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Published in: Journal of Clinical Psychology in Medical Settings 4/2008

01-12-2008

Different Associations of Health Related Quality of Life with Pain, Psychological Distress and Coping Strategies in Patients with Irritable Bowel Syndrome and Inflammatory Bowel Disorder

Authors: Gabriella Seres, Zoltán Kovács, Ágota Kovács, Olga Kerékgyártó, Krisztina Sárdi, Pál Demeter, Eszter Mészáros, Ferenc Túry

Published in: Journal of Clinical Psychology in Medical Settings | Issue 4/2008

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Abstract

The primary aim of this study was to measure psychological distress, pain severity, health related quality of life (QOL) and pain coping strategies in patients with irritable bowel syndrome (IBS) and ulcerative colitis (UC). A second aim was to determine the influence of somatic and psychological variables on health related QOL. Eighty-eight IBS and 66 UC patients completed the Irritable Bowel Syndrome Quality of Life Questionnaire (IBSQOL), Pain Severity Scale of West Haven Yale Multidimensional Pain Inventory (WHYMPY), Symptom Checklist-90-R (SCL-90-R) and Coping Strategies Questionnaire (CSQ). T-tests and GLM Analysis of Covariance were used for statistical analysis. IBS patients had significantly higher levels of psychological distress, pain severity and maladaptive pain coping strategies (catastrophization), and lower QOL than UC patients. Variance of QOL in IBS was explained for the most part by catastrophization (15%), then by psychological distress (8%), and for the less part by pain severity (5%). In UC, pain severity explained 21%, psychological distress 8%, and catastrophization 3% of the variance of QOL. These results suggest there are differences between IBS and UC patients in the role of physical and psychological factors in QOL and emphasize the importance of cognitive processes in IBS.
Literature
go back to reference Akehurst, R. L., Brazier, J. E., Mathers, N., O’Keefe, C., Kaltenthaler, E., Morgan, A., et al. (2002). Health-related quality of life and cost impact of irritable bowel syndrome in a UK primary care setting. PharmacoEconomics, 20, 455–462. doi:10.2165/00019053-200220070-00003.PubMedCrossRef Akehurst, R. L., Brazier, J. E., Mathers, N., O’Keefe, C., Kaltenthaler, E., Morgan, A., et al. (2002). Health-related quality of life and cost impact of irritable bowel syndrome in a UK primary care setting. PharmacoEconomics, 20, 455–462. doi:10.​2165/​00019053-200220070-00003.PubMedCrossRef
go back to reference Alexander, F. (1950). Psychosomatic medicine. New York: Norton. Alexander, F. (1950). Psychosomatic medicine. New York: Norton.
go back to reference Bernklev, T., Jahnsen, J., Lygren, I., Henriksen, M., Vatn, M., & Moum, B. (2005). Health-related quality of life in patients with inflammatory bowel diseases measured with the Short Form-36: Psychometric assessments and a comparison with general population norms. Inflammatory Bowel Diseases, 11, 909–918. doi:10.1097/01.mib.0000179467.01748.99.PubMedCrossRef Bernklev, T., Jahnsen, J., Lygren, I., Henriksen, M., Vatn, M., & Moum, B. (2005). Health-related quality of life in patients with inflammatory bowel diseases measured with the Short Form-36: Psychometric assessments and a comparison with general population norms. Inflammatory Bowel Diseases, 11, 909–918. doi:10.​1097/​01.​mib.​0000179467.​01748.​99.PubMedCrossRef
go back to reference Blanchard, E. B. (2001). Irritable bowel syndrome. Psychosocial assessment and treatment (pp. 101–113). Washington: American Psychological Association.CrossRef Blanchard, E. B. (2001). Irritable bowel syndrome. Psychosocial assessment and treatment (pp. 101–113). Washington: American Psychological Association.CrossRef
go back to reference Cser, T., & Túry, F. (2001). Irritábilis bél szindróma életminőség kérdőív. In L. Újszászy, M. Udvardy, & P. Kupcsulik (Eds.), Életminőség és vizsgálata a gasztroenterológiában (Hungarian—Quality of life and measurements in gastroenterology) (pp. 227–258). Budapest: Mediszter. Cser, T., & Túry, F. (2001). Irritábilis bél szindróma életminőség kérdőív. In L. Újszászy, M. Udvardy, & P. Kupcsulik (Eds.), Életminőség és vizsgálata a gasztroenterológiában (Hungarian—Quality of life and measurements in gastroenterology) (pp. 227–258). Budapest: Mediszter.
go back to reference Derogatis, L. R. (1977). SCL-90-R, administration, scoring and procedures manual for the revised version. Baltimore: John Hopkins University, School of Medicine. Derogatis, L. R. (1977). SCL-90-R, administration, scoring and procedures manual for the revised version. Baltimore: John Hopkins University, School of Medicine.
go back to reference Drossman, D. A. (1994a). The functional gastrointestinal disorders: Diagnosis, pathophysiology, and treatment (pp. 12–13). Boston: Little, Brown and Company. Drossman, D. A. (1994a). The functional gastrointestinal disorders: Diagnosis, pathophysiology, and treatment (pp. 12–13). Boston: Little, Brown and Company.
go back to reference Drossman, D. A., Creed, F. H., & Olden, K. W. (1999). Psychosocial aspects of the functional gastrointestinal disorders. Gut, 45, 25–30. Drossman, D. A., Creed, F. H., & Olden, K. W. (1999). Psychosocial aspects of the functional gastrointestinal disorders. Gut, 45, 25–30.
go back to reference Drossman, D. A., Leserman, J., & Zhiming, L. (2000). Effects of coping on health outcome among women with gastrointestinal disorders. Psychosomatic Medicine, 62, 309–317.PubMed Drossman, D. A., Leserman, J., & Zhiming, L. (2000). Effects of coping on health outcome among women with gastrointestinal disorders. Psychosomatic Medicine, 62, 309–317.PubMed
go back to reference Drossman, D. A., Thompson, W. G., Talley, N. J., Funch-Jensen, P., Janssens, J., & Whitehead, W. E. (1990). Identification of sub-groups of functional gastrointestinal disorders. Gastroenterology International, 3, 159–172. Drossman, D. A., Thompson, W. G., Talley, N. J., Funch-Jensen, P., Janssens, J., & Whitehead, W. E. (1990). Identification of sub-groups of functional gastrointestinal disorders. Gastroenterology International, 3, 159–172.
go back to reference Guthrie, E., Jackson, J., Shaffer, J., Thompson, D., Tomenson, B., & Creed, F. (2002). Psychological disorder and severity of inflammatory bowel disease predict health-related quality of life in ulcerative colitis and Crohn’s disease. The American Journal of Gastroenterology, 97, 1994–1999. doi:10.1111/j.1572-0241.2002.05842.x.PubMedCrossRef Guthrie, E., Jackson, J., Shaffer, J., Thompson, D., Tomenson, B., & Creed, F. (2002). Psychological disorder and severity of inflammatory bowel disease predict health-related quality of life in ulcerative colitis and Crohn’s disease. The American Journal of Gastroenterology, 97, 1994–1999. doi:10.​1111/​j.​1572-0241.​2002.​05842.​x.PubMedCrossRef
go back to reference Han, S. W., McCall, E., Barton, J. R., James, P., Steen, I. N., & Welfare, M. R. (2005). Predictors of quality of life in ulcerative colitis: The importance of symptoms and illness representations. Inflammatory Bowel Diseases, 11, 24–34. doi:10.1097/00054725-200501000-00004.PubMedCrossRef Han, S. W., McCall, E., Barton, J. R., James, P., Steen, I. N., & Welfare, M. R. (2005). Predictors of quality of life in ulcerative colitis: The importance of symptoms and illness representations. Inflammatory Bowel Diseases, 11, 24–34. doi:10.​1097/​00054725-200501000-00004.PubMedCrossRef
go back to reference Irwin, C., Falsetti, S. A., Lydiard, R. B., Ballenger, J. C., Brock, C. D., & Brener, W. (1996). Comorbidity of posttraumatic stress disorder and irritable bowel syndrome. The Journal of Clinical Psychiatry, 57, 576–578.PubMed Irwin, C., Falsetti, S. A., Lydiard, R. B., Ballenger, J. C., Brock, C. D., & Brener, W. (1996). Comorbidity of posttraumatic stress disorder and irritable bowel syndrome. The Journal of Clinical Psychiatry, 57, 576–578.PubMed
go back to reference Koloski, N. A., Talley, N. J., & Boyce, P. M. (2001). Predictors of health care seeking for irritable bowel syndrome and nonulcer dyspepsia: A critical review of the literature on symptom and psychosocial factors. The American Journal of Gastroenterology, 96, 1340–1349. doi:10.1111/j.1572-0241.2001.03789.x.PubMedCrossRef Koloski, N. A., Talley, N. J., & Boyce, P. M. (2001). Predictors of health care seeking for irritable bowel syndrome and nonulcer dyspepsia: A critical review of the literature on symptom and psychosocial factors. The American Journal of Gastroenterology, 96, 1340–1349. doi:10.​1111/​j.​1572-0241.​2001.​03789.​x.PubMedCrossRef
go back to reference Lackner, J. M., Gellman, R., Gudleski, G., Sanders, K., Krasner, S., Katz, L., et al. (2005). Dysfunctional attitudes, gender, and psychopathology as predictors of pain affect in patients with irritable bowel syndrome. Journal of Cognitive Psychotherapy, 19, 151–161. doi:10.1891/jcop.19.2.151.66790.CrossRef Lackner, J. M., Gellman, R., Gudleski, G., Sanders, K., Krasner, S., Katz, L., et al. (2005). Dysfunctional attitudes, gender, and psychopathology as predictors of pain affect in patients with irritable bowel syndrome. Journal of Cognitive Psychotherapy, 19, 151–161. doi:10.​1891/​jcop.​19.​2.​151.​66790.CrossRef
go back to reference Lakner, J. M., & Quigley, B. M. (2005). Pain catastrophising mediates the relationship between worry and pain suffering in patients with irritable bowel syndrome. Behaviour Research and Therapy, 43, 943–957. doi:10.1016/j.brat.2004.06.018.CrossRef Lakner, J. M., & Quigley, B. M. (2005). Pain catastrophising mediates the relationship between worry and pain suffering in patients with irritable bowel syndrome. Behaviour Research and Therapy, 43, 943–957. doi:10.​1016/​j.​brat.​2004.​06.​018.CrossRef
go back to reference Levy, R. L., Cain, K. C., Jarrett, M., & Heitkemper, M. M. (1997). The relationship between daily life stress and gastrointestinal symptoms in women with irritable bowel syndrome. Journal of Behavioral Medicine, 20, 177–193. doi:10.1023/A:1025582728271.PubMedCrossRef Levy, R. L., Cain, K. C., Jarrett, M., & Heitkemper, M. M. (1997). The relationship between daily life stress and gastrointestinal symptoms in women with irritable bowel syndrome. Journal of Behavioral Medicine, 20, 177–193. doi:10.​1023/​A:​1025582728271.PubMedCrossRef
go back to reference Lydiard, R. B. (2001). Irritable bowel syndrome, anxiety and depression: What are the links? The Journal of Clinical Psychiatry, 62, 38–45.PubMed Lydiard, R. B. (2001). Irritable bowel syndrome, anxiety and depression: What are the links? The Journal of Clinical Psychiatry, 62, 38–45.PubMed
go back to reference Magni, G., Bernasconi, G., Mauro, P., D’Odorico, A., Sturniolo, G. C., Canton, G., et al. (1991). Psychiatric diagnosis in ulcerative colitis. A controlled study. British Journal of Psychiatry: Journal of Mental Sciences, 158, 413–415.CrossRef Magni, G., Bernasconi, G., Mauro, P., D’Odorico, A., Sturniolo, G. C., Canton, G., et al. (1991). Psychiatric diagnosis in ulcerative colitis. A controlled study. British Journal of Psychiatry: Journal of Mental Sciences, 158, 413–415.CrossRef
go back to reference Masand, P. S., Kaplan, D. S., Gupta, S., & Bhandary, A. N. (1997). Irritable bowel syndrome and dysthymia: Is there a relationship? Psychosomatics, 38, 63–69.PubMed Masand, P. S., Kaplan, D. S., Gupta, S., & Bhandary, A. N. (1997). Irritable bowel syndrome and dysthymia: Is there a relationship? Psychosomatics, 38, 63–69.PubMed
go back to reference Pallis, A. G., Vlachonikolis, I. G., & Mouzas, I. A. (2002). Assessing health-related quality of life in patients with inflammatory bowel disease, in Crete, Greece. BMC Gastroenterology, 2. doi:10.1186/1471-230X-2-1. Pallis, A. G., Vlachonikolis, I. G., & Mouzas, I. A. (2002). Assessing health-related quality of life in patients with inflammatory bowel disease, in Crete, Greece. BMC Gastroenterology, 2. doi:10.​1186/​1471-230X-2-1.
go back to reference Petrak, F., Hardt, J., Clement, T., Borner, N., Egle, U. T., & Hoffmann, S. O. (2001). Impaired health-related quality of life in inflammatory bowel diseases: Psychosocial impact and coping styles in a national German sample. Scandinavian Gastroenterology, 36, 375–382.CrossRef Petrak, F., Hardt, J., Clement, T., Borner, N., Egle, U. T., & Hoffmann, S. O. (2001). Impaired health-related quality of life in inflammatory bowel diseases: Psychosocial impact and coping styles in a national German sample. Scandinavian Gastroenterology, 36, 375–382.CrossRef
go back to reference Pinto, C., Lele, M. V., Joglekar, A. S., Panwar, V. S., & Dhavale, H. S. (2000). Stressful life-events, anxiety, depression and coping in patients of irritable bowel syndrome. The Journal of the Association of Physicians of India, 48, 589–593.PubMed Pinto, C., Lele, M. V., Joglekar, A. S., Panwar, V. S., & Dhavale, H. S. (2000). Stressful life-events, anxiety, depression and coping in patients of irritable bowel syndrome. The Journal of the Association of Physicians of India, 48, 589–593.PubMed
go back to reference Porcelli, P., Leoci, C., & Guerra, V. (1996a). A prospective study of the relationship between disease activity and psychologic distress in patients with inflammatory bowel disease. Scandinavian Journal of Gastroenterology, 31, 792–796. doi:10.3109/00365529609010354.PubMedCrossRef Porcelli, P., Leoci, C., & Guerra, V. (1996a). A prospective study of the relationship between disease activity and psychologic distress in patients with inflammatory bowel disease. Scandinavian Journal of Gastroenterology, 31, 792–796. doi:10.​3109/​0036552960901035​4.PubMedCrossRef
go back to reference Sewitch, M. J., Abrahamowicz, M., Bitton, A., Daly, D., Wild, G. E., Cohen, A., et al. (2001). Psychological distress, social support, and disease activity in patients with inflammatory bowel disease. The American Journal of Gastroenterology, 96, 1470–1479. doi:10.1111/j.1572-0241.2001.03800.x.PubMedCrossRef Sewitch, M. J., Abrahamowicz, M., Bitton, A., Daly, D., Wild, G. E., Cohen, A., et al. (2001). Psychological distress, social support, and disease activity in patients with inflammatory bowel disease. The American Journal of Gastroenterology, 96, 1470–1479. doi:10.​1111/​j.​1572-0241.​2001.​03800.​x.PubMedCrossRef
go back to reference Simren, M., Axelsson, J., Gillberg, R., Abrahamsson, H., Svedlund, J., & Bjornsson, E. S. (2002). Quality of life in inflammatory bowel disease in remission: The impact of IBS-like symptoms and associated psychological factors. Inflammatory Bowel Diseases, 8, 373–374. doi:10.1097/00054725-200209000-00014.CrossRef Simren, M., Axelsson, J., Gillberg, R., Abrahamsson, H., Svedlund, J., & Bjornsson, E. S. (2002). Quality of life in inflammatory bowel disease in remission: The impact of IBS-like symptoms and associated psychological factors. Inflammatory Bowel Diseases, 8, 373–374. doi:10.​1097/​00054725-200209000-00014.CrossRef
go back to reference Sullivan, G., Jenkins, P. L., & Blewett, A. E. (1995). Irritable bowel syndrome and family history of psychiatric disorder: A preliminary study. Psychosomatics, 39, 45–54. Sullivan, G., Jenkins, P. L., & Blewett, A. E. (1995). Irritable bowel syndrome and family history of psychiatric disorder: A preliminary study. Psychosomatics, 39, 45–54.
go back to reference Suls, J., Wan, C. K., & Blanchard, B. (1994). A multi-level data-analytic approach for evaluation of relationship between daily life stressor and symptomatology: Patients with irritable bowel syndrome. Health Psychology, 13, 103–113. doi:10.1037/0278-6133.13.2.103.PubMedCrossRef Suls, J., Wan, C. K., & Blanchard, B. (1994). A multi-level data-analytic approach for evaluation of relationship between daily life stressor and symptomatology: Patients with irritable bowel syndrome. Health Psychology, 13, 103–113. doi:10.​1037/​0278-6133.​13.​2.​103.PubMedCrossRef
go back to reference Talley, N. J., Boyce, P., & Owen, B. K. (1995). Psychosocial distress and seasonal symptom changes in irritable bowel syndrome. The American Journal of Gastroenterology, 90, 2115–2119.PubMed Talley, N. J., Boyce, P., & Owen, B. K. (1995). Psychosocial distress and seasonal symptom changes in irritable bowel syndrome. The American Journal of Gastroenterology, 90, 2115–2119.PubMed
go back to reference Toner, B. B., Segal, C. V., Emmott, S. D., & Myran, D. (2000). Cognitive-behavioral treatment of irritable bowel syndrome (pp. 72–76). New York: Guilford. Toner, B. B., Segal, C. V., Emmott, S. D., & Myran, D. (2000). Cognitive-behavioral treatment of irritable bowel syndrome (pp. 72–76). New York: Guilford.
go back to reference Unoka, Z., Rózsa, S., Kő, N., Kállai, J., Fábián, Á., & Simon, L. A. (2004). Derogatis-féle tünetlista hazai alkalmazásával szerzett tapasztalatok (Hungarian—psychometric properties of the Hungarian version of Derogatis Symptom Checklist). Psychiatria Hungarica, 19, 28–35. Unoka, Z., Rózsa, S., Kő, N., Kállai, J., Fábián, Á., & Simon, L. A. (2004). Derogatis-féle tünetlista hazai alkalmazásával szerzett tapasztalatok (Hungarian—psychometric properties of the Hungarian version of Derogatis Symptom Checklist). Psychiatria Hungarica, 19, 28–35.
go back to reference Walker, E., Roy-Bryne, P., Katon, W., Li, L., Amos, D., & Jiranek, G. (1990). Psychiatric illness and irritable bowel syndrome: A comparison with inflammatory bowel disease. The American Journal of Psychiatry, 147, 1656–1661.PubMed Walker, E., Roy-Bryne, P., Katon, W., Li, L., Amos, D., & Jiranek, G. (1990). Psychiatric illness and irritable bowel syndrome: A comparison with inflammatory bowel disease. The American Journal of Psychiatry, 147, 1656–1661.PubMed
go back to reference Whitehead, W. E., Crowell, M. D., Robinson, J. C., Heller, B. R., & Schuster, M. M. (1992). Effects of stressful life events on bowel symptoms: Subjects with irritable bowel syndrome compared with subjects without bowel dysfunction. Gut, 33, 825–830. doi:10.1136/gut.33.6.825.PubMedCrossRef Whitehead, W. E., Crowell, M. D., Robinson, J. C., Heller, B. R., & Schuster, M. M. (1992). Effects of stressful life events on bowel symptoms: Subjects with irritable bowel syndrome compared with subjects without bowel dysfunction. Gut, 33, 825–830. doi:10.​1136/​gut.​33.​6.​825.PubMedCrossRef
go back to reference Whitehead, W. E., & Palsson, O. S. (1998). Is rectal pain sensitivity a biological marker for irritable bowel syndrome: Psychological influences on pain perception. Gastroenterology, 115, 263–271. doi:10.1016/S0016-5085(98)70099-X.CrossRef Whitehead, W. E., & Palsson, O. S. (1998). Is rectal pain sensitivity a biological marker for irritable bowel syndrome: Psychological influences on pain perception. Gastroenterology, 115, 263–271. doi:10.​1016/​S0016-5085(98)70099-X.CrossRef
go back to reference Wilson, A., Longstreth, G. F., Knight, K., Wong, J., Wade, S., Chiou, C. F., et al. (2004). Quality of life in managed care patients with irritable bowel syndrome. Managed Care Interface, 17, 24–28.PubMed Wilson, A., Longstreth, G. F., Knight, K., Wong, J., Wade, S., Chiou, C. F., et al. (2004). Quality of life in managed care patients with irritable bowel syndrome. Managed Care Interface, 17, 24–28.PubMed
go back to reference Woodman, C. L., Breen, K., Noyes, R. J., Moss, C., Fagerholm, R., Yagla, S. J., et al. (1998). The relationship between irritable bowel syndrome and family history of psychiatric disorder. General Hospital Psychology, 17, 43–46. Woodman, C. L., Breen, K., Noyes, R. J., Moss, C., Fagerholm, R., Yagla, S. J., et al. (1998). The relationship between irritable bowel syndrome and family history of psychiatric disorder. General Hospital Psychology, 17, 43–46.
Metadata
Title
Different Associations of Health Related Quality of Life with Pain, Psychological Distress and Coping Strategies in Patients with Irritable Bowel Syndrome and Inflammatory Bowel Disorder
Authors
Gabriella Seres
Zoltán Kovács
Ágota Kovács
Olga Kerékgyártó
Krisztina Sárdi
Pál Demeter
Eszter Mészáros
Ferenc Túry
Publication date
01-12-2008
Publisher
Springer US
Published in
Journal of Clinical Psychology in Medical Settings / Issue 4/2008
Print ISSN: 1068-9583
Electronic ISSN: 1573-3572
DOI
https://doi.org/10.1007/s10880-008-9132-9

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