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Psychological Factors Are Associated with Changes in the Health-related Quality of Life in Inflammatory Bowel Disease

Iglesias-Rey, Marta PhD*; Barreiro-de Acosta, Manuel MD, PhD*,†; Caamaño-Isorna, Francisco PhD; Rodríguez, Isabel V. PhD§; Ferreiro, Rocío MD*,†; Lindkvist, Björn MD, PhD; González, Aurelio L. MD; Dominguez-Munoz, J. E. MD, PhD*,†

doi: 10.1097/01.MIB.0000436955.78220.bc
Original Clinical Articles

Background: The effect of different sociodemographic and clinical variables on the health-related quality of life (HRQOL) of patients with inflammatory bowel disease (IBD) is currently known, but the influence of psychological factors has not been sufficiently explored. The objective of this study was to identify psychological predictors of HRQOL in patients with IBD.

Methods: A cross-sectional prospective study was undertaken including 875 consecutive IBD patients. Independent variables were measured using a sociodemographic and clinical questionnaire, the Hospital Anxiety and Depression Scale (HADS) questionnaire, the Perceived Stress Scale (PSS) questionnaire, and the COPE questionnaire. Dependent variables were measured using the Short Form 36 Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ-36). Logistic regression was performed to identify factors associated with HRQOL.

Results: The participation rate was 91.3%. Patients with IBD had a poorer HRQOL than the general population except on the Physical Function, Social Function, and Emotional Function Scale. Moreover, high levels of anxiety, depression, and stress were found to be associated with low levels in all quality of life measurements. No significant relationship was found between HRQOL and coping strategies.

Conclusions: In patients with IBD, stress, anxiety and depression are important determinants of HRQOL and should therefore be considered in the management of this patient population.

Article first published online 4 November 2013

*Foundation for Research in Digestive Diseases (FIENAD); University Hospital of Santiago de Compostela, Santiago de Compostela, Spain;

Gastroenterology Clinic Hospital of Santiago de Compostela, Santiago de Compostela, Spain;

Department of Preventive Medicine and Public Health (CIBERESP), University of Santiago de Compostela, Santiago de Compostela, Spain;

§Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain; and

Department of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Reprints: Manuel Barreiro-de Acosta, MD, PhD, Servicio de Aparato Digestivo, Hospital Clínico Universitario, C/Choupana s/n, 15706 Santiago de Compostela, A Coruña, Spain (e-mail:

The authors have no conflicts of interest to disclose.

Received July 18, 2013

Accepted October 2, 2013

© Crohn's & Colitis Foundation of America, Inc.
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