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Stressful events increase risk of relapse of ulcerative colitis.

ORLANDO, FLA. -- The greater the number of stressful events, the greater the likelihood of relapse within a month in ulcerative colitis patients, a recent study suggests.

Of 60 patients studied for 1 year or until relapse, 22 relapsed. The average time from study entry to relapse was 202 days, Maida J. Sewitch, Ph.D., reported at the annual meeting of the American Psychosomatic Society.

After controlling for age, gender, and number of previous relapses, a significant association was noted between relapse within a month and the number of stressful events experienced in the prior month (hazard ratio 1.26 per event), said Dr. Sewitch of McGill University, Montreal.

The patients--37 women and 23 men with an average age of 39 years--had clinically and endoscopically inactive ulcerative colitis, and all had experienced at least one prior relapse. They were evaluated at a baseline visit and every 3 months or until relapse, and throughout the study period they provided monthly self reports on stressful events (using a psychiatric epidemiology index), on psychological distress (using the Symptom Checklist 90-Revised), and on perceived stress (using the Perceived Stress Scale), said Dr. Sewitch.

"The findings indicate that clinicians should inquire about recent stressful events in their patients given that these events may be markers for increased risk of relapse," she commented. Stressed patients may benefit from more intense maintenance medical therapy to help prevent future exacerbations, and behavioral interventions designed to decrease stress could also improve clinical outcomes, she noted.

Such interventions in ulcerative colitis patients should be further evaluated in randomized controlled trials, Dr. Sewitch concluded.


Tallahassee Bureau
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Title Annotation:Psychosomatic Medicine
Author:Worcester, Sharon
Publication:Clinical Psychiatry News
Geographic Code:1USA
Date:Apr 1, 2004
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