Do Patients with Crohns Disease Differ Psychologically from Those with Ulcerative Colitis

According to German authors, the psychological pattern of patients with ulcerative colitis is more uniform, older patients with Crohn's disease appeared more depressed whereas younger individuals look more active but have pronounced dependency conflicts [20]. North and Alpers reported that Crohn's disease, unlike ulcerative colitis, may be statistically associated with lifetime psychiatric disorders [21] whereas Porcelli et al. found no significant difference as far the capacity to express emotions between ulcerative colitis and Crohn's disease patients [22]. The same finding, i.e. no significant differences among the two types of IBD, was reported by others when looking at the of state anxiety and depression even if both Crohn's disease and ulcerative colitis patients looked more anxious and depressed than controls [23]. The degree of correlation between psychosocial stress and subsequent increased disease was found to be higher in patients with Crohn's disease than in those with ulcerative colitis [24] whereas the latter group did worse than Crohn's subjects when obsessive-compulsive symptoms were compared in 44 children [25].

Alpers, reviewing the published studies, found that Crohn's disease, unlike ulcerative colitis, may be statistically associated with lifetime psychiatric disorders [21]. In a more recent report, when looking at depression scores and health-related quality of life, Guthrie et al. found no difference between Crohn's disease and ulcerative colitis patients [26]. As to lev els of anxiety, defensive strategies and self-image, patients with colonic Crohn's disease were more childishly concrete and more alexithymic, i.e. unable recognise and describe emotions, than patients with ileocolonic Crohn's disease.

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