Original Contribution

The American Journal of Gastroenterology (2007) 102, 122–131; doi:10.1111/j.1572-0241.2006.00931.x

Stressful Life Events as a Risk Factor for Inflammatory Bowel Disease Onset: A Population-Based Case–Control Study

Eric Lerebours MD1,2, Corinne Gower-Rousseau MD1, Veronique Merle MD2, Franck Brazier MD3, Stephane Debeugny MD1, Raymond Marti MD1, Jean Louis Salomez MD1, Marie France Hellot SCD2, Jean Louis Dupas MD3, Jean Frederic Colombel MD4, Antoine Cortot MD4 and Jacques Benichou MD, PhD2

  1. 1Registre des Maladies Inflammatoires Chroniques de l'Intestin (EPIMAD), Service d'Epidémiologie et de Santé Publique, Hôpital Calmette, CHU de Lille, 59037 Lille Cedex, France
  2. 2EPIMAD, Centre de Rouen, Rouen University Hospital, Rouen Cedex, France
  3. 3EPIMAD, Centre d'Amiens, Hôpital Nord, CHU d'Amiens, 80054 Amiens Cedex, France
  4. 4EPIMAD, Service d'Hépato-Gastroentérologie, Hôpital Huriez, CHU de Lille, 59037 Lille Cedex, France

Correspondence: Prof Eric Lerebours, Service d'Hépato-Gastroentérologie et Registre EPIMAD, Hôpital Charles Nicolle, CHU de Rouen, 76031 Rouen Cedex, France.

Received 19 December 2005; Accepted 24 July 2006.

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Abstract

BACKGROUND AND AIMS:

 

Stress is often perceived by patients with inflammatory bowel disease (IBD) as the leading cause of their disease. The aim of this study was to assess whether stress, evaluated through life event (LE) occurrence, is associated with IBD onset.

METHODS:

 

Incident cases of IBD, including 167 patients with Crohn's disease (CD) and 74 with ulcerative colitis (UC), were compared with two control groups, one of 69 patients with acute self-limited colitis (ASLC) and another of 255 blood donors (BDs). Stress was assessed using Paykel's self-questionnaire of LEs. Only LEs occurring within 6 months before the onset of symptoms in IBD cases and ASLC controls and before blood donation in BD controls were registered. Anxiety and depression were assessed using Bate's and Beck's questionnaires, respectively.

RESULTS:

 

In univariate analysis, occurrence of LEs was more frequent in the 6-month period prior to diagnosis in CD cases than in UC cases or either control group. After adjustment for depression and anxiety scores as well as other characteristics such as smoking status and sociodemographic features, this association appeared no longer significant. No associations were noted between occurrence of LEs and onset of UC relative to controls.

CONCLUSIONS:

 

Despite its separate association with CD, LE occurrence does not appear to be an independent risk factor for IBD onset.