Illness perceptions in IBD influence psychological status, sexual health and satisfaction, body image and relational functioning: A preliminary exploration using Structural Equation Modeling

Background and aims: This study aimed to characterize the relationships between illness perceptions, body image and self-consciousness, sexual health (sexual problems and sexual satisfaction), anxiety and depression, and marital and family functioning in patients with IBD. Methods: Seventy-four IBD patients (44 CD, 13 males, 61 females, mean age 38 years) completed an online questionnaire. Illness perceptions explored with the Brief Illness Perceptions Questionnaire, and anxiety and depression measured using the Hospital Anxiety and Depression Scale, Sexual Problems Scale, Sexual Satisfaction Scale, Marital Functioning Scale, Family Functioning Scale, and Body Image and Self-Consciousness During Intimacy Scale. Results: Exploratory Structural Equation Modeling (SEM) provided a final model with an excellent fit (chi(2) (25)=27.84, p=.32, chi(2)/N=1.11, CFI > 0.99, RMSEA< 0.04, SRMR< 0.07, GFI> 0.93). Illness perceptions had a significant direct influence on depression (beta=0.49, p< 0.001), anxiety (beta=0.55, p <0.001), and family functioning (beta = -0.17, p< 0.001). Several mediating pathways were also found involving sexual problems, sexual satisfaction, and body image and self-consciousness during intimacy. Being female was associated with increased sexual problems but increased sexual satisfaction. Conclusions: The findings provide further evidence for the adverse impact of patient IBD-related illness perceptions on anxiety and depression. The findings also provide the preliminary evidence for the impact of illness perceptions and psychological comorbidity in relation to sexual health and relationship and family functioning. These aspects of psychological processing provide a framework and direction for further research into the nature of IBD and its influence on the patient and their family. (C) 2013 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.