Traue H C, Kosarz P
Department of Medical Psychology, University of Ulm, Germany.
Int J Behav Med. 1999;6(2):101-19. doi: 10.1207/s15327558ijbm0602_1.
In a 84-day long-term study involving 20 patients with active Crohn's disease, the relation between daily stress and symptomatology was investigated. The diagnoses were verified clinically, endoscopically, radiologically, and histologically. The Crohn symptomatology was assessed by a daily symptoms diary. The degree of everyday stress was measured with a daily hassles scale. Additionally, the disease activity was measured 4 times. The data were evaluated using a time series analysis method following the ARIMA model (autoregressive integrative moving average model), which takes the autocorrelation of the data into account. In 55% of the cases, a significant correlation between daily hassles and disease activity was found. Patients whose symptomatology responded to stress did not differ from nonresponders in age, duration of the disease, disease activity, frequency of abdominal surgery, partnership situation, or statements concerning their average level of daily hassles. Disease activity in general did not change during the observation period. A verified influence of daily hassles on Crohn symptomatology as a rule occurs on the same day with time lag 0. According to these results, the group of Crohn's disease patients is not homogenous. The widely held assumption that daily hassles influence the symptomatology cannot generally be confirmed. Variations may result from different ways of coping with stress. Long-term effects of daily hassles on the disease are not clear.
在一项为期84天的长期研究中，涉及20名活动性克罗恩病患者，研究了日常压力与症状之间的关系。诊断通过临床、内镜、放射学和组织学检查得以证实。克罗恩病症状通过每日症状日记进行评估。日常压力程度用每日烦恼量表进行测量。此外，疾病活动度测量了4次。数据采用基于自回归积分滑动平均模型（ARIMA模型）的时间序列分析方法进行评估，该模型考虑了数据的自相关性。在55%的病例中，发现每日烦恼与疾病活动度之间存在显著相关性。症状对压力有反应的患者与无反应的患者在年龄、疾病持续时间、疾病活动度、腹部手术频率、伴侣状况或关于其日常烦恼平均水平的表述方面并无差异。总体而言，疾病活动度在观察期内未发生变化。通常，每日烦恼对克罗恩病症状的已证实影响会在同一天出现，时间滞后为0。根据这些结果，克罗恩病患者群体并非同质。普遍认为每日烦恼会影响症状这一假设通常无法得到证实。差异可能源于应对压力的不同方式。每日烦恼对疾病的长期影响尚不清楚。
