Insecure Attachment in a Subgroup with Ulcerative Colitis Defined by ANCA Status (original) (raw)
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The American journal of gastroenterology, 2006
Studies of psychological factors in ulcerative colitis (UC) have produced inconsistent findings. This study sought to determine whether perinuclear antineutrophil cytoplasmic antibody (pANCA) demarcates subtypes which differ with respect to psychobiological interactions. In 148 outpatients with UC, the strength of the relationship between current UC disease activity and psychological distress was assessed. pANCA was determined by ELISA and immunofluorescence, disease activity was determined by symptoms, physical examination, and endoscopy using the St. Mark's index, and depressive symptoms and health anxiety were measured with self-report scales. Pearson correlations between disease activity and depressive symptoms and between disease activity and health anxiety were calculated. In 74 pANCA negative subjects, the relationship between disease activity and measures of psychological distress was significant for disease activity-depression (partial correlation = 0.48, p < 0.001) ...
Attachment and quality of life in patients with inflammatory bowel disease
International Journal of Colorectal Disease, 2014
Purpose Inflammatory bowel diseases (IBD) are chronic disorders affecting psychological well-being, quality of life (QOL), social interactions, and close interpersonal relationships of patients affected. The attachment theory provides a theoretical framework to evaluate the quality of close interpersonal relationships in the context of chronic disorders. The aims of this study were to compare the attachment dimensions between IBD patients and healthy controls and to evaluate the impact of these dimensions on QOL in IBD patients. Methods One hundred three consecutive IBD outpatients (70 with Crohn's disease and 33 with ulcerative colitis) were recruited in the IBD Unit of the University of Bologna. They were clinically evaluated and filled out the questionnaire Short Form health survey-36 (SF-36), assessing QOL, and the attachment style questionnaire (ASQ), assessing attachment dimensions. One hundred three matched healthy subjects filled out the same questionnaires and represented the control group. Results IBD patients exhibited worst scores in the QOL measures (both physical and mental health) and in the attachment dimensions Relationships as secondary and Preoccupation with relationships. In IBD, the significant predictors of physical health were disease activity and disease type, while the significant predictors of mental health were disease activity and type, surgery, and the attachment dimensions Confidence and Preoccupation with relationships. Conclusions Compared to controls, in IBD patients, the close interpersonal relationships are characterized by attachment insecurity that, in turn, is a significant predictor of QOL. These findings suggest plausible insights for psychological interventions in IBD patients with deterioration in QOL.
Determinants of the level of anxiety and fears in a group of patients with ulcerative colitis
Annals of Agricultural and Environmental Medicine
Introduction. Ulcerative colitis is a chronic, inflammatory disease of the mucous membrane of the large intestine manifesting itself through diarrhoea with blood, mucous and pus. It progresses with periods of relapses and remissions. The treatment is a long-term process which should aim at improving the patient's clinical condition and quality of life, as well as minimising the disease-related anxiety and fears. Objective. The aim of the study was recognition of the determinants of the level of anxiety and fears in a group of patients with ulcerative colitis. Materials and method. The prospective study comprised 102 patients with diagnosed ulcerative colitis. The data were collected by means of the following tools: Clinical Disease Activity Index, Rating Form of IBD Patients Concerns (RFIPC), and a questionnaire by the authors. Statistical parametric and non-parametric tests were used to analyse the data, depending on the type of scale and nature of the variable distribution. Results. Most of the patients (64%) were in the active phase of the disease. A high level of fear and anxiety occurred in 73% of the patients and concerned the impact of the disease, intimate life, complications and stigmatisation. The highest levels of fears and anxiety were observed in the field of complications and the impact of the disease on the patients' lives. Conclusions. The disease activity and high levels of anxiety and fears influenced the psychosocial functioning of the patients with ulcerative colitis.
Ulcerative Colitis: Psychosocial Factors Involved
Background: This study aims to extend the knowledge regarding the psychological component of Ulcerative colitis (UC). Materials and methods: Eight questionnaires were completed and were performed deep psychosocial anamnesis, semi-structured interview, and observation, to reconstitute biography, critical incidents of the environmental conditions of the patient (MC) with ulcerative colitis from 2008. Results: Before the diagnosis he had a year bloody diarrhoea, abdominal pain, and a weight loss of 8 kg, that had greatly affected his work, his family and sexual life. The deviation from the socially encouraged norms regarding the life cycles-such as the successful completion of the studies, career, marriage, becoming a parent, children exceeding the socioeconomic and professional status of the family of origin, etc., perceived as catastrophes, frustrated the patient, and exhausted his energy. Psychological questionnaires showed tendency towards instability at the limit, tendency toward accentuation for emotivity and hyperthymia and was identified as the patient often feels tense. Conclusion: Is necessary a rigorous psychosocial anamnesis to reveal the emotional stresses, to introduce a psychologist, a psychotherapist in evaluating and treating the patients with UC.
Clinical Chemistry and Laboratory Medicine, 2000
Background: Dysregulation of antimicrobial response may trigger infl ammatory bowel diseases (IBD). This study analyzed specifi city of anti-neutrophil cytoplasmic antibodies (ANCA) in IBD patients and its clinical signifi cance. Methods: Data from 52 ulcerative colitis (UC) patients with 32 Crohn ' s disease (CD) patients were compared. Primary sclerosing cholangitis (PSC) was present in 12/84 patients. ANCA, ANA and anti-smooth muscle antibodies (ASMA) were detected by IIF. ANCA were tested by ELISA for proteinase 3 (PR3), myeloperoxidase, bactericidal/permeability increasing protein, elastase, cathepsin G, lysozyme and lactoferrin. Results: pANCA were more frequently present in UC than in CD patients (p < 0.001). ANCA titer correlated with the disease activity only in UC patients (p < 0.05). UC patients more frequently had two or more ANCA specifi cities compared to CD patients (p < 0.01). Multi-specifi c ANCA in medium and/or high concentrations were associated with long-lasting (p < 0.05) and left-sided UC (p < 0.001). Multi-specifi c ANCA with ANA and ASMA had sensitivity of 67 % for PSC. Conclusions: Higher concentrations of multi-specifi c ANCA in long-lasting, left-sided UC suggest an infl uence of bacterial stimulation on the break of tolerance. Multi-specifi c ANCA with ANA and ASMA could be markers for PSC. ANCA specifi c to several antigens may worsen infl ammation by reducing antimicrobial capacity of neutrophil proteases and cationic proteins.