Defence Styles, Alexithymia, Illness Perceptions, and HRQOL in IBD

Background/aims: The role of psychological factors in the development and progression of Inflammatory Bowel Disease (IBD) is not completely understood. Several studies have suggested that defence styles, alexithymia and illness perceptions each individually influence the way a person experiences their disease, thereby impacting on health-related quality of life (HRQoL). The study aimed to expand the knowledge base and assist in offering a better understanding of the variables by examining the extent of the relationship that defence styles, alexithymia and illness perceptions have with health-related quality of life. Methods: The study employed a survey design and used opportunity sampling to recruit participants with IBD from a Regional Crohn’s and Colitis support group and outpatient Gastroenterology clinics. Participants were given questionnaire packs containing measures and were asked to post them back to the researcher. Results: The study found that defence styles, alexithymia and illness perceptions were all correlated with HRQoL. However, multiple regression analysis revealed that the alexithymia subgroup, “difficulty identifying feelings” and the neurotic defence style were the only variables that had a significant relationship with HRQoL. It was also found that females and people that were recently diagnosed also had a worse HRQoL. Conclusion: These findings suggest that females who are recently diagnosed with IBD and have difficulty identifying feelings as well as a reliance on neurotic defence styles have a worse HRQoL. Therefore, screening of this population and the introduction of psychotherapy to assist with emotional care might be beneficial in improving HRQoL. Practitioner Points: + Gender, time since diagnosis, neurotic defence styles and difficulties identifying own emotional experiences found to potentially contribute to poorer HRQoL. + Therefore, therapy using emotional identification, especially when a person is just diagnosed, might be beneficial to people with IBD. - The study used a cross-sectional design, therefore it is not possible to infer causation. Future research should use a prospective design.