Initial Assessment of Post-traumatic Stress in a US Cohort of Inflammatory Bowel Disease Patients

Tiffany Noel Taft, Alyse Bedell, Meredith R. Craven, Livia Guadagnoli, Sarah Quinton, Stephen B Hanauer

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Post-traumatic stress (PTS), or the psycho-physiological response to a traumatic or life-threatening event, is implicated in medical patient outcomes. Emerging evidence suggests a complex relationship between PTS, the brain-gut axis, the gut microbiome, and immune function. Inflammatory bowel disease (IBD) may be susceptible to PTS and its subsequent impacts. To date, no study has evaluated PTS in IBD in the United States. METHODS: Adult patients with IBD were recruited from an outpatient gastroenterology practice, via social media, and via a research recruitment website. Patients with irritable bowel syndrome (IBS) were recruited as a comparison group. Participants completed demographic and disease information, surgical and hospitalization history, and the PTSD Checklist-Civilian Version (PCL-C). Statistical analyses evaluated rates of PTS in IBD and IBS, including differences between groups for PTS severity. Regression analyses determined potential predictors of PTS. RESULTS: One hundred eighty-eight participants (131 IBD, 57 IBS) completed the study. Thirty-two percent of IBD and 26% of IBS patients met the criteria for significant PTS symptoms based on PCL-C cutoffs. Inflammatory bowel disease patients are more likely to attribute PTS to their disease than IBS patients. Crohn's disease (CD) patients appear to be the most likely to experience PTS, including those being hospitalized or undergoing ileostomy surgery. Symptom severity is the greatest predictor of PTS for ulcerative colitis and IBS. CONCLUSIONS: Although PTS is relevant in both IBS and IBD, IBD patients are seemingly more susceptible to PTS due their disease experiences, especially CD patients. The nature of PTS symptoms may contribute to IBD disease processes, most notably through sleep disturbance and ANS arousal. Clinicians should assess for PTS in IBD patients as standard of care, especially after a hospitalization or surgery.

Original languageEnglish (US)
Pages (from-to)1577-1585
Number of pages9
JournalInflammatory bowel diseases
Volume25
Issue number9
DOIs
StatePublished - Aug 20 2019

Fingerprint

Inflammatory Bowel Diseases
Irritable Bowel Syndrome
Post-Traumatic Stress Disorders
Checklist
Crohn Disease
Hospitalization
Social Media
Ileostomy
Gastroenterology
Standard of Care
Arousal
Ulcerative Colitis
Sleep
Outpatients
History
Regression Analysis
Demography
Brain

Keywords

  • inflammatory bowel disease
  • post-traumatic stress
  • PTSD

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

Cite this

@article{17652194b3064dc6844abb5f5bafa13c,
title = "Initial Assessment of Post-traumatic Stress in a US Cohort of Inflammatory Bowel Disease Patients",
abstract = "BACKGROUND: Post-traumatic stress (PTS), or the psycho-physiological response to a traumatic or life-threatening event, is implicated in medical patient outcomes. Emerging evidence suggests a complex relationship between PTS, the brain-gut axis, the gut microbiome, and immune function. Inflammatory bowel disease (IBD) may be susceptible to PTS and its subsequent impacts. To date, no study has evaluated PTS in IBD in the United States. METHODS: Adult patients with IBD were recruited from an outpatient gastroenterology practice, via social media, and via a research recruitment website. Patients with irritable bowel syndrome (IBS) were recruited as a comparison group. Participants completed demographic and disease information, surgical and hospitalization history, and the PTSD Checklist-Civilian Version (PCL-C). Statistical analyses evaluated rates of PTS in IBD and IBS, including differences between groups for PTS severity. Regression analyses determined potential predictors of PTS. RESULTS: One hundred eighty-eight participants (131 IBD, 57 IBS) completed the study. Thirty-two percent of IBD and 26{\%} of IBS patients met the criteria for significant PTS symptoms based on PCL-C cutoffs. Inflammatory bowel disease patients are more likely to attribute PTS to their disease than IBS patients. Crohn's disease (CD) patients appear to be the most likely to experience PTS, including those being hospitalized or undergoing ileostomy surgery. Symptom severity is the greatest predictor of PTS for ulcerative colitis and IBS. CONCLUSIONS: Although PTS is relevant in both IBS and IBD, IBD patients are seemingly more susceptible to PTS due their disease experiences, especially CD patients. The nature of PTS symptoms may contribute to IBD disease processes, most notably through sleep disturbance and ANS arousal. Clinicians should assess for PTS in IBD patients as standard of care, especially after a hospitalization or surgery.",
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Initial Assessment of Post-traumatic Stress in a US Cohort of Inflammatory Bowel Disease Patients. / Taft, Tiffany Noel; Bedell, Alyse; Craven, Meredith R.; Guadagnoli, Livia; Quinton, Sarah; Hanauer, Stephen B.

In: Inflammatory bowel diseases, Vol. 25, No. 9, 20.08.2019, p. 1577-1585.

Research output: Contribution to journalArticle

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T1 - Initial Assessment of Post-traumatic Stress in a US Cohort of Inflammatory Bowel Disease Patients

AU - Taft, Tiffany Noel

AU - Bedell, Alyse

AU - Craven, Meredith R.

AU - Guadagnoli, Livia

AU - Quinton, Sarah

AU - Hanauer, Stephen B

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