Effects of coping on health outcome among women with gastrointestinal disorders

Background: Studies have shown that the nature and quality of coping may po sitively or negatively affect health outcome; however, this relationship ha s not been well studied among patients with gastrointestinal (GI) disorders . Objectives: The primary objective was to study the effect of different co ping strategies on the health outcome of women with GI disorders and how th ese coping strategies may modify the effects of education, GI disease type, neuroticism, and abuse severity on health outcome. Methods: We followed 17 4 patients in a referral GI clinic for 12 months to assess their health sta tus as a derived variable of daily pain, bed disability days, psychological distress, daily dysfunction, number of visits to physicians, and number of surgeries and procedures. We obtained at baseline their GI diagnosis (func tional vs. organic), neuroticism score (NEO Personality Inventory), sexual and/or physical abuse history, and scores on two coping questionnaires. Reg ressions analyses were used to determine the relative effect of the coping measures on health outcome and their modifying effects on education, GI dis ease type, neuroticism, and abuse severity. Results: A higher score on the Catastrophizing scale and a lower score on the Self-Perceived Ability to De crease Symptoms scale (Coping Strategies Questionnaire) predicted poor heal th outcome. Less education, a functional GT diagnosis, a higher neuroticism score, and greater abuse severity also contributed to poor health status. However, the effect of GI disease type and neuroticism on health outcome wa s significantly reduced by the coping measures. Conclusions: Maladaptive co ping (eg, catastrophizing) and decreased self-perceived ability to decrease symptoms may adversely affect health outcome and may modify the effect of GI disease type and neuroticism on health outcome.