Supported by grant 33CSCO-108792 from the Swiss National Science Foundation to Roland von Känel & Stefan Begré (Mental Health Core Project of the Swiss Inflammatory Bowel Disease Cohort Study). The funding source was neither involved in data collection, management, analysis, interpretation, or writing, nor in the decision to submit the article for publication.
Article first published online: 25 OCT 2010
Copyright © 2010 Crohn's & Colitis Foundation of America, Inc.
Inflammatory Bowel Diseases
Volume 17, Issue 6, pages 1277–1286, June 2011
How to Cite
Cámara, R. J.A., Lukas, P. S., Begré, S., Pittet, V., von Känel, R. and Swiss Inflammatory Bowel Disease Cohort Study (SIBDCS) Group (2011), Effects of social support on the clinical course of Crohn's disease. Inflamm Bowel Dis, 17: 1277–1286. doi: 10.1002/ibd.21481
Author Contributions and Financial Disclosure: Dr. Cámara, Dr. Begré, and Prof. von Känel developed the hypothesis and the study design. Dr. Cámara drafted the article. Dr. Cámara and Dr. Lukas analyzed, presented (tables and figures), and interpreted the data. Dr. Begré and Prof. von Känel supervised the project. Valérie Pittet provided support in the conceptualization of the study design and assistance in the validation of questionnaires. All authors participated in the literature search, revised the article critically, and approved its final version. Each author states that no financial conflicts of interest exist.
- Issue published online: 10 MAY 2011
- Article first published online: 25 OCT 2010
- Manuscript Accepted: 8 AUG 2010
- Manuscript Received: 6 AUG 2010
- Crohn's disease;
- social support;
- body mass index
Social support has been found to be protective from adverse health effects of psychological stress. We hypothesized that higher social support would predict a more favorable course of Crohn's disease (CD) directly (main effect hypothesis) and via moderating other prognostic factors (buffer hypothesis).
Within a multicenter cohort study we observed 597 adults with CD for 18 months. We assessed social support using the ENRICHD Social Support Inventory. Flares, nonresponse to therapy, complications, and extraintestinal manifestations were recorded as a combined endpoint indicating disease deterioration. We controlled for several demographic, psychosocial, and clinical variables of potential prognostic importance. We used multivariate binary logistic regression to estimate the overall effect of social support on the odds of disease deterioration and to explore main and moderator effects of social support by probing interactions with other predictors.
The odds of disease deterioration decreased by 1.5 times (95% confidence interval [CI]: 1.2–1.9) for an increase of one standard deviation (SD) of social support. In case of low body mass index (BMI) (i.e., 1 SD below the mean or <19 kg/m2), the odds decreased by 1.8 times for an increase of 1 SD of social support. In case of low social support, the odds increased by 2.1 times for a decrease of 1 SD of BMI. Low BMI was not predictive under high social support.
The findings suggest that elevated social support may favorably affect the clinical course of CD, particularly in patients with low BMI. (Inflamm Bowel Dis 2011;)