The causal representation of outpatients with Crohn's disease: is there a link between psychological distress and clinical disease activity?

Objectives: Because of the fluctuating and occasional character of Crohn’s disease (CD), patients have to cope with a changeable condition of health. Personal perceived control is known to be an important element of adaptation to their medical condition. The objectives of this work are to determine if perceived personal control is predictive of the clinical activity of the disease and of psychological distress (depression, anxiety). Methods: The Hospital Anxiety Depression Scale (HADS), the causal dimension scale and the Clinical Global Impression (CGI; assessing perceived severity) were administered to 160 patients affected by Crohn’s disease. Indicators of inflammation (CRP), disease duration and clinical activity of the disease were also asessed. Results: Globally, CD patients perceive their disease as being personally neither controllable nor uncontrollable. Whereas psychological distress is significantly higher when the disease is active, the relationship between the variables appears complex. The feeling of personal control is explained by the clinical activity of the disease (p=.0001) and by the perception that CD is unstable (p
GMS Psycho-Social-Medicine; 10:Doc08; ISSN 1860-5214