Biopsychosocial model of inflammatory bowel diseases: The impact of multisystem comorbidity and mental health on patients' quality of life.
Abstract
Objective
Aim: To determine the association between the presence of comorbid pathology, the frequency and nature of extraintestinal manifestations, and changes in different health-related quality-of-life domains in patients with inflammatory bowel diseases. PATIENTS AND
Methods
Materials and Methods: A total of 248 patients with inflammatory bowel disease were examined, including 117 with Crohn's disease (Group I) and 131 with ulcerative colitis (Group II). The control group consisted of 82 apparently healthy individuals. Patients received inpatient treatment at healthcare institutions in Ivano-Frankivsk. The diagnosis was established in accordance with current clinical guidelines. Quality of life was assessed using the IBDQ questionnaire, while comorbidity was evaluated using the Cumulative Illness Rating Scale (CIRS) and the Charlson Comorbidity Index.
Results
Results: Patients with IBD demonstrated a statistically significant decrease in the overall IBDQ quality-of-life index compared with the control group (119.3±10.48 in Crohn's disease and 127.4±8.3 in ulcerative colitis versus 198.5±12.6; p<0.001), corresponding to a reduction of 39.9% and 35.9%, respectively. The most pronounced impairments were observed in the systemic and social domains, particularly in patients with Crohn's disease. A high prevalence of comorbid pathology was identified (73% in Crohn's disease and 82% in ulcerative colitis), along with a substantial burden of extraintestinal manifestations, characterized by predominant multisystem involvement in Crohn's disease and mental and vascular disorders in ulcerative colitis. The Charlson Comorbidity Index was higher in Crohn's disease (3.14±0.27) compared with ulcerative colitis (2.93±0.14; p≤0.005), indicating a less favorable prognosis in this patient group.
Conclusion
Conclusions: Inflammatory bowel diseases are associated with a marked deterioration in quality of life and a high comorbid burden, substantiating the need for a comprehensive multidisciplinary approach to the management of such patients.