Psychological impairment in inflammatory bowel diseases: the key role of coping and defense mechanisms

A comprehensive investigation of psychological features in chronic patients is very important for tailoring effective treatments. In this study we tested anxiety, depression, health related quality of life (HR-QoL), alexithymia, coping styles, and defense mechanisms, in eighty-four patients with Cro...

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Published in	Research in psychotherapy (Milano). Vol. 26; no. 3
Main Authors	Martino, Gabriella, Viola, Anna, Vicario, Carmelo Mario, Bellone, Federica, Silvestro, Orlando, Squadrito, Giovanni, Schwarz, Peter, Lo Coco, Gianluca, Fries, Walter, Catalano, Antonino
Format	Journal Article
Language	English
Published	Italy PAGEPress Publications, Pavia, Italy 15.01.2024 PAGEPress Publications
Subjects	alexithymia coping and defense mechanisms HR-QoL Inflammatory bowel diseases treatment
Online Access	Get full text
ISSN	2499-7552 2239-8031 2239-8031
DOI	10.4081/ripppo.2023.731

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Summary:	A comprehensive investigation of psychological features in chronic patients is very important for tailoring effective treatments. In this study we tested anxiety, depression, health related quality of life (HR-QoL), alexithymia, coping styles, and defense mechanisms, in eighty-four patients with Crohn disease (CD) and ulcerative colitis (UC). Participants reported low to moderate HRQoL and anxiety, apart from alexithymia. Women experienced lower QoL and higher levels of anxiety and depressive symptoms. Coping and defense strategies were related to distress symptoms and QoL. Positive attitude and principalization, showed negative associations with depression, anxiety and alexithymia and were also found to be associated with mental health. CD patients used significantly more turning against objects (p=0.02) and projections (p=0.01) and UC patients used more reversal (p=0.04). Elderly women showed higher anxiety symptoms and lower perceived QoL. Multiple regression analysis revealed anxiety and depression were independently associated with QoL. Significant differences emerged in defense styles among CD and UC. CD participants used more maladaptive coping and defense styles which were related to mental distress, depression and anxiety, together with higher level of alexithymia. Findings suggest that psychological aspects play a key role in mental health in patients suffering from inflammatory bowel diseases. A multi-integrated clinical strategy including psychotherapeutic interventions should be considered in treating CD and UC.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Ethical statement: the study involving human participants has been reviewed and approved by the Ethical Committee, “Gaetano Martino” University Hospital of Messina, Italy. The patients/participants provided their written informed consent to participate in this study. All methods have been carried out in accordance with the principles of the Declaration of Helsinki and its later amendments. Availability of data and materials: the raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. Correspondence and requests for materials should be addressed to AC. Citation: Martino, G., Viola, A., Vicario, C.M., Bellone, F., Silvestro, O., Squadrito, G., Schwarz, P., Lo Coco, G., Fries, W., Catalano, A. (2023). Psychological impairment in inflammatory bowel diseases: the key role of coping and defense mechanisms. Research in Psychotherapy: Psychopathology, Process and Outcome, 26(3), 731. Publisher’s note: all claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. Contributions: GM and WF were involved in the conception and design of the study. CMV, FB, OS and GS were involved in data acquisition and analysis of data. GM, PS, GLC, WF and AC were involved in analysis and interpretation of data and revised the manuscript critically for important intellectual content. All authors reviewed the manuscript and gave their final approval for the manuscript to be submitted. Conflict of interest: the authors declare no potential conflict of interest.
ISSN:	2499-7552 2239-8031 2239-8031
DOI:	10.4081/ripppo.2023.731