Mediating effect of health anxiety in patients with inflammatory bowel disease between disease perception and...

This study aimed to examine the mediating role of health anxiety in the relationship between illness perception and self-management behavior among individuals with inflammatory bowel disease(IBD). A total of 326 patients with IBD who were treated at our hospital between June 2023, and June 2025 were enrolled. Data were collected using a general information questionnaire, the Brief Illness Perception Questionnaire (BIPQ), the Short Health Anxiety Inventory (SHAI), and the IBD Self-Management Behavior Scale. Among the 326 participants, the mean BIPQ, SHAI, and self-management scores were 47.31 (SD = 12.71), 28.89 (SD = 8.81), and 67.79 (SD = 20.48), respectively. Self-management scores were significantly lower among patients older than 60 years and those with a disease duration of more than five years, whereas higher scores were observed among patients with a monthly income greater than 5,000 yuan (all P < 0.05). BIPQ scores were negatively correlated with self-management behavior (r = -0.660) and positively correlated with SHAI scores (r = 0.417). SHAI scores were negatively correlated with self-management behavior (r = -0.501). Mediation analysis showed that the BIPQ scores had both a direct negative association with self-management behavior (coefficient = -1.180, accounting for 82.69% of the total effect) and an indirect association mediated through health anxiety (coefficient = -0.246, accounting for 17.31% of the total effect). The 95% bias-corrected bootstrap confidence interval for the indirect effect did not include zero. Patients with IBD in this cohort exhibited predominantly negative illness perceptions, elevated health anxiety, and suboptimal self-management behaviors. The findings suggest that illness perception is associated with self-management behavior both directly and indirectly through the mediating role of health anxiety. These cross-sectional findings suggest the potential value of integrating psychological assessment and intervention into routine IBD care to improve patient self-management and long-term health outcomes. However, causal inferences cannot be drawn from the present data.