ABSTRACT
BACKGROUND: Clinical parameters predict health-related quality of life (HRQOL) in inflammatory bowel disease (IBD), but some patients have impaired HRQOL despite being in clinical remission. OBJECTIVE: To identify personality and psychological distress variables associated with HRQOL in IBD. METHOD: In a cross-sectional study of 185 IBD patients, the General Health Questionnaire, the Hopkins' Symptoms Distress Checklist, the Defense Style Questionnaire and the Life Style Index were administered. The Inflammatory Bowel Disease Questionnaire was used for the assessment of HRQOL. RESULTS: Psychological distress was associated with impaired HRQOL in a dose-response fashion. Somatization mediated the relationships of anxiety and depression with HRQOL. Few years of education, more extensive use of the reaction-formation defense mechanism and higher rates of somatization were the variables most closely and independently associated with impaired HRQOL. CONCLUSIONS: Somatization and reaction-formation are independent correlates of disease-specific HRQOL in IBD patients, and this could be relevant to psychological interventions.
Subject(s)
Inflammatory Bowel Diseases/psychology , Quality of Life , Stress, Psychological , Anxiety , Cross-Sectional Studies , Defense Mechanisms , Depression , Female , Humans , Male , Middle Aged , Personality , Somatoform Disorders/psychology , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To access health-related quality of life (HRQOL) in systemic sclerosis (SSc) patients using the World Health Organization Quality of Life Instrument, Short-Form (WHOQOL-BREF), and to identify the association between clinical, psychopathological, and personality parameters and SSc patients' HRQOL. METHODS: Fifty-six patients with SSc were compared with 72 patients with rheumatoid arthritis (RA), 43 with systemic lupus erythematosus (SLE), 34 with Sjögren syndrome (SS), and 74 healthy controls. A wide range of clinical information was collected and the following self-report instruments were used: the WHOQOL-BREF, the General Health Questionnaire, the Symptom Distress Check List, the Hostility and Direction of Hostility Questionnaire, the Defense Style Questionnaire, and the Sense of Coherence scale. RESULTS: HRQOL perceived by SSc patients was significantly impaired compared with healthy controls. Initial examination of HRQOL across groups of rheumatology patients revealed similar HRQOL, but when age, pain, psychopathology, and coping strategies were taken into account, SSc patients had impaired physical health QOL in comparison with RA, SLE, and SS patients. Arthritis-related pain was closely associated with SSc patients' HRQOL. Elevated psychological distress symptoms as well as certain personality traits, such as maladaptive defenses and lower sense of coherence, were also associated with diminished HRQOL. CONCLUSIONS: Impaired psychological functioning is associated with diminished HRQOL in SSc, and consequently, treatment of depressive symptoms should be considered a priority. Moreover, assessment of HRQOL should only be used in conjunction with specific psychological distress measurements, to detect the influence of psychopathology on HRQOL.
Subject(s)
Quality of Life/psychology , Scleroderma, Systemic/physiopathology , Scleroderma, Systemic/psychology , Adult , Aged , Arthritis, Rheumatoid/physiopathology , Arthritis, Rheumatoid/psychology , Case-Control Studies , Female , Health Status , Health Surveys , Humans , Lupus Erythematosus, Systemic/physiopathology , Lupus Erythematosus, Systemic/psychology , Male , Middle Aged , Personality , Regression Analysis , Scleroderma, Systemic/complications , Sjogren's Syndrome/physiopathology , Sjogren's Syndrome/psychologyABSTRACT
OBJECTIVE: The aim of the present study was to identify certain clinical parameters and personality characteristics associated with various forms of psychopathology in systemic sclerosis (SSc) patients. METHODS: Fifty-six SSc patients participated in the study, and 74 healthy participants served as controls. A wide range of clinical information was collected, and the following self-report instruments were used: General Health Questionnaire, Symptom Distress Checklist-90-R, Defense Style Questionnaire, Sense of Coherence (SOC) Scale, and Hostility and Direction of Hostility Questionnaire. RESULTS: The odds of being assessed with a psychiatric diagnosis upon interview were 4.5 times greater among SSc patients compared with controls. Disease duration and lower rates of SOC were found to be associated with elevated symptoms of general psychological distress. Elevated symptoms of depression were strongly associated with esophageal involvement, hostility, and defense style used. Elevated symptoms of anxiety were mainly associated with arthritis-related painful conditions and SOC, while psychotic-like symptoms were only associated with age and a specific personality structure. CONCLUSIONS: SSc patients experience elevated symptoms of psychological distress. Several clinical parameters are associated with distress, but the role of various personality traits could not be disregarded. Early psychiatric assessment and intervention could prevent psychological distress in SSc patients.
