Table 2.
Summary of studies assessing association between stress and disease exacerbations in inflammatory bowel disease (IBD)
| Variable | Patients | Finding | Reference |
| Adverse life events | |||
| Retrospective analysis of life events preceding disease onset | 60 patients with UC | Positive association | Fava72 |
| Retrospective 2 year analysis of life events preceding disease relapse | 70 patients with CD, 44 patients with UC | Positive correlation with relapse in CD but not UC | Paar71 |
| Analysis of life events preceding relapse | 30 patients with UC | Positive association | Bach77 |
| Prospective 6 months of life events preceding exacerbation | 124 patients with IBD | Positive association with no lag time | Duffy78 |
| Prospective 2 year analysis of life events preceding disease relapse | 32 patients with IBD | No association | North73 |
| Prospective 1 year analysis of adverse life events and disease relapse | 108 patients with IBD | No association | Von Wietersheim74 |
| Retrospective analysis of incidence of adverse life events in preceding 12 months in patients with UC and healthy controls | 122 patients with UC | Greater incidence of life events in preceding 12 months in patients with UC | Tocchi79 |
| 1 year prospective analysis of life events and disease relapse | 60 patients with UC | Positive association of life events and relapse in the following month | Bitton75 |
| Retrospective 16 year analysis of prevalence of IBD in patients who lost a child and controls | 21 062 parents who lost a child | No increased prevalence of IBD | Li80 |
| Prospective 2 year analysis of depression and life events and disease relapse | 18 patients with CD | Positive association of depression and (less so) life events with disease relapse simultaneously and at 8–12 weeks | Mardini76 |
| Chronic perceived stress | |||
| Prospective 2 year analysis of PSQ score and disease exacerbation | 62 patients with UC | Increased risk of exacerbation with increased PSQ score | Levenstein81 |
| Analysis of mucosal endoscopic appearance and PSQ score | 46 patients with asymptomatic UC | Increased PSQ score in patients with mucosa abnormalities | Levenstein82 |
| Daily stress | |||
| Prospective 28 days of daily stress with self rated disease severity | 10 patients with CD | Positive association in some individuals | Garrett83 |
| Prospective 1 year analysis of stress with disease exacerbation | 11 patients with IBD | Positive association | Greene84 |
CD, Crohn’s disease; UC, ulcerative colitis; IBD, inflammatory bowel disease; PSQ, perceived stress questionnaire.