Systematic review: psychosocial factors associated with pain in inflammatory bowel disease

Sweeney, Louise; Moss‐Morris, Rona; Czuber‐Dochan, Wladyslawa; Meade, Laura; Chumbley, Gillian; Norton, Christine

doi:10.1111/apt.14493

Cited by 85 publications

(78 citation statements)

References 76 publications

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“…Various symptoms not directly related to intestinal inflammation have been found to impact on patient-reported outcomes and may, therefore, be of importance in patient management. A recent review has demonstrated several psychological factors to be associated with pain in IBD patients and that such factors remain important regardless of disease activity [9]. Although we found that depressive and anxiety symptoms were not independently associated with pain severity in multivariate analyses, these symptoms may be of importance in some patients [7,9].…”

Section: Discussioncontrasting

confidence: 69%

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Pain Severity and Vitamin D Deficiency in IBD Patients

et al. 2019

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Background: Pain and vitamin D deficiency are common in inflammatory bowel disease (IBD). Disease activity, fatigue, frequent relapses, prior surgery and psychological factors all seem to influence the experience of pain in IBD. Vitamin D deficiency has been associated with muscle and skeletal pain. This study aimed to determine whether there is an association between vitamin D deficiency and severity of pain in patients with IBD, and to investigate the influence of other socio-demographic and psychological variables on the experience of pain. Methods: Patients with IBD were recruited from nine hospitals in Norway in a multicenter cross-sectional study. The Brief Pain Inventory (BPI) questionnaire was used to measure pain. Disease activity was assessed using clinical disease activity indices, C-reactive protein (CRP) and fecal calprotectin. Regression models were fitted to explore a possible association between 25-hydroxyvitamin D and pain severity. Results: Of 407 patients included in the analyses, 229 (56%) had Crohn’s disease (CD) and 178 (44%) had ulcerative colitis (UC). Vitamin D deficiency was present in half (203/407) of patients. Presence of pain was reported by 76% (309/407). More severe pain was associated with female gender and increased disease activity scores, but not with increased CRP or fecal calprotectin. In CD, patients without prior intra-abdominal surgery reported more severe pain. In multivariate analyses, there was no association between 25-hydroxyvitamin D and pain severity. Conclusions: In this study, no significant association between pain severity and vitamin D deficiency was revealed in patients with IBD.

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Section: Discussioncontrasting

confidence: 69%

“…Modulating factors, including different psychological factors, may significantly contribute to the clinical manifestation and severity of pain [7][8][9]. Emotional problems and inadequate coping mechanisms have been associated with development of chronic pain syndromes [4].…”

Section: Introductionmentioning

confidence: 99%

Pain Severity and Vitamin D Deficiency in IBD Patients

et al. 2019

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“…Poor mental health has also been previously reported as a significant predictor of hospitalization, readmission, and increased risk of surgery in those with IBD. Pain, fatigue, and opioid use are also known to be associated with poor mental health in IBD . Therefore, our findings demonstrate that high rates of distress are likely to contribute to the burden of IBD at the personal and societal levels and translate into large costs of IBD care in Australia…”

Section: Discussionmentioning

confidence: 70%

“…Pain, fatigue, and opioid use are also known to be associated with poor mental health in IBD. [30][31][32][33] Therefore, our findings demonstrate that high rates of distress are likely to contribute to the burden of IBD at the personal and societal levels and translate into large costs of IBD care in Australia. 1 The limitations of this survey have been previously discussed 17 and include the following: its online nature, which precluded an objective assessment of IBD status and disease activity; a female-predominant sample of people aged 16 years and older excluded the pediatric population and limited the generalizability of its findings; and a low participation rate from people in remote areas.…”

Section: Discussionmentioning

confidence: 74%

Psychological distress is highly prevalent in inflammatory bowel disease: A survey of psychological needs and attitudes

et al. 2019

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Background and Aim Data on patient needs and access to psychological services in inflammatory bowel disease (IBD) are scarce. This study aimed to describe the levels of distress and the needs, attitudes, and access to psychological services for people within Australia against established Australian IBD Standards. Methods An online cross‐sectional survey was conducted with Australians ≥16 years old recruited via Crohn's & Colitis Australia membership, public and private clinics, and the Royal Flying Doctor Service. K10 was used to measure psychological distress. The Chi‐square test was used to compare those with and without distress on key variables. Results Overall, 731 respondents provided complete data (71.5% female, mean age 46.5 years). Overall, 50% of respondents reported distress; only 15.2% were currently seeing a mental health practitioner; only 16.1% were asked about their mental health by their IBD specialist or IBD nurse; and only 12.2% reported access to a mental health practitioner as part of their IBD service. Those with psychological distress were significantly less satisfied with their IBD care; more commonly hospitalized; had an active disease, fistula or perianal disease, pain, or fatigue; and were receiving steroids, opioids, or antidepressants (all P < 0.05). As many as 68.2% of those with severe distress were not seeing a mental health practitioner. Conclusions The integrated biopsychosocial model of health care, with regular mental health screening and good access to mental health professionals, is requested by people living with IBD to improve their outcomes.

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“…1 Patients with IBD suffer physical discomfort, which is often accompanied by depression, anxiety, sleep disorders, and other mental and psychological problems. [2][3][4] IBD arthritis (IBDA) is arthritis associated with IBD, which is the most common parenteral manifestation of IBD. Roughly 15% to 20% of the patients with IBD may have arthralgia or arthritis.…”

mentioning

confidence: 99%

<p>Influence Of Narrative Medicine-Based Health Education Combined With An Online Patient Mutual Assistance Group On The Health Of Patients With Inflammatory Bowel Disease and Arthritis</p>

Zhang¹,

Xu³

et al. 2020

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Systematic review: psychosocial factors associated with pain in inflammatory bowel disease

Abstract: Psychosocial factors appear to play a significant role in IBD-pain. Further research is required to explore psychosocial constructs in relation to IBD-pain, with use of validated pain measures, large sample sizes and clearer characterisation of disease activity.

Cited by 85 publications

References 76 publications

Pain Severity and Vitamin D Deficiency in IBD Patients

Pain Severity and Vitamin D Deficiency in IBD Patients

Psychological distress is highly prevalent in inflammatory bowel disease: A survey of psychological needs and attitudes

<p>Influence Of Narrative Medicine-Based Health Education Combined With An Online Patient Mutual Assistance Group On The Health Of Patients With Inflammatory Bowel Disease and Arthritis</p>

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