A Psychosomatic Comparison of Patients with Ulcerative Colitis and Crohnʼs Disease

Abstract

A two-phase study of 123 patients with either ulcerative colitis or Crohn's disease indicates a similarly high incidence of emotional disturbance and life crises prior to the illness onset in both somatic diseases. There are no significant differences between patients with the two diseases in a large number of demographic, psychosocial, personality, behavioral, psychiatric, and physical disease characteristics. In both syndromes, more severe emotional disturbance is associated with more severe demonstrable physical disease. The findings support the theory that these two somatic processes represent ends of a spectrum of biological response to similar psychosocial and personality factors. This study also indicates the need for early identification and treatment of emotional disturbance in both groups of patients, for which the Cornell Medical Index is a useful screening device.The clinical impression of an association between inflammatory disease of the lower intestinal tract and emotional disturbance has generated a great deal of research since Murray's original study, which suggested "psychogenic factors" in the etiology of "ulcerative colitis" (1). Most of this research, though not all, has supported the importance of psychological factors in the etiology and course of inflammatory bowel From the

Fatigue and health-related quality of life in inflammatory bowel disease

“…There are a few studies that found depression to be an independent risk factor for fatigue in IBD and in the combination of IBD and PSC. 53,48 In most studies, IBD severity was not associated with depressive symptoms 54 or a firm diagnosis of depression [55][56][57][58] ; however, it is difficult to measure the influence of depression as such, since invalidating fatigue symptoms could be a cause of depressive symptoms as well. Even more, it was found that psychological factors such as a depressive mood-associated with anxiety and impaired quality of life-are capable of negatively influencing the disease course of IBD.…”

Psychopathology and Verbal Expression in Psychosomatic and Psychoneurotic Patients

“…Attempts to define the psychopathology in psychosomatic patients have included descriptions of certain personality profiles [Dunbar, 1947], specific intrapsychic conflicts [Alexander, 1950], and measuring lev els of anxiety, depression or other neurotic symptoms. While many studies have demonstrated high levels of psychopathology in psychosomatic pa tients [McKegney et al, 1970;Weiner, 1977], other studies have shown no greater incidence of psychopathology than in normal populations [Feldman et al, 1967;Zealley et al, 1970], These conflicting results have failed to advance psychosomatic theory and sometimes led to the faulty conclusion that an illness cannot be considered psychosomatic when there is no mea surable psychopathology. Perhaps there is no direct etiological relationship between psychopathology, as traditionally defined, and psychosomatic dis order.…”

Colitis granulomatosa und Colitis ulcerosa aus der Sicht des Internisten: Epidemiologie – Pathologie Diagnostik

“…verschlimmert haben, fehlt hierfür noch jeglicher Beweis [211. Ebensowenig ist bei Patienten mit M. Crohn/Colitis ulcero sa ein typisch prämorbides Persönlichkeitsbild festzustellen [22]. Dies schließt jedoch nicht aus.…”