Generational differences in illness perception among adults with inflammatory bowel disease: a multicenter cross-sectional study.

Abstract

Background: Illness perception plays a key role in shaping coping strategies, treatment adherence, and quality of life in individuals with inflammatory bowel disease (IBD). Despite growing interest in patient-centered care, evidence on generational differences in illness perception among adults with IBD remains limited.

Objectives: To examine differences in illness perception across generational cohorts of adults with IBD and to explore potential implications for generation-sensitive clinical care.

Methods: A multicenter cross-sectional study was conducted between April and June 2024 across nine Italian IBD units. Adult outpatients with Crohn's disease or ulcerative colitis completed the Brief Illness Perception Questionnaire. Participants were categorized into Baby Boomers, Generation X, Millennials, or Generation Z based on year of birth. Between-group comparisons were performed, and propensity score-weighted analyses were applied to adjust for clinical and sociodemographic variables.

Results: A total of 387 patients were included in the primary analysis. Significant differences in illness perception emerged across generational cohorts. Baby Boomers reported more threatening illness perceptions, characterized by greater perceived consequences, concern, chronicity, and overall illness threat. Younger cohorts reported lower perceived burden and higher perceived personal control. These patterns were broadly consistent after adjustment for measured sociodemographic, clinical, molecular, and therapeutic variables.

Conclusion: Illness perception varies meaningfully across generational cohorts in adults with IBD. Incorporating age-cohort-specific perspectives into clinical communication and care planning may enhance patient engagement and support more tailored, effective management strategies.