Öznur Özlem, Utz Sandra, Schlee Christoph, Langhorst Jost
Department for Integrative Medicine, Medical Faculty, University of Duisburg-Essen, Essen, Germany.
Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany.
Brain Behav Immun Health. 2025 Apr 30;46:101006. doi: 10.1016/j.bbih.2025.101006. eCollection 2025 Jul.
One of the major factors for deterioration and relapse in inflammatory bowel diseases is chronic (psychological) stress. Aim of the present study was to compare the reaction of N = 33 patients with Crohn's disease that either participated in a multimodal stress management and lifestyle modification program (n = 19) or not (n = 14) to the induction of acute stress after the day-clinic by using the validated instrument of the Trier Social Stress Test (TSST). A mixed-methods approach using self-reported stress perception (questionnaire, qualitative interviews), diary records, and blood samples was applied. Immune and endocrine measures of stress were collected before and repeatedly after stress exposure. Analysis of the blood samples indicated changes in leucocyte and platelet levels only in the intervention group. Differences in the reaction to acute stress might be explained by a significant reduction in perceived (chronic) stress levels in the intervention group compared to baseline (p = .004), whereas there was no change in the control group (p = .472). Diary records (during the day-clinic) showed a notable increase in the number of relaxation techniques (p < .001) and meditative movements (p > .001) performed in the intervention group compared to the control group. In the qualitative interviews (of the intervention group), patients reported a reduction in stress in their daily lives and in acute stressful situations as a result of using the newly learned specific stress management techniques. The observed improvements in stress management (questionnaire, qualitative interviews), indicated by the reduction in perceived stress, and immune function, suggested by the blood sample results, highlight the potential of integrating multimodal stress management and lifestyle changes into the treatment approach for Crohn's disease patients. Further research is warranted to explore the long-term effects and the multiple mechanisms underlying these observed changes.
炎症性肠病病情恶化和复发的主要因素之一是慢性（心理）压力。本研究的目的是，使用经过验证的特里尔社会应激测试（TSST）工具，比较33例克罗恩病患者在日间门诊后对急性应激诱导的反应，这些患者中19例参加了多模式压力管理和生活方式改变计划，另14例未参加。采用了一种混合方法，包括自我报告的压力感知（问卷调查、定性访谈）、日记记录和血液样本。在应激暴露前后多次收集压力的免疫和内分泌指标。血液样本分析表明，只有干预组的白细胞和血小板水平发生了变化。干预组与基线相比，感知（慢性）压力水平显著降低（p = 0.004），而对照组没有变化（p = 0.472），这可能解释了两组对急性应激反应的差异。日记记录（在日间门诊期间）显示，与对照组相比，干预组进行的放松技巧（p < 0.001）和冥想运动（p > 0.001）的次数显著增加。在（干预组的）定性访谈中，患者报告说，由于使用了新学到的特定压力管理技巧，他们在日常生活和急性应激情况下的压力有所减轻。压力管理方面观察到的改善（问卷调查、定性访谈），表现为感知压力的降低，以及血液样本结果表明的免疫功能改善，突出了将多模式压力管理和生活方式改变纳入克罗恩病患者治疗方法的潜力。有必要进一步研究，以探索这些观察到的变化的长期影响和潜在的多种机制。
