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Unfavourable outcome for women in a study of health-related quality of life, social factors and work disability in Crohn's disease

Stjernman, Henrika,b; Tysk, Curtc,d; Almer, Svenb; Ström, Magnusb; Hjortswang, Henrikb

European Journal of Gastroenterology & Hepatology: August 2011 - Volume 23 - Issue 8 - p 671–679
doi: 10.1097/MEG.0b013e328346f622
Original Articles: Inflammatory Bowel Disease

Objective The aim was to describe health-related quality of life (HRQL) and social factors, sickness and disability variables in a large population-based cohort of patients with Crohn's disease (CD).

Methods HRQL was measured with Short Form-36 in 497 adult patients with CD at three outpatient clinics. Comparisons were made with age–sex-matched background population and with ulcerative colitis (UC). Social factors, employment, sickness compensation and disability pension for CD were compared with national population registers.

Results CD had a greater negative effect on HRQL than did UC. This difference was more pronounced for women. Compared with background population, patients with CD had lower educational level, and had a two-fold rise in long-term sickness and disability pension rate. Women with CD had higher rates of sickness and disability than men with CD and were more often living single, though procreation was not affected.

Conclusion This study characterized the burden of CD in a large population-based cohort. CD had higher impact on HRQL, compared with UC. Women with CD had worse outcome in subjective health status, but not in objective assessment of disease activity. Women also had higher rates of sickness, disability pension and single living. The mechanism underlying the sex-related inequalities in outcome for CD warrants further elucidation.

aDivision of Gastroenterology, Department of Medicine, Gastroenterology and Hepatology Unit, County Hospital Ryhov, Jönköping

bDivision of Gastroenterology and Hepatology, Department of Clinical and Experimental Medicine, Linköping University, Linköping

cDivision of Gastroenterology, Department of Medicine, Örebro University Hospital

dSchool of Health and Medical Sciences, Örebro University, Örebro, Sweden

Correspondence to Henrik Stjernman, MD, Division of Gastroenterology, Department of Internal Medicine, Gastroenterology and Hepatology Unit, County Hospital Ryhov, Länssjukhuset Ryhov, S-551 85 Jönköping, Sweden Tel: +46 36 321978; fax: +46 36 322055; e-mail:

Received January 13, 2011

Accepted March 18, 2011

© 2011 Lippincott Williams & Wilkins, Inc.