Defense mechanisms in inflammatory bowel disease

Area of Science:

• Gastroenterology
• Psychiatry
• Psychology

Background:

• Psychiatric disturbances and personality features are implicated in inflammatory bowel disease (IBD).
• The role of defense mechanisms in IBD formation, course, and prognosis remains under-explored.
• This study investigates the association between defense styles, ego mechanisms, and IBD, including ulcerative colitis and Crohn's disease.

Purpose of the Study:

• To determine if specific defense styles and ego mechanisms of defense are associated with inflammatory bowel disease.
• To compare the defense profiles of patients with Crohn's disease and ulcerative colitis.

Main Methods:

• Seventy-six IBD outpatients (39 Crohn's disease, 33 ulcerative colitis, 4 intermediate) participated.
• Psychometric assessments included the Symptom Distress Checklist (SCL-90-R), Defense Style Questionnaire (DSQ), and Hostility and Direction of Hostility Questionnaire (HDHQ).

Main Results:

• Crohn's disease patients showed a more immature defensive profile (maladaptive action, consumption, pseudo-altruism) compared to ulcerative colitis patients.
• These differences were statistically significant and independent of demographic and clinical factors.
• Disease activity positively correlated with defensive profiles in both IBD types; no significant psychiatric symptom differences were observed.

Conclusions:

• Crohn's disease patients exhibit a distinct, more immature defensive profile than ulcerative colitis patients.
• Psychologically mature IBD patients experienced fewer relapses and surgical interventions.
• Personality aspects, particularly defense mechanisms, appear to influence patients' adaptation to inflammatory bowel disease.