Impact of age at diagnosis on college adjustment in students with inflammatory bowel disease

Little is known about the experience of college students with inflammatory bowel disease (IBD) and the factors associated with transition readiness, academic adjustment, and alternatively, those associated with academic hardship and attrition.

Survey-based cross-sectional studies, including those addressing disease-specific quality of life (Short Inflammatory Bowel Disease Questionnaire), IBD disease activity (Harvey-Bradshaw Index and Patient Simple Clinical Colitis Activity Index), college adjustment (Student Adjustment to College Questionnaire), transition readiness (Transition Readiness Assessment Questionnaire [TRAQ]), and self-efficacy (inflammatory bowel disease self-efficacy scale).

The surveys were completed by 135 participants (59 IBD patients [37 Crohn's disease and 22 ulcerative colitis]; 76 controls). Participants with IBD were matched with respect to age, gender, academic status, and involvement in extracurricular activities. Participants endorsed making important college decisions associated with their disease and were significantly more likely to live at home (p < 0.001), take fewer credits (p < 0.02), and more likely than controls to have their education interrupted (p < 0.0005). Participant age at diagnosis was an important factor associated with college adjustment, with older age at diagnosis having the most association with the ability to adjust to college life. As expected based on prior literature, TRAQ scores suggested better than expected transition readiness in college students with IBD (p < 0.0006) with subscores revealing that female students are better at managing health issues and daily activities.

IBD affects the college experience of students-patients significantly and can have life-long implications. Newly diagnosed students are at risk of poor college adjustment impacting academic performance and their future success. Male students are at greater risk than female students of poor transitioning to adult IBD care. Students with IBD should receive enhanced and age-specific modern IBD care.