Psychological distress, social support, and disease activity in patients with inflammatory bowel disease

OBJECTIVES: The objectives of this study were to compare the psychological status of patients in active and inactive disease states, to assess social support, and to identify correlates of psychological distress in patients w ith inflammatory bowel disease (IBD). METHODS: This cross-sectional study was conducted in 200 patients (mean age 36.7 yr [SD = 14.8], 119 [59.5%] female) with long-standing IBD who were s een in tertiary care. Psychosocial assessments included psychological distr ess (Symptom Checklist-90R), social support (Social Support Questionnaire-6 ), perceived stress (Perceived Stress Scale-10), and recent minor stressful events (Weekly Stress Inventory). Disease activity was assessed with the H arvey Bradshaw Index. RESULTS: Patients reported higher levels of satisfaction with social suppor t and smaller network sizes compared with normative values. Using multiple linear regression, the independent correlates of psychological distress (p = 0.0001; adjusted R-2 = 0.62) were as follows: active disease (p = 0.0234) , less time since diagnosis (p = 0.0012), and greater number (p = 0.0001) a nd impact of stressful events (p = 0.0003). A statistically significant int eraction term (p = 0.0171) revealed that the relationship between psycholog ical distress and perceived stress changes depending on the level of satisf action with social support. For patients with low levels of perceived stres s, satisfaction with social support did not affect levels of psychological distress. However, for patients who experienced moderate to high levels of perceived stress, high satisfaction with social support decreased the level of psychological distress. CONCLUSIONS: These findings suggest that strategies aimed at improving soci al support can have a favorable impact on psychological distress and, ultim ately, can improve health outcomes in patients with IBD. (C) 2001 by Am. Ce ll. of Gastroenterology.