Post-traumatic stress disorder symptoms in Crohn's disease patients following surgery: a cross-sectional study

Crohn's disease (CD) involves chronic intestinal inflammation, frequently requiring surgical intervention. CD patients undergoing surgery often undergo increased psychological stress. One of the outcomes of persistent stress is post-traumatic stress (PTS), a mental health concern associated with immune dysregulation and disease progression. However, research on PTS in CD patients following surgery is limited.

This study aims to explore the incidence and associated factors of PTS in CD patients after surgery.

A retrospective cross-sectional study.

This retrospective cross-sectional study investigated 124 patients with CD who underwent surgery between September 2015 and July 2023. Online questionnaires, including the PTSD checklist, 5th edition (PCL-5), Crohn's and Colitis Knowledge Score, and Short Generic Patient Experience Questionnaire, were employed. The potential risk factors for PTS were evaluated through univariate and multivariate analyses.

Among sampled individuals, 44 patients (35.5%) were classified into the PTS group. The patients in the PTS group had a significant lower monthly income (27.3% vs 8.8%, p = 0.006), higher Harvey-Bradshaw Index score (3.82 ± 3.25 vs 2.31 ± 2.50, p = 0.009), more occurrence of perianal lesions (36.4% vs 20%, p = 0.047), higher ostomy (36.4% vs 20%, p = 0.047), and laparotomy rates (31.8% vs 15%, p = 0.028). Through logistic regression analysis, we identified postoperative complications and a history of multiple surgeries as independent risk factors for PTS (p = 0.002 and p = 0.019, respectively).

PTS is common in CD patients requiring bowel resection and multiple surgeries, as well as other postoperative related factors, can invoke psychological and mental stress. These findings provide insights for formulating medical service strategies that prioritize patient mental health.