Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Department of Gastroenterology and Hepatology, University Hospital Zurich and Zurich University, Zurich, Switzerland.
J Gastroenterol. 2022 Nov;57(11):848-866. doi: 10.1007/s00535-022-01902-7. Epub 2022 Jul 28.
The bidirectional "gut-brain axis" has been implicated in the pathogenesis of inflammatory bowel diseases (IBD). While the influence of stress and depressive symptoms on IBD is well-characterized, the role of personality remains insufficiently investigated.
Personality was assessed in 1154 Swiss IBD cohort study (SIBDCS) patients via the NEO-Five-Factor Inventory (NEO-FFI) as well as in 2600 participants of the population-based CoLaus¦PsyCoLaus cohort study (NEO-FFI-revised). The NEO-FFI subcomponents activity, self-reproach and negative affect were associated with higher IBD disease activity and were combined to a NEO-FFI risk score. This risk score was validated and its effect on clinical IBD course and psychological endpoints was analysed in time-to-event and cumulative incidence analyses.
In time-to-event analyses, a high NEO-FFI risk score was predictive for the clinical endpoints of new extraintestinal manifestation [EIM, adjusted hazard ratio (aHR) = 1.64, corrected p value (q) = 0.036] and two established composite flare endpoints (aHR = 1.53-1.63, q = 0.003-0.006) as well as for the psychological endpoints depressive symptoms (aHR = 7.06, q < 0.001) and low quality of life (aHR = 3.06, q < 0.001). Furthermore, cumulative incidence analyses showed that patients at high NEO-FFI risk experienced significantly more episodes of active disease, new EIMs, one of the flare endpoints, depressive episodes and low disease-related quality of life. Personalities of IBD patients showed only minor differences from the general population sample (Pearson's r = 0.03-0.14).
Personality assessed by the NEO-FFI contained considerable predictive power for disease recurrence, depressive symptoms and low quality of life in IBD patients. Nevertheless, the personalities of IBD patients did not substantially differ from the general population.
双向“肠脑轴”与炎症性肠病（IBD）的发病机制有关。虽然压力和抑郁症状对 IBD 的影响已经得到充分的描述，但人格的作用仍未得到充分的研究。
通过 NEO-Five-Factor Inventory（NEO-FFI）评估了瑞士 IBD 队列研究（SIBDCS）中的 1154 名患者（NEO-FFI）和基于人群的 CoLaus¦PsyCoLaus 队列研究（NEO-FFI-修订版）中的 2600 名参与者的人格。NEO-FFI 的子成分活动、自责和消极情绪与更高的 IBD 疾病活动有关，并被合并为 NEO-FFI 风险评分。该风险评分在时间事件和累积发生率分析中进行了验证，并分析了其对临床 IBD 病程和心理终点的影响。
在时间事件分析中，高 NEO-FFI 风险评分可预测新的肠外表现（EIM）的临床终点（调整后的危险比[aHR]=1.64，校正后的 p 值[q]=0.036）和两个已建立的复合爆发终点（aHR=1.53-1.63，q=0.003-0.006），以及心理终点抑郁症状（aHR=7.06，q<0.001）和低生活质量（aHR=3.06，q<0.001）。此外，累积发生率分析表明，处于高 NEO-FFI 风险的患者经历了更多的疾病活跃期、新的 EIM、一个爆发终点、抑郁发作和低疾病相关的生活质量。IBD 患者的人格与一般人群样本仅有较小的差异（皮尔逊 r=0.03-0.14）。
NEO-FFI 评估的人格对 IBD 患者的疾病复发、抑郁症状和生活质量有相当大的预测能力。然而，IBD 患者的人格与一般人群并没有实质性的不同。
