Illness Perception in Inflammatory Bowel Disease Patients is Different Between Patients With Active Disease or in Remission: A Prospective Cohort Study

J Crohns Colitis. 2019 Mar 30;13(4):417-423. doi: 10.1093/ecco-jcc/jjy183.

Abstract

Background: Inflammatory bowel diseases [IBD] are characterised by significant quality of life [QoL] impairment, as well as illness perception. Assessing illness perception may help in optimising the management of IBD patients.

Methods: In this single-centre, observational, transversal study, consecutive adult IBD patients were enrolled and stratified according to disease activity [active/remission]. The Revised Illness Perception Questionnaire [IPQ-R], based on identity, opinions, and causes of their disease was administered to all patients. Comparison within IPQ-R parameters was done between clinically active patients and those in remission.

Results: A total of 201 patients were enrolled (Crohn's disease [CD] = 47%). The most frequently reported IBD-related symptoms were fatigue [86.9%], loss of strength [83.3%], pain [80%], and weight loss [68.2%]. Active patients reported significantly more frequently fatigue [p = 0.005], sore eyes [p = 0.046], and sleep difficulties [p = 0.001], and reported more symptoms than controls [p = 0.023]. Overall, the patients considered stress [84.1%], altered immunity [69.32%], family problems [49.4%], and emotional status [40.9%] as the main causes of IBD. Work overload was more frequently considered as a disease cause in active patients than in those in remission [p = 0.002]. Smoking, family history, and previous inadequate therapies were considered as a relevant risk factor for illness by only 20% of patients. Active IBD patients had more negative thoughts on prognosis [p = 0.001] and more negative emotions [p < 0.0001]. Patients in remission were significantly more convinced about treatment control [p = 0.007] and had clearer understanding of illness [p = 0.009].

Conclusions: Illness perception is impaired in IBD patients. Adequate educational and psychological support may be helpful in the optimal management of IBD patients.

Keywords: Crohn’s disease; Perception; inflammatory bowel disease; psychology; ulcerative colitis.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Abdominal Pain / etiology
  • Adult
  • Colitis, Ulcerative / complications*
  • Colitis, Ulcerative / etiology
  • Colitis, Ulcerative / psychology*
  • Crohn Disease / complications*
  • Crohn Disease / etiology
  • Crohn Disease / psychology*
  • Emotions
  • Eye Diseases / etiology
  • Family Relations / psychology
  • Fatigue / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Weakness / etiology
  • Perception
  • Prospective Studies
  • Severity of Illness Index
  • Sleep Wake Disorders / etiology
  • Stress, Psychological / psychology
  • Surveys and Questionnaires
  • Weight Loss
  • Workload / psychology