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Epidemiology of depression and distress in patients with inflammatory bowel disease (IBD) and validation of an indicator scale of perceived stress for psychosocial impairments

Published online by Cambridge University Press:  16 April 2020

J. Hardt
Affiliation:
Institute of Social Medicine, University of Luebeck, University Medical Centre, Lübeck, Germany Section of Occupational Health Research, Institute for Safety Engineering (IST), FB D, University of Wuppertal (BUW), Wuppertal, Germany
S. Conrad
Affiliation:
Institute of Social Medicine, University of Luebeck, University Medical Centre, Lübeck, Germany Evidence-based Medicine and Guidelines, Agency for Quality in Medicine (AQuMed/ÄZQ), Berlin, Germany
C. Muche-Borowski
Affiliation:
Institute of Social Medicine, University of Luebeck, University Medical Centre, Lübeck, Germany Association of the Scientific Medical Societies in Germany (AWMF), Düsseldorf and Berlin, Germany
H. Raspe
Affiliation:
Institute of Social Medicine, University of Luebeck, University Medical Centre, Lübeck, Germany Population-based Medicine, University of Luebeck, University Medical Centre, Lübeck, Germany

Abstract

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Background

Previous studies showed associations of stress and episodes of active disease [1,2]. We reported survey data on psychosocial problems of IBD patients [3]. This study investigates associations of stress with health impairments and analyses a scale of perceived stress as an indicator for psychosocial impairments (construct/criterion validity) [4].

Methods

In a multiregional German survey in 2005, 1083 patients with Crohn's disease (CD) and ulcerative colitis were recruited (gastroenterological practices, university outpatient clinics, patient organization). The questionnaire incorporated WHO's ICF [5] and established items and scales (i.a. HADS [6]). Scale construction followed item response theory analysing psychometric properties.

Results

Of the survey responders (58% CD, 65% female, mean age 42yrs), ⅓ reported severe fatigue. Clinically relevant anxiety was observed in 24%, depression in 29% of men and 21% of women. With three items we constructed a scale with good psychometric properties. Three groups (low, moderate, high perceived stress) were identified, differing substantially in reported anxiety/depression and the GIBDI disease activity score.

Conclusions

IBD patients report multiple psychosocial impairments. The scale of perceived stress may identify IBD patients with high demand for psychosocial attendance, if confirmed in independent samples. For enhanced secondary prevention [7] we propose integration of this psychosocial indicator into the diagnostic process.

Type
W09-01
Copyright
Copyright © European Psychiatric Association 2011

References

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