Ulcerative colitis (UC) is a chronic relapsing inflammatory bowel disease.
Psychological factors such as depression and stress are under debate to contribute to the risk of relapse.
The impact of mucosal healing to reduce the risk of relapse had not been studied prospectively.
Dr Jost Langhorst and colleagues identified whether depression and stress increase and mucosal healing reduces the risk of clinical relapse in patients with UC in clinical remission.
Patients in clinical remission were followed prospectively for 1 year, or less if they relapsed.
|Male gender was also predictive for a relapse|
|Inflammatory Bowel Disease|
Endoscopy and histology score and long-term perceived stress were measured at baseline.
Mucosal healing was defined by a Mayo Endoscopy score of 0–1.
The team measured depression (Hospital Anxiety and Depression Scale) and acute perceived stress (Cohen Perceived Stress Scale) at baseline and after 1, 3, 6, 9, and 12 months.
A time-dependent multivariate Cox regression model determined the predictors of time to relapse.
The research team included 75 patients into the final analysis, of which 28 relapsed.
The team found that short-term stress at the last visit before relapse, and male gender, but not baseline mucosal healing, baseline long-term stress, and depression at the last visit before relapse were predictive for a relapse.
Dr Langhorst's team concludes, "Short-term stress but not depression nor mucosal healing was predictive for the risk of relapse in patients with ulcerative colitis in clinical remission."
"Larger multicentre studies are necessary to confirm our findings."