An Evil Backstage Manipulator: Psychological Factors Correlated with Health‐Related Quality of Life in Chinese Patients with Crohn’s Disease

Abstract

Health-related quality of life (HRQoL) is recommended as one of essential parameters to evaluate treatment effect and clinical outcome in patients with Crohn's disease (CD). Recent studies reported that psychological factors might play a role in HRQoL in Western and American CD patients. Sufficient evidences in Chinese CD patients are still unavailable. This study is dedicated to investigate the correlation of various psychological factors with HRQoL in Chinese CD patients. We prospectively collected 40 active and 40 quiescent CD patients in China and found that psychological factors, especially neuroticism and anxiety, significantly correlate with and affect HRQoL in both active and quiescent CD groups. This is the first report revealing correlation between psychological factors and HRQoL in Chinese CD patients. Therefore, we assume that our results can contribute to a better understanding of etiology and tailoring of management in Chinese patients with Crohn's disease and are beneficial to our colleagues to compare the heterogeneous characteristics of Crohn's disease in different ethnic groups.

A systematic review of the psychological correlates of adjustment outcomes in adults with inflammatory bowel disease

“…Five studies have investigated the link between three personality traits and adjustment outcomes; neuroticism, perfectionism and type D personality (Flett et al, 2011, Boye et al, 2008, Moreno-Jiménez et al 2007Liu et al, 2013 (table 2). At a cross sectional bivariate level, preliminary evidence (1/1) suggests a significant relationship between other (r=.50 p< 0.001), and socially prescribed (r=.59 p<0.001) perfectionism and reduced psychosocial functioning.…”

“…The Preliminary evidence suggests that Type D personality may have a similar influence on outcomes (Liu et al, 2013). Perfectionism is also unhelpful for adjustment, however whether this relationship would be maintained when taking socio-demographic and disease variables into consideration is currently unknown but warrants further investigation (Flett et al, 2011).…”

“…A systematic search of the literature identified several psychological correlates of adjustment which were grouped into six categories; personality traits, interpersonal traits, stress and coping, emotions and emotional control, IBD related cognitions and non IBD related cognitions.The most studied personality trait is neuroticism. Consistently at a multivariate level results show neuroticism to be significantly associated with negative adjustment outcomes, specifically with reduced emotional functioning(Boye et al, 2008, Moreno-Jiménez et al 2007Liu et al, 2013.Neuroticism shows an equal influence on adjustment outcomes as clinical variables such as relapses per year and type of treatment.…”

“…At a multivariable level after adjusting for socio demographic and clinical factors, 100% of results (4/4) show neuroticism(Boye et al, 2008, Moreno-Jiménez et al 2007Liu et al, 2013 and type D personality (1/1) ( β -0.053 p<0.001, to be significantly associated with a reduced quality of life. Further, neuroticism was specifically associated with worse emotional and social functioning, and with reduced…”

The need for interdisciplinary quality of life studies for patients with Crohn's Disease - a systematic review

“…In psychological terms and behaviors patients can vary in extremely different ways of addressing a health problem, experiencing opinions about their own functioning or subjective health, despite a similar intensity of disease symptoms. For instance, there's evidence that illness perception [41], psychological factors [42], personality traits [43], stress, anxiety and depression [44] as well as coping strategies [45] have a significant impact on HRQoL scores of CD patients. This may mean that there are differences between high-functioning and low-functioning people with CD that cannot be grasped by the traditional clinical paradigm.…”