An epidemiological study of ulcerative colitis and regional enteritis among adults in Baltimore—III: Psychological and possible stress-precipitating factors

Abstract

One hundred and fifty-eight ulcerative colitis and 69 regional enteritis patients hospitalized in Baltimore were interviewed about a variety of events which might be considered disruptive emotionally or psychologically. The events studied included social and cultural discontinuities (e.g. differences between spouse's and patient's religion or education), geographic mobility, job changes and possible stressful events occurring shortly before the patient's hospitalization. The reports of such events by the ulcerative colitis and regional enteritis patients (study groups) differed very little from the reports by a group of 105 irritable colon patients and by a sample of 735 persons in the general population (comparison groups). The study groups had a somewhat different family background (in nativity and birth order) than the comparison groups, but it is not clear what part these factors play in the development of the diseases studied. The methods used in this field study may not be entirely appropriate to determining the role of psychological factors in ulcerative colitis and regional enteritis but the findings are in agreement with those where more intensive psychiatric interviewing was used. Careful, controlled studies employing a variety of methods and comparison groups are necessary in order to assess the importance of psychological factors in these diseases.