Facteurs psychosociaux et risque de rechute au cours de la maladie de Crohn

Lainé, Agnès; Laurent, Alexandra; Mariage, André; Boschetti, Gilles; Charlois, Anne-Laure; Roblin, Xavier; Bommelaer, Gilles; Nancey, Stéphane; Flourié, Bernard

doi:10.1016/j.amp.2015.03.030

Cited by 3 publications

(3 citation statements)

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“…Despite the inclusion of DIA and DAF assessment in the best model, no factors predicted CD. A 1-year longitudinal study found that psychosocial factors associated with chronic disease (i.e., stress induced by the physical symptoms of the disease, the use of emotion-focused coping, loss of resources and the quality of life related to chronic diseases) were the best predictors of vulnerability to relapse in CD (94). Due to their longitudinal dimension, the quantitative and qualitative data in this paper provided a comprehensive assessment of the stressors and quality of life associated with relapse.…”

Section: Discussionmentioning

confidence: 99%

Interoceptive Abilities in Inflammatory Bowel Diseases and Irritable Bowel Syndrome

et al. 2020

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Alexithymia is usually described by three main dimensions difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and externally oriented thinking (EOT). The most commonly used questionnaire investigating alexithymia, the Toronto Alexithymia Scale (TAS-20), supports this three-factor structure. One important assumption is that alexithymia severity is associated to vulnerability to somatic diseases, among them gastrointestinal disorders. However, the association between alexithymia and gastrointestinal disorders is not systematic, thus questioning the role of alexithymia as a vulnerability factor for those illnesses. A recent factor analysis suggested another fourfactor structure for the TAS-20: difficulties in awareness of feelings (DAF), difficulties in interoceptive abilities (DIA), externally oriented thinking (EOT), and poor affective sharing (PAS). We assume that DIA and DAF might be more relevant to investigate the association between alexithymia and gastrointestinal disorders. The rationale is that DIA and DAF reflect impairments in emotion regulation that could contribute to an inappropriate autonomic and HPA axis homeostasis in irritable bowel syndrome (IBS), ulcerative colitis (UC), or Crohn's disease (CD). The aim of this study was to investigate whether DIA and DAF are associated with the presence of IBS, UC or CD, while checking for anxiety, depression, parasympathetic (vagus nerve) activity and cortisol levels. We recruited control participants (n=26), and patients in remission who were diagnosed with IBS (n=24), UC (n=18), or CD (n=21). Participants completed questionnaires to assess anxiety, depression, and alexithymia. A blood sample and an electrocardiogram were used to measure the level of cortisol and parasympathetic activity, respectively. Logistic regressions with the four-factor structure of the TAS-20 revealed that DIA was a significant predictor of IBS (W(1)=6.27, p=.01). Conversely, DIA and DAF were not significant predictors in CD and UC patients. However, low cortisol level was a Frontiers in Psychiatry | www.frontiersin.org

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Section: Discussionmentioning

confidence: 99%

Interoceptive Abilities in Inflammatory Bowel Diseases and Irritable Bowel Syndrome

et al. 2020

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“…Many of them suggest a psychological etiology of their illness and wonder about the impact of their life events and emotions on their physical health. Although some studies have identified the role played by psychosocial factors on adjustment to CD [42][43][44][45], we are not aware of any studies that have explored the link between significant life events and mental health on the onset of the disease or the flare-up of symptoms. These aspects should be explored in further research.…”

Section: Discussionmentioning

confidence: 97%

«Digesting Crohn’s Disease»: The Journey of Young Adults since Diagnosis

Touma,

Zanni,

Blanc

et al. 2023

JCM

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Crohn’s disease affects 2.5 million people in Europe (more than 100,000 people in France) and often occurs between the ages of 15 and 30, a period marked by self-construction. However, few studies have focused on the experience of the diagnosis during this sensitive developmental stage. This study aimed to qualitatively explore the experience of Crohn’s disease in young adults since their diagnosis. Fifteen young adults (18–35 years) diagnosed with Crohn’s disease participated in a semi-directive interview. Narrative data were subjected to a thematic analysis, and thirty percent of the interviews were double-coded. The results revealed an evolution of four main themes since diagnosis: (1) course of care, (2) illness perceptions, (3) disease management and (4) self-perception. For most participants, the onset of the disease was difficult, marked by severe symptoms requiring hospitalization, numerous medical examinations and sometimes several consultations before diagnosis. This journey was more difficult when it was associated with negative relations with the medical staff, who were sometimes perceived as unsupportive. Thus, some people described this diagnostic period as an “ordeal”, while others experienced it as a “relief” from their suffering. The announcement of the diagnosis was often a “shock”, an “upheaval” or a “downfall”, followed by phases of denial associated with a desire to maintain a “normal life” and not to be defined by the disease. Despite a difficult start, most participants grew from their experience with CD, with a sense of a personal development that was made possible by self-regulation processes that enabled them to draw on their own experience and resources to adjust to their illness. By highlighting positive possibilities for evolution, this study suggests the importance of supporting the psychological resources of young adults by proposing, at an early stage, psychological support or therapies focused on acceptance and engagement.

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“…Définies comme « l'ensemble des efforts cognitifs et comportementaux destinés à maîtriser, réduire ou tolérer les exigences internes ou externes qui menacent ou dépassent les ressources d'un individu » (Lazarus and Folkman, 1991, p141) elles représentent un enjeu majeur dans la prise en charge des patients. En effet, plusieurs études ont montré un lien entre stratégies de coping et évolution de la maladie (Bitton et al, 2008 ;Pelissier, Dantzer, Canini, Mathieu, & Bonaz 2010 ;Lainé et al, 2016). Elles paraissent également être déterminantes dans le niveau de qualité de vie des patients (Maes, Leventhal, & De Ridder, 1996 ;Stroebe, Shut, & Stroebe, 1995 ;Luo et al, 2018).…”

Section: Introductionunclassified