Exploration of personality in the patients with the inflammatory bowel disease

Lela Trikoš; Njegica Jojić; Goran Knežević; Marko Živanović; Petar Svorcan; Aleksandar Jovanović

doi:10.2298/VSP171006023T

Lela Trikoš University Clinical Hospital Centre Zvezdara, Psychiatric Hospital, Belgrade, Serbia
Njegica Jojić University Clinical Hospital Centre Zvezdara, Clinical Department of Gastroenterology and Hepatology, Belgrade, Serbia
Goran Knežević University of Belgrade, Faculty of Philosophy, Department of Psychology, Belgrade, Serbia
Marko Živanović University of Belgrade, Faculty of Philosophy, Department of Psychology, Belgrade, Serbia
Petar Svorcan University of Belgrade, Faculty of Philosophy, Faculty of Medicine, Belgrade, Serbia
Aleksandar Jovanović Clinical Centre of Serbia, Clinic for Psychiatry, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP171006023T

Keywords: inflammatory bowel diseases, colitis ulcerative, crohn disease, personality, surveys and questionnaires

Abstract

Abstract

Background/Aim. Inflammatory bowel diseases (IBD), which include the ulcerative colitis (UC) and the Crohn’s disease (CD), are chronic diseases, the course of which is under the influence of numerous psychosocial factors. The aim of this study was the exploration of the personality traits of patients with IBD. Methods. This cross-sectional study has been conducted at the University Clinical Hospital Centre Zvezdara, Belgrade, Serbia. The study involved 150 patients suffering from IBD of both genders, out of which 50.7% and 49.3% of the patients suffering from UC and CD, respectively. The main inclusion criteria were: age 18 to 65 years and confirmed the diagnosis of UC or CD in remission. The sociodemographic and disease related data were collected from the hospital medical records. The personality traits related data were collected using the self-report forms of The Revised NEO Personality Inventory (NEO PI–R) and the inventory for the Assessment of Dysregulation (DELTA 10). Results. At the domain-level, the significant differences between IBD sample and normative sample were found in the Neuroticism (p < 0.01) and the Disintegration (p < 0.01). At the facet-level, the IBD sample scored significantly higher than the normative sample on Anxiety (p < 0.01), Assertiveness (p < 0.01), Tender-Mindedness (p < 0.01) and Dutifulness (p < 0.01), and the significantly lower scores on Warmth (p < 0.01), Excitement Seeking (p < 0.01), Positive Emotion (p < 0.01), Actions (p < 0.01), and on the all facets of Disintegration except Depression, Somatoform Dysregulation and Social Anhedonia (p < 0.01). The differences between UC and CD were found only at the facet-level. The facets that adds the most predictive power to the discriminative function is the General Executive Impairment, followed by Warmth, Self-Discipline, Depression and Mania. Conclusion. The IBD patients showed to differ from the general population in terms of basic personality structure at the domain-level, and at the facet-level. The differences between the UC and CD patients can be found only at the facet-level. Screening of the personality traits and early detection of the IBD patients who are at a greater risk of mental disorders and bad psychosocial functioning can enable their adequate prevention and improve the course of the disease.

Author Biographies

Goran Knežević, University of Belgrade, Faculty of Philosophy, Department of Psychology, Belgrade, Serbia

Professor of Faculty of Philosophy

Petar Svorcan, University of Belgrade, Faculty of Philosophy, Faculty of Medicine, Belgrade, Serbia

Director of University Clinical Hospital Centre Zvezdara, Belgrade, Serbia

Professor of Faculty of Medicine, University of Belgrade, Serbia

References

REFERENCES

Ananthakrishnan AN. Epidemiology and risk factors for IBD. Nat Rev Gastroenterol Hepatol 2015; 12(4): 205–17.

Burisch J, Pedersen N, Čuković-Čavka S, Brinar M, Kaimakliotis I, Duricova D, et al. East–West gradient in the incidence of in-flammatory bowel disease in Europe: the ECCO-EpiCom in-ception cohort. Gut 2013; 63(4): 588–97.

Magro F, Gionchetti P, Eliakim R, Ardizzone S, Armuzzi A, Barreiro-de Acosta M, et al. Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis. Part 1: Definitions, Diagnosis, Extra-intestinal Manifestations, Pregnancy, Cancer Surveillance, Surgery, and Ileo-anal Pouch Disorders. J Crohns Colitis 2017; 11(6): 649–70.

Gomollón F, Dignass A, Annese V, Tilg H, Van AG, Lindsay JO, et al. 3rd European Evidence-based Consensus on the Diag-nosis and Management of Crohn’s Disease 2016: Part 1: Diagnosis and Medical Management. J Crohns Colitis 2016; 11(1): 3–25.

Engel G. The need for a new medical model: a challenge for biomedicine. Science 1977; 196(4286): 129–36.

Van Assche G, Dignass A, Bokemeyer B, Danese S, Gionchetti P, Moser G, et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis Part 3: Special situations. J Crohns Colitis 2013; 7(1): 1–33.

Knowles S, Tribbick D, Salzberg M, Ftanou M, Connell W, Macrae F, et al. Prevalence of mental health disorders in inflammatory bowel disease: an Australian outpatient cohort. Clin Exp Ga-stroenterol 2015; 8: 197–204.

Vidal A, Gómez-Gil E, Sans M, Portella MJ, Salamero M, Piqué JM, et al. Health-related quality of life in inflammatory bowel disease patients: the role of psychopathology and personality. Inflamm Bowel Dis 2008; 14(7): 977–83.

Huyard C, Derijks L, Haak H, Lieverse L. Intentional Nonadherence as a Means to Exert Control. Qual Health Res 2017; 27(8): 1215–24.

Đurić-Jočić D, Džamonja-Ignjatović T, Knežević G. Neo Pi-R: Ap-plication and interpretation Belgrade: Center for Applied Psy-chology; 2004. (Serbian)

Costa PT, McCrae RR. Domains and Facets: Hierarchical Per-sonality Assessment Using the Revised NEO Personality In-ventory. J Pers Assess 1995; 64(1): 21–50.

Ferguson E. Personality is of central concern to understand health: towards a theoretical model for health psychology. Health Psychol Rev 2013; 7(Suppl 1): S32–S70.

Knežević G, Lazarević LB, Bosnjak M, Purić D, Petrović B, Teovanović P, et al. Towards a personality model encompassing a Disintegration factor separate from the Big Five traits: A me-ta-analysis of the empirical evidence. Pers Individ Differ 2016; 95: 214–22.

Knezevic G, Savic D, Kutlesic V, Opacic G. Disintegration: A re-conceptualization of psychosis proneness as a personality trait separate from the Big Five. J Res Personal 2017; 70: 187–201.

Sirois FM. Who Looks Forward to Better Health? Personality Factors and Future Self-Rated Health in the Context of Chronic Illness. Int J Behav Med 2015; 22(5): 569–79.

Morys JM, Kaczówka A, Jeżewska M. Assessment of selected psychological factors in patients with inflammatory bowel dis-ease. Prz Gastroenterol 2016; 11(1): 47–53.

Bannaga AS, Selinger CP. Inflammatory bowel disease and an-xiety: links, risks, and challenges faced. Clin Exp Gastroenterol 2015; 8: 111–7.

Coenen S, Weyts E, Ballet V, Noman M, van Assche G, Vermeire S, et al. Identifying predictors of low adherence in patients with inflammatory bowel disease. Eur J Gastroenterol Hepatol 2016; 28(5): 503–7.

Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut 2006; 55(6): 749–53.

Travis SP, Stange EF, Lémann M, Oresland T, Chowers Y, Forbes A, et al. European Crohn’s and Colitis Organisation. European evidence based consensus on the diagnosis and management of Crohn’s disease: current management. Gut 2006; 55(Suppl 1): i16–35.

Lahiff C, Safaie P, Awais A, Akbari M, Gashin L, Sheth S, et al. The Crohn’s disease activity index (CDAI) is similarly elevated in patients with Crohn’s disease and in patients with irritable bowel syndrome. Aliment Pharmacol Ther 2013; 37(8): 786–94.

Costa PT, Maccrae RR. Revised NEO personality inventory (NEO PI-R) and NEO five-factor inventory (NEO-FFI): Professional manual. Odessa, FL: Psychological Assessment Resources; 1992.

Knežević G, Džamonja-Ignjatović T, Đurić-Jočić D. The five factor model of personality Belgrade: Center for Applied Psychology; 2004. (Serbian)

Hakulinen C, Elovainio M, Pulkki-Råback L, Virtanen M, Ki-vimäki M, Jokela M. Personality and depressive symptoms: in-dividual participant meta-analysis of 10 cohort studies. De-press Anxiety 2015; 32(7): 461–70.

Kim S, Stewart R, Bae K, Kim S, Shin I, Hong YJ, et al. Influences of the Big Five personality traits on the treatment response and longitudinal course of depression in patients with acute coronary syndrome: A randomised controlled trial. J Affect Disord 2016; 203: 38–45.

Barlow DH, Sauer-Zavala S, Carl JR, Bullis JR, Ellard KK. The Nature, Diagnosis, and Treatment of Neuroticism: Back to the Future. Clin Psychol Sci 2014; 2(3): 344–65.

Ormel J, Bastiaansen A, Riese H, Bos EH, Servaas M, Ellenbogen M, et al. The biological and psychological basis of neuroticism: Current status and future directions. Neurosci Biobehav Rev 2013; 37(1): 59–72.

Hengartner MP, van der Linden D, Bohleber L, von Wyl A. Big five personality traits and the general factor of personality as moderators of stress and coping reactions following an emergency alarm on a swiss university campus. Stress Health 2016; 33(1): 35–44.

Nazarinasab M, Pakseresht S, Fadai M. Investigating the Mental Health Status of Patients with Ulcerative Colitis and its Rela-tionship with Clinical and Demographic Variables. Int J Phar-ma Res Health Sci 2017; 5(2): 1632–6.

Mikocka-Walus A, Knowles SR, Keefer L, Graff L. Controversies revisited: a systematic review of the comorbidity of depression and anxiety with inflammatory bowel diseases. Inflamm Bowel Dis 2016; 22(3): 752–62.

Brooks AJ, Rowse G, Ryder A, Peach EJ, Corfe BM, Lobo AJ. Sys-tematic review: psychological morbidity in young people with inflammatory bowel disease - risk factors and impacts. Aliment Pharmacol Ther 2016; 44(1): 3–15.

Häuser W, Moser G, Klose P, Mikocka-Walus A. Psychosocial is-sues in evidence-based guidelines on inflammatory bowel dis-eases: A review. World J Gastroenterol 2014; 20(13): 3663–71.

Barlow DH, Ellard KK, Sauer-Zavala S, Bullis JR, Carl JR. The Origins of neuroticism. Perspect Psychol Sci 2014; 9(5): 481–96.

Hentschel S, Eid M, Kutscher T. The Influence of Major Life Events and Personality Traits on the Stability of Affective Well-Being. J Happ Studies 2017; 18(3): 719–41.

Anglim J, Grant S. Predicting Psychological and Subjective Well-Being from Personality: Incremental Prediction from 30 Facets Over the Big 5. J Happ Studies 2016; 17(1): 59–80.

Sutin AR, Zonderman AB, Ferrucci L, Terracciano A. Personality Traits and Chronic Disease: Implications for Adult Personality Development. J Gerontol B Psychol Sci Soc Sci 2013; 68(6): 912–20.

Boye B, Jahnsen J, Mokleby K, Leganger S, Jantschek G, Jantschek I, et al. The INSPIRE study: are different personality traits re-lated to disease-specific quality of life (IBDQ) in distressed patients with ulcerative colitis and Crohn’s disease? Inflamm Bowel Dis 2008; 14(5): 680–6.