The development of a social morbidity score in patients with chronic ulcerative colitis as a potential guide to treatment


Author for Correspondence & Reprints:
Professor RJ Nicholls
Visiting Professor of Colorectal Surgery and Emeritus Consultant Surgeon
Department of Biosurgery and Surgical Technology, Imperial College, St. Mary’s Campus, Praed Street, London, W2 1NY UK.


Aim:  Present quality of life (QoL) instruments for inflammatory bowel disease (IBD) do not evaluate many social aspects of patients’ lives that are potentially important in clinical decision making. We have developed a new Social Impact of Chronic Conditions - IBD questionnaire (SICC-IBD) to assess these areas.

Method:  A 34-item questionnaire was piloted to determine quality of life relating to education, personal relationships, employment, independence and finance. It was compared with the SF-36v2 and Inflammatory Bowel Disease (IBDQ) questionnaires in 150 patients with chronic ulcerative colitis on an endoscopic surveillance register who had never had surgery.

Results:  Reliability and validity testing enabled the questionnaire to be shortened to only 8 items. There was a high level of reliability (Cronbach’s alpha = 0.72). The questionnaire correlated well with the social functioning domain of the SF-36 (rs=0.56) and was able to distinguish clinical severity of disease.

Conclusion:  The SICC-IBD is a new tool for assessment of patients with ulcerative colitis, which has identified new aspects of social disability for further study and for potential use as an additional tool in therapy decisions.