Lang, Brian M; Ledergerber, Martina; Jordi, Sebastian Bruno Ulrich; Krupka, Niklas; Biedermann, Luc; Schreiner, Philipp; Juillerat, Pascal; Wyss, Jacqueline; Vavricka, Stephan R; Zeitz, Jonas; von Känel, Roland; Rogler, Gerhard; Beerenwinkel, Niko; Misselwitz, Benjamin (2023). Because I'm happy - positive affect and its predictive value for future disease activity in patients with inflammatory bowel diseases: a retrospective cohort study. Therapeutic advances in gastroenterology, 16(17562848231179335), p. 17562848231179335. Sage 10.1177/17562848231179335
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lang-et-al-2023-because-i-m-happy-positive-affect-and-its-predictive-value-for-future-disease-activity-in-patients-with.pdf - Published Version Available under License Creative Commons: Attribution-Noncommercial (CC-BY-NC). Download (1MB) | Preview |
BACKGROUND
While the detrimental impact of negative emotions on the clinical course of inflammatory bowel disease (IBD) and quality of life has been extensively investigated, evidence for a potential impact of positive emotions is scarce.
OBJECTIVES
We aim to analyse contributing factors of positive affect and their predictive value for disease course in IBD patients.
DESIGN
In this retrospective cohort study, epidemiological, psychosocial and IBD disease characteristics of Swiss IBD cohort study patients were analysed longitudinally.
METHODS
Epidemiological, psychosocial and disease characteristics were extracted from the database of the Swiss IBD cohort study. Participants' positive emotions were assessed cross-sectionally with the seven-item Marburg questionnaire (range 1-6) addressing positive affect in different aspects of daily life. Predictors of positive emotions were identified by linear regression. The quantitative longitudinal impact of positive emotions on the further disease course was analysed using a multivariable Cox proportional hazards model.
RESULTS
Among 702 IBD patients, those reporting more positive emotions were found to have significantly less intense medical treatment, less pain and fewer depressive symptoms (p < 0.05). A higher percentage of variability in positive emotions was explained by pain (36%) and depressive symptoms (13%) than by epidemiological characteristics (0.3%), or characteristics of IBD and its treatment (2.4%). Patients with higher levels of positive emotions (score > 3.5) experienced longer flare-free survival, also after adjusting for confounders (adjusted hazard ratio: 0.39, p < 0.05).
CONCLUSIONS
The absence of pain and depressive symptoms were the strongest drivers for high positive affect. Higher scores of positive affect were associated with longer disease-free survival in IBD patients.
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