QUALITY-OF-LIFE IN INFLAMMATORY BOWEL-DISEASE - THE INTERACTION OF DISEASE-ACTIVITY WITH PSYCHOSOCIAL FUNCTION

Objectives: To evaluate the disease-specific and psychological factors that influence quality of life (QOL) in patients with inflammatory bo wel disease (IBD) as measured by the recently developed IBD disease-sp ecific QOL measure the Inflammatory Bowel Disease Questionnaire (IBDQ) . Methods: Twenty-two patients (eight males and 14 females) were studi ed, 16 with Crohn's disease and six with ulcerative colitis (mean age 32 yr). Patients' disease activity was measured with the Dutch Crohn's activity index and the St. Mark's colitis activity index, and QOL was measured by the IBDQ. AIL patients completed self-report questionnair es for psychological function, which included the Sickness Impact Prof ile (SIP), the Symptom Checklist-90-R (SCL), and the Self-Control Sche dule (SCS). Results: By combining the psychological measures and the d isease activity into a single variable, this composite variable signif icantly predicted QOL (r = 0.53, p < 0.02), but disease activity alone did not predict overall QOL. Improved psychosocial functioning (Sickn ess Impact Profile) predicted greater overall QOL (IBDQ total: p = -0. 49, p < 0.05) and better social functioning (r = -0.65, p < 0.01). Gre ater psychological distress (SCL) and disease activity predicted more systemic symptoms CSCL-Positive Symptom Total (PST): p = -0.48,p < 0.0 5; disease activity: r = -0.65, p < 0.03) and poorer emotional functio ning (SCL-PST: minus] 0.75, p < 0.001; disease activity: p = -0.82, p < 0.03). Disease type, gender, age of onset, and psychological coping (SCS) were not predictive of disease-specific QOL, but coping (SCS) wa s significantly correlated with psychological distress (p = -0.58,p < 0.05 for the SCL-90-PST). Conclusion: This study confirms the importan ce of psychological functioning in determining QOL of IBD patients and must be considered jointly with disease activity.