High Stress of Crohn's Disease Associated With Flare-Ups

Exacerbations much more likely for patients with disease-related posttraumatic stress disorder

THURSDAY, Dec. 2 (HealthDay News) -- Posttraumatic stress disorder (PTSD) associated with the burden of having Crohn's disease appears to be linked to disease exacerbations, according to a study published online Dec. 1 in Frontline Gastroenterology.

Rafael J.A. Cámara, M.D., of the Bern University Hospital in Switzerland, and colleagues ascertained levels of Crohn's disease-related posttraumatic stress in 597 Crohn's patients over a period of 18 months using the Posttraumatic Diagnostic Scale (PDS). The researchers compared the incidence of disease exacerbations in the patients with high PDS scores (15 points or more; suggestive of PTSD) and those with lower scores.

The researchers found that the Crohn's patients with a PDS score of 15 or more (19.1 percent) had more than four times higher odds of having an exacerbation (odds ratio, 4.3) than the patients with PDS scores of less than 15; they had 13 times higher odds of having an exacerbation than the Crohn's patients with a PDS score of zero.

"Gastroenterologists should be aware of the impact of Crohn's disease on psychological well-being and the fact that this relationship is probably bidirectional. This knowledge may open the door to psychological interventions. Gastroenterologists may wish to ask about re-experiencing, avoidance and hyperarousal and, depending on the intensity of symptoms, may be advised to refer patients for psychological counseling or for a structured clinical interview to assess for PTSD," the authors write.

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