Modifiable Psychological Factors are Associated With Clusters of Pain, Fatigue, Fecal Incontinence, and Irritable Bowel Syndrome-Type Symptoms in Inflammatory Bowel Disease: A Latent Profile Analysis - Scorecard - MDSpire
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Modifiable Psychological Factors are Associated With Clusters of Pain, Fatigue, Fecal Incontinence, and Irritable Bowel Syndrome-Type Symptoms in Inflammatory Bowel Disease: A Latent Profile Analysis
Clinical Scorecard: Psychological Factors Subject to Change Linked to Symptom Clusters of Pain, Fatigue, Fecal Incontinence, and IBS-like Symptoms in Inflammatory Bowel Disease: A Latent Profile Investigation
At a Glance
Category
Detail
Condition
Inflammatory Bowel Disease (IBD) with symptoms of pain, fatigue, fecal incontinence, and IBS-like symptoms
Key Mechanisms
Cognitive behavioral factors including negative symptom perceptions, all-or-nothing and avoidance behaviors, depression, and anxiety influencing symptom perception and perpetuation
Target Population
People with IBD experiencing fatigue, pain, and fecal urgency/incontinence symptoms, including those in clinical remission
Care Setting
Integrated medical and psychological care settings, including digital symptom interventions
Key Highlights
Three symptom profiles identified: Moderate (50%), High (40%), and Severe (10%) symptom burden.
Psychological factors such as depression, anxiety, negative symptom perceptions, and maladaptive behaviors significantly increase risk of high/severe symptom profiles.
Symptoms often persist despite clinical remission and are linked to cognitive behavioral factors rather than inflammation alone.
Guideline-Based Recommendations
Diagnosis
Assess symptom clusters of fatigue, pain, and fecal incontinence alongside clinical and inflammatory markers.
Evaluate psychological factors including depression, anxiety, and cognitive behavioral patterns in patients with IBD.
Management
Combine medical treatment targeting inflammation with cognitive behavioral interventions to address symptom perpetuation.
Implement tailored interventions such as the IBD-BOOST program focusing on modifying negative symptom perceptions and maladaptive behaviors.
Provide early identification and support for patients exhibiting high or severe symptom profiles.
Monitoring & Follow-up
Regularly monitor symptom severity and psychological status regardless of inflammatory disease activity.
Track changes in cognitive and behavioral factors to guide intervention adjustments.
Risks
Ignoring psychological contributors may lead to persistent symptoms despite controlled inflammation.
Female gender, comorbidity, longer disease duration, and presence of IBS-type symptoms increase risk of severe symptom burden.
Patient & Prescribing Data
Adults with IBD experiencing fatigue, pain, fecal incontinence, and IBS-like symptoms, including those in remission
Addressing modifiable cognitive behavioral factors alongside standard medical care can improve symptom management and quality of life.
Clinical Best Practices
Incorporate psychological assessment into routine IBD care to identify patients at risk of high symptom burden.
Use cognitive behavioral therapy principles to target negative symptom perceptions and avoidance behaviors.
Adopt an integrated care model combining medical and psychological treatments for comprehensive symptom management.
by Vari Wileman, Joseph Chilcot, Christine Norton, Ailsa Hart, Laura Miller, Imogen Stagg, Natasha Seaton, Richard Pollok, Qasim Aziz, Rona Moss-Morris
