Self-perception and adjustment to Crohn's disease in emerging and young adults: The clinical and psychosocial associated factors

Abstract

Objectives

Crohn's disease is often declared in early adulthood, between 15 and 30 years old, a period marked by important psychosocial transitions. Yet, the diagnosis’ impact during this sensitive developmental period remains little explored. The aim was to assess whether self-perception and adjustment to illness differ depending on age (emerging adults versus young adults) and time since diagnosis (< 2 years vs > 2 years), and explore associations between self-perception, clinical and psychosocial variables.

Method

In this cross-sectional study, participants were emerging adults (18–25 years old) and young adults (26–35 years old) with Crohn's disease, recruited via an association and communities of patients online. They answered an online survey assessing their disease activity, illness perception, coping strategies, social support and self-perception.

Results

Fifty-two participants (18–35 years old) were included. Mann-Whitney's U test showed that compared to those diagnosed for over two years, those recently diagnosed perceive symptoms as more severe and frequent, with a greater emotional impact, and rely more on catastrophizing and distraction when coping with pain. Multiple regressions showed those reporting higher emotional response to symptoms, less perceived guidance and support in their self-esteem, present poorer self-worth. Those relying more on catastrophizing, less on ignorance, reporting severe joint pain and less concern about their disease present an altered perception of their appearance.

Conclusion

Crohn's disease may have a significant impact on young adults, particularly the first years after diagnosis. Transactional and self-regulation variables seem to essentially be associated with self-perception's outcomes. Interventions focusing on illness representations, pain management and acceptance of uncertainty may allow a better integration of the disease in their life and self-perception.