Abstract

ObjectivesPeople with Crohn's disease and ulcerative colitis (inflammatory bowel disease: IBD), commonly experience high levels of depressive symptoms and stress and low levels of subjective wellbeing (SWB). Mindfulness is increasingly considered an adjuvant IBD treatment. The relationships between depression, disease symptoms and mindfulness have not previously been considered within the theory of SWB homeostasis. This theory states that SWB is normally maintained by a homeostatic system around a setpoint range but can fail when psychological challenges dominate consciousness. This study explored the relationship among SWB and patient-reported psychological and IBD symptoms and investigated whether mindfulness practice is independently associated with SWB homeostatic resilience.DesignThis cross-sectional study recruited participants through online IBD support groups.MethodsParticipants (n = 739; 62% Crohn's disease) detailed symptoms of depression and stress, patient-reported disease symptoms, and regularity of mindfulness practice.ResultsThe sample had significantly lower SWB (hedges g = −0.98) than normative data. A logistic regression found mindfulness practice doubled the Crohn's disease participants' odds of reporting SWB within the normal homeostatic range, after controlling for psychological, physical, and demographic variables (OR 2.15, 95% CI: 1.27, 3.66). A one-point increase of patient-reported bowel symptoms reduced the participant's odds of reporting SWB in the normal homeostatic range by about a third (OR 0.66, 95% CI: 0.50, 0.85). However, the influence of mindfulness or disease symptoms on SWB was not observed for people with ulcerative colitis.ConclusionThese findings provide initial evidence for an association between mindfulness and SWB homeostatic resilience in a clinical population.

Highlights

  • The umbrella term “inflammatory bowel disease” (IBD) refers to two chronic, gastrointestinal conditions: ulcerative colitis (UC) and Crohn’s disease (CD)

  • This study provides some evidence that individuals with IBD are at risk of being unable to retain SWB homeostasis and indicates that this population requires specific support to shore up SWB resilience in the light of expected disease-related physical and psychological challenges

  • This study provides preliminary evidence that mindfulness could support SWB homeostasis, for people with CD

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Summary

Introduction

The umbrella term “inflammatory bowel disease” (IBD) refers to two chronic, gastrointestinal conditions: ulcerative colitis (UC) and Crohn’s disease (CD). IBD is increasing in prevalence across ethnic groups and geographies [2]. The interaction of internal microbial factors and external environmental factors in IBD is the subject of many studies, but a clear picture is yet to emerge. The disease’s unpredictability, the uncertain nature of flares and their triggers, and its socially awkward symptoms contribute to significant psycho-social anxieties for people with IBD. These range from specific stressors relating to always needing to be near a toilet [4], to general worries such as body image or the effect of IBD on one’s future [5]. The psychological impacts of living with IBD are increasingly being investigated, with depression and psychological stress key factors [6–11]

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