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Employment status, difficulties at work and quality of life in inflammatory bowel disease patients

De Boer, Angela G.E.M.; Bennebroek Evertsz’, Floor; Stokkers, Pieter C.; Bockting, Claudia L.; Sanderman, Robert; Hommes, Daniel W.; Sprangers, Mirjam A.G.; Frings-Dresen, Monique H.W.

European Journal of Gastroenterology & Hepatology: October 2016 - Volume 28 - Issue 10 - p 1130–1136
doi: 10.1097/MEG.0000000000000685
Original Articles: Inflammatory Bowel Diseases

Objectives To assess employment status, difficulties at work and sick leave in inflammatory bowel disease (IBD) patients and their relation with sociodemographic and clinical factors, quality of life (QoL), and anxiety and depression.

Materials and methods IBD patients attending an IBD outpatients’ clinic received self-report questionnaires on employment status, IBD-related difficulties at work and sick leave (Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness), sociodemographic factors, QoL (Inflammatory Bowel Disease Questionnaire and 12-item Short-form Health Survey) and anxiety and depression (Hospital Anxiety and Depression Scale). Disease activity was assessed by their gastroenterologist. Associations between paid employment and sick leave with sociodemographic and clinical factors, QoL and anxiety and depression were assessed by regression analyses.

Results In total, 202 IBD patients of working age, with a mean age of 41 years, participated; 63% had Crohn’s disease and 37% had ulcerative colitis, and 57% were women and 19% had active disease. In all, 123 (61%) patients were in paid employment, of whom 31 (25%) were on sick leave, whereas 46 (23%) received a disability pension. Concentration problems (72%), low working pace (78%) and delayed work production (50%) were the most prevalent IBD-related work difficulties. IBD patients without paid employment were older and more often women, with active disease, lower QoL and higher anxiety and depression rates. Sick leave was associated with lower QoL and higher anxiety and depression rates.

Conclusion More than half of IBD patients were in paid employment, whereas almost a quarter was receiving a disability pension. A large majority experienced work difficulties. Having no paid employment was associated with poorer QoL and more anxiety and depression symptomatology.

aCoronel Institute of Occupational Health

bDepartment of Medical Psychology, Academic Medical Center

cDepartment of Gastroenterology, Sint Lucas Andreas Hospital, Amsterdam

dDepartment of Clinical and Health Psychology, Utrecht University, Utrecht

eDepartment of Clinical Psychology

fDepartment of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

gDepartment of Medicine, Center for Inflammatory Bowel Diseases, University of California Los Angeles, Los Angeles, California, USA

Correspondence to Angela G.E.M. De Boer, PhD, Coronel Institute of Occupational Health, Academic Medical Center, PO Box 22700, 1100 DE Amsterdam, The Netherlands Tel: +31 20 566 5323; fax: +31 20 697 7161; e-mail:

Received March 4, 2016

Accepted May 11, 2016

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.