BACKGROUND: Stress has been suggested to play a potential role in inflammatory bowel disease (IBD) pathogenesis, but studies focussing on the occurrence of specific life stress events among IBD patients are scarce. Therefore, the aim of the present study was to explore the association between various life stress events and IBD. METHODS: Patients with IBD (N = 98, mean age: 38.45, 54.1% men) were compared to a group of healthy controls (N = 405, mean age: 36.45, 58.0% men) originating from a health survey conducted on a representative population sample of Czech adults. The Life Stressor Checklist-Revised (LSC-R) was used to assess the stressors. RESULTS: IBD patients had higher odds of reporting life stressors overall (p < 0.001), life stressors before the age of 16 (p < 0.004) and a higher score in traumatic stress (p < 0.005) and interpersonal violence (p < 0.001) when compared to the control group. Gender- and diagnosis-related differences are discussed. CONCLUSION: Reporting life stressors experienced during childhood or adulthood is strongly associated with IBD. This should be considered in illness management, especially in a severe course of IBD.

2nd Department of Internal Medicine University Hospital Olomouc 1 P Pavlova 185 6 779 00 Olomouc Czech Republic

Department of Gastroenterology and Digestive Endoscopy University Hospital St Michael's Hospital Satinskeho 1 811 08 Bratislava Slovakia

Department of Social Work St Elizabeth College of Health and Social Work Namestie 1 maja 1 810 00 Bratislava Slovakia

Faculty of Medicine Department of Psychiatry Slovak Medical University in Bratislava Limbova 12 833 03 Bratislava Slovakia

Faculty of Medicine Palacky University Krizkovskeho 511 8 779 00 Olomouc Czech Republic

Olomouc University Social Health Institute Palacky University Univerzitni 22 779 00 Olomouc Czech Republic

Psychiatric Psychotherapeutic Outpatient Clinic Pro Mente Sana Heydukova 27 811 06 Bratislava Slovakia

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Kaplan G.G., Ng S.C. Globalisation of inflammatory bowel disease: Perspectives from the evolution of inflammatory bowel disease in the UK and China. Lancet. Gastroenterol. Hepatol. 2016;1:307–316. doi: 10.1016/S2468-1253(16)30077-2. PubMed DOI

Cho J.H. The genetics and immunopathogenesis of inflammatory bowel disease. Nat. Rev. Immunol. 2008;8:458–466. doi: 10.1038/nri2340. PubMed DOI

Zelinkova Z. Genetika nešpecifických črevných zápalov. In: Jurgoš L., Kužela L., Hrusovsky S., editors. Gastroenterológia. Veda; Bratislava, Slovakia: 2006.

Bernstein C.N., Hitchon C.A., Walld R., Bolton J.M., Sareen J., Walker J.R., Graff L.A., Patten S.B., Singer A., Lix L.M., et al. Increased burden of psychiatric disorders in inflammatory bowel disease. Inflamm. Bow. Dis. 2019;25:360–368. doi: 10.1093/ibd/izy235. PubMed DOI PMC

Drossman D.A., Leserman J., Mitchell C.M., Zagami E.A., Appelbaum M.I. Health-related quality of life in inflammatory bowel disease: Functional status and patient worries and concerns. Dig. Dis. Sci. 1989;34:1379–1386. doi: 10.1007/BF01538073. PubMed DOI

Mawdsley J.E., Rampton D.S. Psychological stress in IBD: New insights into pathogenic and therapeutic implications. Gut. 2005;54:1481–1491. doi: 10.1136/gut.2005.064261. PubMed DOI PMC

North C.S., Alpers D.H., Helzer J.E., Spitznagel E.L., Clouse R.E. Do life events or depression exacerbate inflammatory bowel disease? A prospective study. Ann. Intern. Med. 1991;114:381–386. doi: 10.7326/0003-4819-114-5-381. PubMed DOI

Lerebours E., Gower-Rousseau C., Merle V., Brazier F., Debeugny S., Marti R., Salomez J.L., Hellot M.F., Dupas J.L., Colombel J.F., et al. Stressful life events as a risk factor for inflammatory bowel disease onset: A population-based case-control study. Am. J. Gastroenterol. 2007;102:122–131. doi: 10.1111/j.1572-0241.2006.00931.x. PubMed DOI

Vidal A., Gomez-Gil E., Sans M., Portella M.J., Salamero M., Piqué J.M., Panés J. Life events and inflammatory bowel disease relapse: A prospective study of patients enrolled in remission. Am. J. Gastroenterol. 2006;101:775–781. doi: 10.1111/j.1572-0241.2006.00476.x. PubMed DOI

Theis M.K., Boyko M.K. Patient perceptions of causes of inflammatory bowel disease. Am. J. Gastroenterol. 1994;89:1920. PubMed

Anathakrishnan A.N., Bernstein C.N., Iliopoulos D., Macpherson A., Neurath M.F., Raja Ali R.A., Vavricka S.R., Fiocchi C. Environmental triggers in IBD: A review of progress and evidence. Nat. Rev. Gastroent. Hepat. 2018;15:39–49. doi: 10.1038/nrgastro.2017.136. PubMed DOI

Bernstein M.T., Burchill C., Targownik L.E., Singh H., Roos L.L. Events within the first year of life, but not the neonatal period, affect risk for later development of inflammatory bowel disease. Gastroenterology. 2019;156:2190–2197. doi: 10.1053/j.gastro.2019.02.004. PubMed DOI PMC

Fuller-Thomson E., Lateeff R., Sulman J. Robust association between inflammatory bowel disease and generalised anxiety disorder: Findings from nationally representative Canadian study. Inflamm. Bow. Dis. 2015;21:2341–2348. doi: 10.1097/MIB.0000000000000518. PubMed DOI

Targownik L.E., Sexton K.A., Bernstein M.T., Beatie B., Sargent M., Walker J.R., Graff L.A. The relationship among perceived stress, symptoms, and inflammation in persons with inflammatory bowel disease. Am. J. Gastroenterol. 2015;110:1001–1012. doi: 10.1038/ajg.2015.147. PubMed DOI

Wintjens D.S.J., de Jong M.J., van der Meulen-de Jong A.E., Romberg-Camps M.J., Becx M.C., Maljaars J.P., van Bodegraven A.A., Mahmmod N., Markus T., Haans J., et al. Novel Perceived Stress and Life Events Precede Flares of Inflammatory Bowel Disease: A Prospective 12-Month Follow-Up Study. J. Crohns Colitis. 2019;13:410–416. doi: 10.1093/ecco-jcc/jjy177. PubMed DOI

Bernstein M.T., Targownik L.E., Sexton K.A., Graff L.A., Miller N., Walker J.R. Assessing the relationship between sources of stress and symptom changes among persons with IBD over time: A prospective study. Can. J. Gastroenterol. Hepatol. 2016;2016:1681507. doi: 10.1155/2016/1681507. PubMed DOI PMC

Beatrize P., Guillermo V. Stressful events possibly related to the onset of IBD. Am. J. Gastroenterol. 2019;114:S25. doi: 10.14309/01.ajg.0000578444.92415.20. DOI

Keefer L., Keshavarzian A., Mutlu E. Reconsidering the methodology of “stress” research in inflammatory bowel disease. J. Crohns Colitis. 2008;2:193–201. doi: 10.1016/j.crohns.2008.01.002. PubMed DOI PMC

Kascakova N., Furstova J., Polackova Solcova I., Heveriova M., Heveri M., Hasto J., Tavel P. Life stressor checklist (LSC-R): The occurrence of stressors in adult Czech population and the association with health. Cesk. Psychol. 2018;63(Suppl. 1):80–98.

Wolfe J., Kimerling R., Brown P., Chrestman K., Levin K. Psychometric review of the Life Stressor Checklist-Revised. In: Stamm B., editor. Measurement of Stress, Trauma, and Adaptation. Sidran Press; Lutherville, MD, USA: 1996. pp. 198–201.

Choi K.R., Kim D., Jang E.Y., Bae H., Kim S.H. Reliability and validity of the Korean version of the lifetime stressor checklist-revised in psychiatric outpatients with anxiety or depressive disorders. Yonsei Med. J. 2017;58:226–233. doi: 10.3349/ymj.2017.58.1.226. PubMed DOI PMC

Openshaw M., Thompson L.M., Pheils P.B., Mendoza-Flores M.E., Humphreys J. Childhood trauma is associated with depressive symptoms in Mexico City women. Rev. Panam. Salud. Pública. 2015;37:308–315. PubMed

Schumacher A.M., Jaramillo D., Uribe T., De Pheils P.B., Holzemer W., Taylor D., Tiwari A., Canaval G.E., Mendoza Flores G.E., Belknap R.A., et al. The relationship of two types of trauma exposure to current physical and psychological symptom distress in community sample of colombian women: Why interpersonal violence deserves more attention. Health Care Women Int. 2010;31:946–961. doi: 10.1080/07399332.2010.503290. PubMed DOI

Jakobsen C., Paerregaard A., Munkholm O., Wever V. Environmental factors and risk of developing paediatric inflammatory bowel disease—A population based study 2007–2009. J. Crohns Colitis. 2013;7:79–88. doi: 10.1016/j.crohns.2012.05.024. PubMed DOI

Brooks A.J., Rowse A., Ryder E., Peach J., Corfe B.M., Lobo A.J. Systematic review: Psychological morbidity in young people with inflammatory bowel disease—Risk factors and impacts. Aliment. Pharm. Therap. 2016;44:3–15. doi: 10.1111/apt.13645. PubMed DOI

Reed-Knight B., van Tilburg M.A.L., Levy R.L., Langer S.L., Romano J.M., Murphy T.B., Du Pen M.M., Feld A.D. Maladaptive coping and depressive symptoms partially explain the association between family stress and pain-related distress in youth with IBD. J. Pediatr. Psychol. 2018;43:94–103. doi: 10.1093/jpepsy/jsx082. PubMed DOI PMC

Rolland J.S. A conceptual model of chronic and life-threatening illness and its impact on the family. In: Chilman E., Nunnally C., Cox F., editors. Chronic Illness and Disability. Sage; Beverly Hills, CA, USA: 1988. pp. 17–68.

Arnold J., Buschman Gemma P., Cushman L.F. Exploring parental grief: Combining quantitative and qualitative measures. Arch. Psychiat. Nurs. 2005;19:245–255. doi: 10.1016/j.apnu.2005.07.008. PubMed DOI

Rolland J.S. Family Systems and Chronic Illness. J. Psychother. Fam. 1988;3:143–168. doi: 10.1300/J287v03n03_10. DOI

Bernstein C.N., Walker J.R., Graff L.A. On studying the connection between stress and IBD. Am. J. Gastroenterol. 2006;101:782–785. doi: 10.1111/j.1572-0241.2006.00474.x. PubMed DOI

Pellisier S., Dantzer C., Canini F., Mathieu N., Bonaz B. Psychological adjustment and autonomic disturbances in inflammatory bowel diseases and irritable bowel syndrome. Psychoneuroendocrinology. 2010;35:653–662. doi: 10.1016/j.psyneuen.2009.10.004. PubMed DOI

van der Have M., Minderhoud I.M., Kaptein A.A., Leenders M., Siersema P.D., Fidder H.H., Oldenburg B. Substantial impact of illness perceptions on quality of life in patients with Crohn’s disease. J. Crohns Colitis. 2013:e292. doi: 10.1016/j.crohns.2012.11.002. PubMed DOI

van Erp S.J.H., Brakenhof L.K.M.P., Vollmann M., van der Heijde D., Veenedaal R.A., Fidder H.H., Hommes D.W., Kaptein A.A., van der Meulen-de Jong A.E., Scharloo M. Illness perceptions and outcomes in patients with inflammatory bowel disease: Is coping a mediator? Int. J. Behav. Med. 2017;24:205–214. doi: 10.1007/s12529-016-9599-y. PubMed DOI

Brooks A.J., Norman P., Peach E.J., Ryder A., Scott A.J., Narula P., Corfe B.M., Lobo A.J., Rowseb G. Prospective study of psychological morbidity and illness perceptions in young people with inflammatory bowel disease. J. Crohns Colitis. 2019;13:1003–1011. doi: 10.1093/ecco-jcc/jjz028. PubMed DOI

Morrison G., Van Langenberg D.R., Gibson S.J., Gibson P.R. Chronic pain in inflammatory bowel disease: Characteristics and associations of a hospital-based cohort. Inflamm. Bowel Dis. 2013;19:1210–1217. doi: 10.1097/MIB.0b013e318280e729. PubMed DOI

Mikocka-Walus A.A., Turnbull D.A., Moulding N.T., Wilson I.G., Andrews J.M., Holtmann G.J. Controversies surrounding the comorbidity of depression and anxiety in inflammatory bowel disease patients: A literature review. Inflamm. Bowel Dis. 2007;13:225–234. doi: 10.1002/ibd.20062. PubMed DOI

Keefer L., Kane S.V. Considering the bidirectional pathways between depression and IBD: Reccomendations for comprehensive IBD care. Gastroenterol. Hepatol. 2017;13:164–169. PubMed PMC

Petruo V.A., Krauss E., Kleist A., Hardt J., Hake K., Peirano J., Krause T., Ehehalt R., von Arnauld de la Perriere P., Buning J., et al. Perceived distress, personality characteristics, coping strategies and psychosocial impairments in a national German multicenter cohort of patients with Crohn’s disease and ulcerative colitis. Z. Gastroenterol. 2019;57:473–483. doi: 10.1055/a-0838-6371. PubMed DOI

Thomann A., Lis S., Reindl W. Adverse childhood events and psychiatric comorbidity in a single-centre IBD-cohort. J. Crohns Colitis. 2018;12(Suppl. 1):796. doi: 10.1093/ecco-jcc/jjx180.923. DOI

Drossman D.A., Li Z., Leserman J., Toomey T.C., Hu Y.J. Health status by gastrointestinal diagnosis and abuse history. Gastroenterology. 1996;110:999–1007. doi: 10.1053/gast.1996.v110.pm8613034. PubMed DOI

Wegman H.L., Stetler C.A. Meta-Analytic review of the effects of childhood abuse on medical outcomes in adulthood. Psychosom. Med. 2009;71:805–812. doi: 10.1097/PSY.0b013e3181bb2b46. PubMed DOI

Greenfield E.A., Lee C., Friedman E.L., Springer K.W. Childhood abuse as a risk factor for sleep problems in adulthood: Evidence from a U.S. National Study. Ann. Behav. Med. 2011;42:245–256. doi: 10.1007/s12160-011-9285-x. PubMed DOI PMC

Caplan R.A., Maunder R.G., Stempak J.M., Silverberg M.S., Hart T.L. Attachment, childhood abuse, and IBD-related quality of life and disease activity outcomes. Inflamm. Bow. Dis. 2014;20:909–915. doi: 10.1097/MIB.0000000000000015. PubMed DOI

Fuller-Thomson E., West K.J., Sulman J., Baird S.L. Childhood maltreatment is associated with ulcerative colitis but not Crohn’s disease: Findings from a population-based study. Inflamm. Bowel Dis. 2015;21:2640–2648. doi: 10.1097/MIB.0000000000000551. PubMed DOI

Nurmi E., Haapamaki J., Paavilainen E., Rantanen A., Hilila M., Arkkila P. The burden of inflammatory bowel diasease on health care utilization and quality of life. Scand. J. Gastroenterol. 2013;48:51–57. doi: 10.3109/00365521.2012.685750. PubMed DOI

Moore K.A., Cooper C.I. Stress in mental health professionals: A theoretical overview. Int. J. Soc. Psychiatry. 1996;42:82–89. doi: 10.1177/002076409604200202. PubMed DOI

Drossman D.A. Abuse, trauma, and GI illlness: Is there a link? Am. J. Gastroenterol. 2011;106:14–25. doi: 10.1038/ajg.2010.453. PubMed DOI

Keefer L., Palsson O.S., Pandolfino J.E. Best practise update: Incorporating psychogastroenterology into management of digestive disorders. Gastroenterology. 2018;154:1249–1257. doi: 10.1053/j.gastro.2018.01.045. PubMed DOI

Weaver E., Szigethy E. Managing pain and psychosocial care in IBD: A primer for the practising gastroenterologist. Curr. Gastroenterol. Rep. 2020;22:20. doi: 10.1007/s11894-020-0757-7. PubMed DOI

Graff L., Walker J.R., Clara I., Lix L., Miller N., Rogala L., Rawsthorne P., Bernstein C.N. Stress coping, distress, and health perceptions in inflammatory bowel disease and community controls. Am. J. Gastroenterol. 2009;104:2959–2969. doi: 10.1038/ajg.2009.529. PubMed DOI

Baumeister H., Kriston L., Bengel J., Härter M. High agreement of self-report and physician-diagnosed somatic conditions yields limited bias in examining mental–physical comorbidity. J. Clin. Epidemiol. 2010;63:558–565. doi: 10.1016/j.jclinepi.2009.08.009. PubMed DOI

Exploring intimacy and family planning in Inflammatory Bowel Diseases: a qualitative study