of positive religious coping on overall HRQoL.
  
  
  CONCLUSIONS
  Religious coping is significantly associated with psychological distress, HRQoL, and adherence in IBD.
authors.affiliation: Department of Clinical Medicine, Universidade Federal do Ceará, Fortaleza, CE, BR.
authors.forename: Thiago H
authors.initials: TH
authors.lastname: Freitas
authors.affiliation: Department of Psychiatry, University of Ioannina, Ioannina, GR.
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Hyphantis
authors.affiliation: 3rd Department of Psychiatry, Aristotle University of Thessaloniki, Thessaloniki, GR.
authors.forename: Elias
authors.initials: E
authors.lastname: Andreoulakis
authors.affiliation: Center for Experimental Models in Psychiatry, Department of Psychiatry and Behavioral Sciences, The University of Texas Medical School at Houston, Houston, TX, US.
authors.forename: João
authors.initials: J
authors.lastname: Quevedo
authors.affiliation: Department of Clinical Medicine, Universidade Federal do Ceará, Fortaleza, CE, BR.
authors.forename: Hesley L
authors.initials: HL
authors.lastname: Miranda
authors.affiliation: Department of Clinical Medicine, Universidade Federal do Ceará, Fortaleza, CE, BR.
authors.forename: Gilberto S
authors.initials: GS
authors.lastname: Alves
authors.affiliation: Institute of Biomedicine of Brazilian Semi-Arid, Department of Clinical Medicine, Faculty of Medicine, UFC, Fortaleza, CE, BR.
authors.forename: Marcellus H
authors.initials: MH
authors.lastname: Souza
authors.affiliation: Institute of Biomedicine of Brazilian Semi-Arid, Department of Clinical Medicine, Faculty of Medicine, UFC, Fortaleza, CE, BR.
authors.forename: Lúcia L
authors.initials: LL
authors.lastname: Braga
authors.affiliation: Department of Psychology, Bowling Green State University, Bowling Green, OH, US.
authors.forename: Kenneth I
authors.initials: KI
authors.lastname: Pargament
authors.affiliation: Mood Disorders Psychopharmacology Unit, University of Toronto, Toronto|ON, CA.
authors.forename: Joanna K
authors.initials: JK
authors.lastname: Soczynska
authors.affiliation: Mood Disorders Psychopharmacology Unit, University of Toronto, Toronto|ON, CA.
authors.forename: Roger S
authors.initials: RS
authors.lastname: McIntyre
authors.affiliation: Department of Clinical Medicine, Universidade Federal do Ceará, Fortaleza, CE, BR.
authors.forename: André F
authors.initials: AF
authors.lastname: Carvalho
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology; D001938:Brazil; D003093:Colitis, Ulcerative / Q000523:psychology* / Q000628:therapy; D003424:Crohn Disease / Q000523:psychology* / Q000628:therapy; D003866:Depressive Disorder / Q000523:psychology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D012069:Religion and Psychology; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology*