Determinants of life satisfaction in inflammatory bowel disease

Background: in patients with Crohn's disease (CD) and ulcerative colitis (UC), medical, sociodemographic, and psychologic risk and protective factors for general and health-related life satisfaction (GLS and HRLS, respectively)-defined as preference-based judgments of general and health-related quality of life-have not been studied to date. Methods: A total of 429 of 868 (49%) outpatients (CD, n = 317; UC, it = 112) attending 3 tertiary care centers and members of the German Crohn's Disease/Ulcerative Colitis Foundation completed the sociodernographic and medical questionnaires of the German Competence Network Inflammatory Bowel Diseases, the Hospital Anxiety and Depression Scale, and the Questions on Life Satisfaction(Modules). Disease activity was assessed by the German Inflammatory Bowel Disease Activity Index. Questions on Life Satisfaction(Modules) data were compared with a representative sample of the German general Population. Results: GLS and HRLS were reduced compared with the general German Population (P < 0.005). Logistic regression showed that mental disorder was a risk factor of reduced GLS in CD [odds-ratio (OR), 2.7; P < 0.01] and UC (OR, 6.3; P < 0.02). Membership in a self-help organization offered no protection against reduced GLS in CD (OR, 0.5; P < 0.02). In CD, psychiatric (OR, 10.4; P < 0.01) and medical comorbidity (OR, 2.0; P < 0.02) and disease activity (OR, 4.0; P < 0.01) were risk factors of reduced HRLS, whereas in UC, only disease activity (OR, 6.6; P < 0.01) predicted reduced HRLS. Conclusions: To improve GLS and HRLS in inflammatory bowel disease, both the treatment of bowel disease and medical and psychiatric comorbidity are necessary. Strengthening of social Support is an additional way to promote GLS.