Illness perception and stress is associated with disease severity and anxiety, depression, and quality of life in Crohn’s disease patients, according to a study published in the Journal of Patient Preferences and Adherence.

Interventions that aim to improve illness perception and reduce stress could be effective in improving patients’ psychological health and quality of life.

For the study,“Illness perceptions and stress: mediators between disease severity and psychological well-being and quality of life among patients with Crohn’s disease,” a team of researchers led by Dr. Jie Zhong of the Department of Gastroenterology at Shanghai Jiao Tong University in China analyzed 159 Crohn’s disease patients who were attending an outpatient clinic or who were hospitalized.

The researchers measured the patients’ disease severity, illness perception, coping strategies, stress perception, anxiety and depression levels, and quality of life using the relevant questionnaires.

They found that disease severity, illness perception, maladaptive coping (also defined as non-coping), stress, anxiety and depression, and quality of life were significantly correlated in these patients.

Using a mathematical model, Zhong and colleagues showed that disease severity had a direct influence on illness perception, which had a direct influence on stress.

Both illness perception and stress had direct influences on anxiety, depression, and quality of life. However, maladaptive coping did not directly influence anxiety, depression, or quality of life.

Finally, stress had a direct influence on maladaptive coping, and disease severity and anxiety had a direct influence on quality of life.

The authors concluded that there are relationships between more severe disease status, poorer illness perception, use of more maladaptive coping strategies, greater perceived stress, higher levels of anxiety and depression, and lower quality of life in patients with Crohn’s disease.

“Interventions aimed at improving illness perception and reducing perceived stress could probably be effective in improving the psychological health and quality of life,” they wrote.

Crohn’s disease, together with ulcerative colitis, the other main type of inflammatory bowel disease (IBD), affects around 28 million people around the world. The disease negatively affects their psychological well-being, and anxiety and depression are common in IBD patients.