[Determination of subjective burden from chronic inflammatory bowel disease and its psychosocial consequences. Results from a study of 200 patients].
Somatic symptoms of chronic organic diseases do not sufficiently explain the degree to which the individual's daily life is impaired. Quality of life questionnaires are increasingly used to measure long term effects of therapy and rehabilitation. The present study is concerned with determining factors associated with the quality of life of patients suffering from inflammatory bowel disease (IBS). We investigated 200 consecutive inpatients with IBS (Crohn's disease 119, ulcerative colitis 81; 142 males, females; mean age 36.8 years) of the Niederrhein Clinic, a centre for gastroenterologic diseases and metabolic disorders. We assessed sociodemographic data of the last three years, the results of all recent clinical examinations (pattern and extension of inflammatory lesions) CDAI and CAI to determine the activity of the disease, expert ratings of disease severity as well as impact on family, partnership, social environment and leisure activities, psychometric data concerning anxiety (STAI), depression (Paranoid-Depressivitätsskala), and coping (FKV). The subjective impairment was measured by structured interviews. The inflammatory activity of IBS and the intensity of symptoms correlated only insignificantly with the subjective impairment. Depression (as measured by the Paranoid-Depressivitätsskala) and a depressive style of coping (FKV) revealed to be the best predictors for subjective impairment. For patients with a mild to moderate degree of IBS quality of life does not significantly depend on the degree and severity of disease. A depressive coping style seems to be a crucial target of rehabilitation and psychotherapy in IBS.