Background: Inflammatory bowel diseases (IBD) are characterized by significant quality of life (QoL) impairment, as well as an alterated illness perception. Evaluation and characterization of illness perception may play a role in optimizing the clinical management of IBD patients.
Methods: This was a single-center, observational, transversal study. Consecutive adult IBD patients were enrolled and stratified according to disease activity (active/remission). The validated Revised Illness Perception Questionnaire (IPQ-R), based on identity (defined as the presence or absence, since diagnosis, of the commonest symptoms associated with chronic disease, and their relationship with the disease), current view (patient's opinion about emotional dimensions), and causes (patient's opinion about 18 possible illness causes and indication of the three most relevant causes of actual health status) was administered to all patients. Comparison in IPQ-R parameters was done between active patients and those who were in remission.
Results: In the entire study population (n=201, CD=47%; UC=53%), the most reported symptoms were fatigue (86.9%), loss of strength (83.3%), pain (80%), weight loss (68.2%). Patients with active disease reported significantly more fatigue (p=0.005), sore eyes (p=0.046), sleep difficulties (p=0.001) as related to their disease, and reported more symptoms as related to their disease (p=0.023). Active IBD patients were significantly more convinced about the cyclical timeline of the disease (p=0.002), more negative thoughts on prognosis (p=0.001) and more negative emotions (p=0.000). Patients in remission were significantly more convinced about for treatment control (p=0.007) and had clearer understanding of illness (p=0.009) towards active patients.
Stress (84.1%), altered immunity (69.32%), familiar problems (49.4%), emotional status (40.9%) were considered as the main causes of IBD in the entire study population. Job overload was more frequently considered as a disease cause in active patients than in those in remission (p=0.002). Smoking, familial history, previous inadequate therapy (19.3%, 26.1%, 18.7%, respectively) were not considered as a relevant factor for illness.
Conclusions: Illness perception is impaired in IBD patients, especially in active disease. Adequate educational and psychological support may be helpful in the optimal management of IBD patients.