scholarly journals Az alacsony intenzitású, bizonyítottan hatékony kognitív viselkedésterápia Crohn-betegségben

2018 ◽  
Vol 159 (9) ◽  
pp. 363-369
Author(s):  
Dóra Antal-Uram ◽  
László Harsányi ◽  
Dóra Perczel-Forintos
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Psychosocial Functioning ◽  
Psychiatric Comorbidity ◽  
Psychiatric Symptoms ◽  
Psychosocial Interventions ◽  
Well Being ◽  
Self Esteem ◽  
Cognitive Emotion Regulation ◽  
Low Intensity

Abstract: Inflammatory bowel disease (Crohn’s disease and colitis ulcerosa) is a chronic, long-term condition that causes chronic inflammation in the digestive tract, and shows an increasing incidence and prevalence worldwide. Changes in disease activity over time affect psychological distress which increases the risk of exacerbations. Beside somatic symptoms (such as abdominal pain, diarrhoea and weight loss), psychiatric comorbidity (in particular major depression, anxiety, social phobia) is common in patients with Crohn’s disease. This case study illustrates the management and stabilization of a 21-year-old adult male patient with active Crohn’s disease and with severe psychiatric comorbidity. The patient was diagnosed with avoidant personality disorder and dysruptive mood dysregulation disorder based on the results of psychodiagnostics (SCID-II structured clinical interview, MMPI personality inventory and disease-specific clinical questionnaires such as Beck Depression Inventory, Beck Hopelessness Scale, Social Cognition Questionnaire, Anger Expression Scale, Cognitive Emotion Regulation Questionnaire, Rosenberg Self-Esteem Scale). The main aim of psychotherapy is to increase the adherence to pharmacotherapy, to promote psychosocial functioning, to improve well-being and to enhance adaptive coping strategies. Low-intensity cognitive-behavioural psychotherapy was used which included psychoeducation, motivational interview, behavioural activation, patient diary, cognitive restructuring, problem-solving training, and family consulting. Twenty-five sessions were held weekly in outpatient form and 3 sessions of crisis intervention after the surgery at the hospital. The efficacy of the treatment was measured by self-reported questionnaires at baseline and at two follow-up sessions which corroborated a very significant decrease in the severity of depression, hopelessness, while emotional regulation and self-esteem became more adaptive. The remission of the above-mentioned psychiatric symptoms resulted in the improvement of the pharmacotherapy adherence and the quality of life. Low-intensity psychosocial interventions are proven to be an effective way of delivering evidence-based psychotherapy. Orv Hetil. 2018; 159(9): 363–369.

Crohn's Disease — More Than a Chronic Illness

1985 ◽  
Vol 33 (12) ◽  
pp. 604-609
Author(s):  
Roberta Messner ◽  
Sylvia Gardner ◽  
Susan Lewis
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Interpersonal Relationships ◽  
Well Being ◽  
Primary Care Providers ◽  
Chronic Inflammatory Bowel Disease ◽  
Care Providers ◽  
Care Needs ◽  
Positive Effects ◽  
Optimal Health

Crohn's disease is a chronic, inflammatory bowel disease which may occur in single or multiple areas of the entire GI tract from the mouth to the anus. This multifaceted disorder is manifested by various unpredictable health disturbances, affecting its victims' physical and psychosocial well-being. Individuals with Crohn's disease present a multitude of nursing challenges as they often lack the positive effects of proper nutrition, physical activity, emotional expression, interpersonal relationships, and family life. Nurses are the primary care providers who can comprehensively address the varied and complex health care needs of individuals with Crohn's disease. The core theme is the belief that it is essential for these individuals to maintain a sense of control in the midst of an altered lifestyle. Occupational health nurses can assist employees with Crohn's disease to develop a variety of physical and psychosocial strategies to cope with the unpleasant, even repugnant, aspects of a disease for which there is no known cure. The promotion of optimal health, based on the nursing process, is the objective toward which the unique efforts of nursing are directed.

scholarly journals COVID-19 Pandemic’s Effects on Disease and Psychological Outcomes of People With Inflammatory Bowel Disease in Portugal: A Preliminary Research

2020 ◽  
Author(s):  
Inês A Trindade ◽  
Nuno B Ferreira
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Depressive Symptoms ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Well Being ◽  
Psychological Outcomes ◽  
Symptom Perception ◽  
Inflammatory Bowel

Abstract Aims No empirical research on the psychological impact of the coronavirus disease 2019 (COVID-19) pandemic on people living with IBD, a population known to typically present high levels of anxiety and depression and to be potentially vulnerable to COVID-19, has yet been conducted. This study aimed to explore the links between contextual variables related to the COVID-19 pandemic and disease and psychological outcomes. Methods The sample included 124 Portuguese patients with Crohn’s disease or ulcerative colitis (85.48% women) who completed self-reported measures in an online survey during April 2020. Results Fear of contracting COVID-19 and medication adherence were both high and unrelated. About half of the sample presented moderate (37.10%) to severe (14.50%) anxiety. Normal and mild anxiety levels were at 29.80% and 18.50%, respectively. Regarding depressive symptoms, 51.60% of the sample presented normal levels, 27.40% mild severity, 16.10% moderate, and 4.8% severe. No differences were found between Crohn’s disease and ulcerative colitis patients. Regression analyses showed that anxiety explained IBD symptom perception (β = 0.29; P = 0.022); fear of contracting COVID-19 (β = 0.35; P < 0.001) and IBD symptom perception (β = −0.22; P = 0.009) explained depressive symptoms; and fear of contracting COVID-19 (β = 0.41; P < 0.001), IBD symptom perception (β = 0.26, P < 0.001), and being in isolation (β = −0.16, P = 0.041) explained anxiety. Type of medication was not linked to these outcomes. Conclusions The COVID-19 pandemic does not seem to be affecting adherence to medication but seems to present relevant effects on psychological well-being. Inflammatory bowel disease health care professionals should be attentive of patients’ psychological response to this pandemic and of its possible consequences on disease expression. This study additionally provided a psychometrically sound measure of fear of contracting COVID-19.

scholarly journals RELATIONSHIP AMONG PSYCHOLOGICAL WELL-BEING, RESILIENCE AND COPING WITH SOCIAL AND CLINICAL FEATURES IN CROHN’S DISEASE PATIENTS

2019 ◽  
Vol 56 (2) ◽  
pp. 131-140 ◽  
Author(s):  
Arlete Silva ACCIARI ◽  
Raquel Franco LEAL ◽  
Cláudio Saddy Rodrigues COY ◽  
Cristiana Corrrêa DIAS ◽  
Maria de Lourdes Setsuko AYRIZONO
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Coping Strategies ◽  
Clinical Features ◽  
Family Income ◽  
Well Being ◽  
Self Control ◽  
Prolonged Treatment ◽  
Psychological Well Being ◽  
And Coping

ABSTRACT BACKGROUND: Crohn’s disease is chronic, requires prolonged treatment, affects the physical and psychosocial health of patients and may alter their routine, quality of life and well-being. Recent studies recommend monitoring the health of these patients considering physical, psychological and psychosocial aspects, because they are directly related to the disease activity. These studies highlight the relevance of patients’ emotional and behavioral conditions and suggest that the identification of the factors that influence the psychological well-being, resilience and Coping in these patients can favor the proper treatment. OBJECTIVE: To relate psychological well-being, resilience and Coping with social and clinical features of Crohn’s disease patients. METHODS: Prospective study including 104 patients with Crohn’s disease, both genders and mean age of 39 years. Standardized scales were used to assess and to relate psychological well-being, resilience and Coping with social and clinical variables. A questionnaire to characterize the sample and standardized scales in data collection (psychological well-being, resilience pillars and Coping strategies inventory - Folkman & Lazarus) were used. Descriptive analysis of data and statistics for comparison of results were performed. RESULTS: There were significant differences (P<0.05) showing better psychological well-being for male patients, those who without children, were not religious, were employed and were doing complementary activities in addition to clinical treatment. More resilience for the male gender, those who without children, were not religious, divorced, separated or widowed, that received some monthly income; who did not undergo surgery, had the first symptoms after 30 years old and who had complementary activity. There were also significant differences in the use of Coping: usually, women used more developed escape and avoidance strategies; single, married or in stable-union patients used more self-control; not religious used positive revaluation strategy; the ones who were employed showed more self-control and positive reassessment; the ones who had lower family income indicated that they used less the self-control; the ones who had higher family income used more positive re-evaluation; patients who were diagnosed with Crohn’s disease between the second decade of life showed to use mores more the positive reassessment strategy than those who were 20 years old or younger. CONCLUSION: Social aspects influenced psychological well-being, resilience and Coping in patients with Crohn’s disease more strongly than clinical aspects. It was possible to identify the profiles with better and worse psychological well-being, resilience and Coping of those who need more support, as well as to know the most used Coping strategies in the studied group.

scholarly journals Quality of Life of Children with Crohn’s Disease as a Potential Criterion for Monitoring Disease Activity

Doctor Ru ◽  
2020 ◽  
Vol 19 (10) ◽  
pp. 27-32
Author(s):  
А.R. Tahirova ◽  
◽  
I.V. Sichinava ◽  
O.F. Savvateeva ◽  
E.V. Borisova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Psychosocial Functioning ◽  
Activity Index ◽  
Extraintestinal Manifestations ◽  
Pedsql 4.0

Study Objective: To analyse the activity dynamics of Crohn’s disease (CD) and the quality of life (QoL) of children aged 8–17 years. Study Design: Open prospective non-randomized comparative study. Materials and Methods. The quality of life was assessed in 37 healthy children and 28 children with Crohn's disease (17 boys and 11 girls). Disease activity (Paediatric Crohn’s Disease Activity Index, PCDAI) was determined using PedsQL 4.0 Generic Core Scales questionnaire which comprises assessment of health and activity, child’s attitude, problems with interpersonal relations, and progress at school. Observation spanned over 18 months; tests parameters were assessed at the beginning (first visit), after 6, 12 and 18 months. QoL was assessed by both children and their parents, the indicators were assessed over time and compared with the levels of activity, the duration of the disease, and the presence of extraintestinal manifestations of the disease. Study Results. Children with CD aged 8–17 years demonstrated a decrease in the majority of PedsQL 4.0 parameters. The shifts are observed both when QoL is assessed by children and their parents. The therapy in these patients is accompanied by positive QoL dynamics; these changes occur in parallel with a decrease in the values of the CD activity index, suggesting the possibility of using the QoL parameters to predict the course of the disease and the effectiveness of the treatment in this population. PCDAI values in subjects demonstrated moderate statistically significant negative correlations with “Physical activity” (r = –0.412), “Attitude” (r = –0.364), “Psychosocial functioning” (r = –0.306) and “School life” (r = –0.344) and the overall PedsQL 4.0 values (r = –0.406). The duration of the disease has statistically significant negative correlation with “Physical activity” (r = –0.386), “Attitude” (r = –0.423), “Psychosocial functioning” (r = –0.345), and the integral PedsQL 4.0 value (r = –0.397); the presence of extraintestinal manifestations demonstrated moderate negative correlation with “Physical activity” (r = –0.342), “School life” (r = –0.431) and overall value (r = –0.372). Conclusion. Monitoring of the health-related quality of life should become a mandatory component of the examination and management of children with inflammatory bowel diseases, since this category of patients is characterized by a significant decrease relative to the corresponding indicators in healthy peers. Keywords: inflammatory bowel disorder, Crohn’s disease, quality of life, disease activity, extraintestinal manifestations.

scholarly journals P369 High prevalence of abdominal pain in Crohn’s Disease patients of the TRUST study cohort- Is there a connection to inflammatory activity?

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S386-S387
Author(s):  
T Kugel ◽  
C Maaser ◽  
T Kucharzik ◽  
I Fischer ◽  
S Kolterer ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Crohn's Disease ◽  
Clinical Response ◽  
Well Being ◽  
Inflammatory Activity ◽  
Study Cohort ◽  
Treatment Intensification ◽  
Pain Experience ◽  
Reactive Protein

Abstract Background Pain is a debilitating symptom in many patients with Crohn’s disease (CD) both in flare and in remission [1]. However, pain is insufficiently understood and therefore often underrepresented in disease management [2]. Thus, it is of paramount importance to raise awareness for this common but insufficiently managed IBD symptom. With this analysis, we aimed to investigate (1) the prevalence of abdominal pain (AP) and (2) the correlation of AP with further parameters including inflammatory activity assessed by intestinal ultrasound (IUS), lab parameters and patient-well-being in CD patients of the TRUST study cohort. Methods We evaluated the prevalence of pain in 230 of 234 CD patients of the prospective, non-interventional, multi-centre TRUST study. At baseline, all patients were in clinical flare (Harvey-Bradshaw index (HBI) of≥7) and received treatment intensification. IUS parameters such as bowel wall thickness (BWT) and clinical data were assessed at baseline and after 3, 6, and 12 months. AP was analysed using the HBI subscore 2. To investigate the connection between AP and inflammation, AP was correlated with BWT and C-reactive protein (CRP). Results Based on the TRUST study, we found that 95.2% of patients in clinical flare experienced AP. AP was significantly reduced within 12 weeks after treatment intensification (p &lt; 0.001) but 30% (n=69) to 48.3% (n=111) of patients still experienced AP at the subsequent visits (p(T1-T2) = 0.668; p(T2-T3) = 1.000) (figure 1). Of note, 35.6%-42.5% of patients with clinical response had a lasting pain experience (figure 2). AP positively correlated with poor well-being which is in line with previously published results [3]. We found a weak positive correlation between AP and inflammatory activity, represented by BWT (not shown), and between AP and CRP (table 1). Figure 1: Percentage of patients with mild, moderate or severe abdominal pain during the study. *Friedman test with post-hoc Wilcoxon tests. Figure 2: Percentage of patients with abdominal pain and clinical response (reduction of total HBI≥3 points) at the indicated visit Table 1: Spearmann rank correlations for abdominal pain vs. poor general well-being (as measured by the HBI subscore 1) and vs. CRP at baseline Conclusion Our results clearly demonstrate that more than 1/3 of CD patients suffers from AP despite treatment intensification and clinical improvement. We found a weak correlation between AP and markers of inflammatory activity suggesting the existence of a subgroup of patients with persistent pain experience even with IBD treatment. Our data emphasize the importance of adjuvant pain management in IBD. References

Perceived distress, personality characteristics, coping strategies and psychosocial impairments in a national German multicenter cohort of patients with Crohn’s disease and ulcerative colitis

2019 ◽  
Vol 57 (04) ◽  
pp. 473-483 ◽  
Author(s):  
Vanessa Petruo ◽  
Ekaterina Krauss ◽  
Anika Kleist ◽  
Juliane Hardt ◽  
Karsten Hake ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Psychological Distress ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Disease Status ◽  
Well Being ◽  
Stress Coping ◽  
Paranoid Ideation ◽  
Psychological Impairment

Abstract Background and aims This study examined differences in personality, psychological distress, and stress coping in inflammatory bowel disease (IBD) depending on type of disease and disease activity. We compared patients suffering from Crohn’s disease (CD) and ulcerative colitis (UC) with controls. While the literature is replete with distinctive features of the pathogenesis of IBD, the specific differences in psychological impairments are not well studied. Methods In this German national multicenter study, participants were recruited from 32 centers. Two hundred ninety-seven questionnaires were included, delivering vast information on disease status and psychological well-being based on validated instruments with a total of 285 variables. Results CD patients were more affected by psychological impairments than patients suffering from UC or controls. Importantly, patients with active CD scored higher in neuroticism (p < 0.01), psychological distress (p < 0.001) and maladaptive stress coping (escape, p = 0.03; rumination, p < 0.03), but less need for social support (p = 0.001) than controls. In contrast, patients suffering from active UC showed psychological distress (p < 0.04) and maladaptive coping (avoidance, p < 0.03; escape, p = 0.01). Patients in remission seemed to be less affected. In particular, patients with UC in remission were not inflicted by psychological impairments. The group of CD patients in remission however, showed insecurity (p < 0.01) and paranoid ideation (p = 0.04). Conclusions We identified specific aspects of psychological impairment in IBD depending on disease and disease activity. Our results underscore the need for psychological support and treatment particularly in active CD.

scholarly journals Relief of Psychiatric Symptoms in a Patient with Crohn's Disease after Metronidazole Therapy

2000 ◽  
Vol 30 (1) ◽  
pp. 213-214 ◽  
Author(s):  
R. H. Sandler ◽  
E. R. Bolte ◽  
M. G. Chez ◽  
M. J. Schrift
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Psychiatric Symptoms
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