Collective Psychology and Behavioral Characteristics of Patients with Inflammatory Bowel Disease: A Single Cohort Study

Abstract

Background: We previously treated patients with inflammatory bowel disease (IBD) using color therapy as part of projective psychotherapy and found differences in preferred colors selected in an imagined stressful situation between patients with ulcerative colitis (UC) and those with Crohn’s disease (CD). In this study, we investigated differences in color selection among UC patients, CD patients, and healthy volunteers (HVs). More precisely, formal analysis using a projective technique was performed to evaluate their emotional characteristics when coping with stress, and egogram analysis was performed to investigate their collective psychological characteristics and behavioral characteristics as social selves. Methods: Eighty-three HVs, 70 UC patients, and 71 CD patients were shown a sheet displaying images of bottles each containing 2 horizontally separated compartments filled in the same color or different colors. The preferred colors selected under imagined psychological stress (loneliness) were analyzed using a projection approach to investigate the emotional characteristics of the inner self. The Tokyo University Egogram New Version II (TEG^®II) was then used to analyze collective psychological characteristics and behavioral characteristics as social selves in the HV, UC, and CD groups. Results: Comparison of all 3 groups with the χ² test showed that more participants chose calm colors in the CD group than in the HV and UC groups, while more participants chose stimulating colors in the UC group than in the CD group (p < 0.01). Analysis of TEG^®II results with one-way analysis of variance and then with the Tukey-Kramer multiple comparison test revealed differences in collective psychological characteristics and behavioral characteristics in all 3 groups. Comparing scores for 5 types of ego states (Critical Parent, Nurturing Parent, Adult, Free Child, and Adapted Child) revealed that more participants in the CD group had a low Critical Parent score than in the HV group (p < 0.05). More participants in the IBD group had a low Nurturing Parent score than in the HV group (CD vs. HV, p < 0.01; UC vs. HV, p < 0.05). Significantly more participants in the UC group had a higher Adult score than in the HV or CD group (each p < 0.01). Conclusions: The psychological characteristics of patients with IBD differ depending on the type of disease (i.e., CD vs. UC). Management based on such differences should be provided for patients with each disease type.