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Longitudinal study of quality of life and psychological functioning for active, fluctuating, and inactive disease patterns in inflammatory bowel disease

Authors

  • Lisa M. Lix PhD,

    1. Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
    2. University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Canada
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  • Lesley A. Graff PhD,

    1. University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Canada
    2. Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Canada
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  • John R. Walker PhD,

    1. University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Canada
    2. Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Canada
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  • Ian Clara MA,

    1. University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Canada
    2. Department of Psychology, University of Manitoba, Winnipeg, Canada
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  • Patricia Rawsthorne RN,

    1. University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Canada
    2. Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
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  • Linda Rogala RN,

    1. University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Canada
    2. Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
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  • Norine Miller RN,

    1. University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Canada
    2. Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
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  • Jason Ediger PhD,

    1. University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Canada
    2. Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
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  • Thea Pretorius MSc,

    1. Health, Leisure, and Human Performance Research Institute, University of Manitoba, Winnipeg, Canada
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  • Charles N. Bernstein MD

    Corresponding author
    1. University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Canada
    2. Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
    • Department of Internal Medicine, University of Manitoba, 804F-715 McDermot Ave., Winnipeg, MB R3E 3P4, Canada
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  • The conduct of this research and preparation of the article were independent of these funding sources

Abstract

Background: The aim was to assess quality of life (QOL) and psychological functioning in inflammatory bowel disease (IBD) as related to patterns of disease activity over time.

Methods: Study participants were 388 recently diagnosed individuals from the population-based Manitoba IBD Cohort Study. They completed mail-out surveys at 6-month intervals and clinical interviews annually. Based on their 2-year pattern of self-reported disease activity, participants were assigned to 1 of 3 groups: consistently active, fluctuating, or consistently inactive disease. Disease type (Crohn's disease [CD] or ulcerative colitis [UC]) was confirmed through chart review. Change over time was modeled for measures of QOL and positive and negative psychological functioning using mixed-effects regression analyses.

Results: Half of the participants had fluctuating disease activity, while almost one-third of participants reported consistent active disease. Participants with the fluctuating activity pattern showed significant improvement in disease-specific QOL compared to participants with consistent activity. Perceived stress, health anxiety, and pain anxiety decreased while pain catastrophizing and mastery increased over time, although the amount of change was not significantly different among disease activity patterns. However, when the data were averaged over time there were significant differences among disease activity patterns on most outcomes. Significant effects of CD versus UC were observed only for the pain measures.

Conclusions: Change in IBD QOL is influenced by one's longitudinal profile of disease activity, but change in psychological functioning is not. Effects of disease activity on psychological functioning were modest, suggesting that disease has an impact even when patients are not experiencing active symptoms.

(Inflamm Bowel Dis 2008)

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