Psychological Factors

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• IBD activity is strongly related to psychological symptoms, including distress/anxiety (e.g., feeling wound up, inability to relax, feelings of panic and worry) and depression (e.g., loss of interest in enjoyable activities, feeling sad and unhappy, slowed down, lacking energy)
• Psychologists and doctors have found consistent relationships between IBD and a range of concerns including diminished energy, impaired sense of control (due to an unknown disease course), impaired body image, increased isolation and fear, and feeling "dirty"
• Rates of reported psychological symptoms, such as anxiety and depression in IBD cohorts are higher (up to 50%) than in comparison to other chronic disease illness groups
• In comparison to healthy controls (and other illness groups such as IBS and colon cancer), individuals with more severe IBD report more psychiatric distress. Not surprisingly, IBD sufferers also report reduced self-esteem, increased body image concerns and sexual problems
• Psychological factors are known to have a long term effect on the physiological system, particularly on gastrointestinal motility and the immune response

Risk factors for the development of psychological distress in IBD

Risk factors for the development of psychological distress in IBD include:

• Stress (daily hassles vs. major life events)
• Symptoms exacerbation
• Comorbid psychiatric diagnosis (such as depression)
• Appraisal of uncertainty
• Emotion-focused rather than problem focused coping
• Lack of information about the disease course and treatment
• Lack of social support
• Inability to grieve over lost body image
• Persistent anger or denial over illness
• Feeling out of control
• Significant degree of social impairment

This section provides more detail on:

• Depression
• Anxiety
• Stress
• Sleep
• Links