I have several friends who have Crohn’s Disease or UC. One thing that is common in my admittedly small sample is that they are all kind of nutty. Made me wonder if there is a pychological component to they diseases. An internet search shows that there is some thoughts in the medical community about this. I was wondering if anyone on the Dope has first hand knowledge on the subject.
What is UC?
ulcerative colitis
First let’s make sure to NOT confuse IBD (inflammatory bowel disease, generally divided into Crohn’s disease or Ulcerative Colitis based on the pathology) with IBS (irritable bowel syndrome).
The former is a very well-established disease entity with definite pathology fairly clearly demonstrable on biopsy. Severe bleeding, intestinal perforation, and malnutrition are common consequences of this disease, along with chronic abdominal pain. Management often requires very potent medications like corticosteroids or other strong immune modulators. This disease is life-threatening; people die of the complications of it. Many folks with this illness are seriously ill a lot, often requiring hospitalization and surgeries, and this affects their psychosocial functioning. But I’m not aware of any studies indicating that they have a higher rate of mental illness than other people with similarly morbid chronic diseases.
The latter (irritable bowel syndrome) is a cluster of symptoms generally involving nausea, abdominal cramping or bloating, and intermittent/alternating diarrhea or constipation, without bleeding or changes seen on most examinations of the colon. Management generally involves high fiber diet, counselling, behavior modification, and a few drugs which may change how the bowel nerves transmit pain signals. This syndrome is not life-threatening in and of itself. This is the population that has a high association with personality disorder diagnoses.
They are separate diseases which share certain symptoms and are often discussed in the same articles. I know two sisters. One has UC and the other has Crohn’s.
QtM my small sample including the two sisters do have IBD not IBS, both Crohn’s and UC. A google search of the terms with “psychological component” comes up with many cites some saying there is a link others saying its an outmoded idea. I am not qualified to tell if the cites are reputable or to interpret it so I posted the question here.
Understood. In my (admittedly brief) review of the current literature I don’t see anything that makes me think psychological components play any role larger than typical for chronic disease in general with this diagnosis.
What is not in question is the nuttiness of the women I know.
What Qad said (of course!).
Here is a free full text recent review of the topic (click on the pdf link for full text). But at least note this sentence in the abstract:
“The few studies that address the issue of anxiety and depression as risk factors for (inflammatory bowel disease) do not yet provide enough information to support definite conclusions”.
In other words, it’s still not clear what comes first: anxiety/depression or the inflammatory bowel disease.
That said, informally medical people will often mention someone having a ‘Crohn’s personality’, but as QtM points out, this may represent personality traits anyone in chronic pain might develop. I have seen a technologist comment that the next patient won’t turn out to have Crohn’s simply based on a 2 minute interaction with them - and be right.
Maybe it’s the illness that makes them nutty, not the other way around.
A couple of them (the sisters) I have known since high school. Long before either developed symptoms. So no.
Crazy peoples get sick too.
Nutty people get sick too.
Or as a psychiatrist friend of mine puts it: Some people have ticks, some have fleas. Some have both ticks and fleas.
ETA: Scooped again by the insightful Jackmannii.
Where they diagnosed by a licensed medical practitioners?
To Be clear, I’m not talking about whether the nuttiness has been diagnosed in anyway; I’m wondering if the bowel troubles have been evaluated by licensed medical professionals.
Absolutely. In fact one is on full disability because of Crohns. Two others that I know well are able to function better but have been dealing with it for years. The one that is a very good friend of mine says that her UC tends to flair up at times of great stress.
I think we need to distinguish between the questions: does mental problems (ie “nuttiness”) present as a risk factor for these diseases, or does it exacerbate these illness (or both?).
Emotional stress seems to exacerbate these illnesses (painting with a broad brush). Whether or not it is a risk factor seems to be up for debate.
Pretty much my question. To be clear as far as I know those I am talking about are not severely mentally ill. Some problems with anxiety, depression, insomnia, odd phobias. But not to the extent that they can’t function in the real world normally. Overall Iwouldn’twanttodatethemitis.
Everyone I know with IBD (me and a woman I used to work with) has their head pretty well on their shoulders. I wouldn’t say we’re the absolute happy-go-luckiest people on the planet, but that doesn’t strike me as too healthy either.
–Cliffy
I have on good authority that you are both fucked in the head. Sorry.