The role of distress and pain catastrophizing on the health-related quality of life of children with inflammatory bowel disease.

OBJECTIVES Inflammatory bowel disease (IBD) can be particularly challenging during the pediatric age with a relevant impact on patient's health-related quality of life (HRQoL). Disease activity accounts for only a small part of the variability in HRQoL, and psychological factors can play a significant role. We aimed to evaluate the impact of patient's distress and pain catastrophizing on children and adolescents with IBD. METHODS We prospectively recruited children aged 8-18 with IBD and recorded demographic and disease characteristics. Patients answered questionnaires on HRQoL (IMPACT III), distress (Distress Thermometer, DT), and pain catastrophizing (Pain Catastrophizing Scale - Children, PCS-C). Univariate and multivariate regression models analysis were used to evaluate correlations between patients's characteristics, disease activity, distress, pain catastrophizing and HRQoL. RESULTS Seventy-one patients were enrolled (median age 13.6, 49.3% Crohn's disease, 50.7% ulcerative colitis). Median HRQoL, DT and PCS-C scores were 78.6 (IQR 68.0-87.1), 3.0 (1.0-5.0), and 12.0 (4.0-23.0) respectively. Patient's distress and pain catastrophizing levels significantly correlated with HRQoL. Pain catastrophizing had the strongest impact on HRQoL (Spearman correlation coefficient, ρ 0.73), followed by distress (ρ 0.67), and ulcerative colitis severity (ρ 0.67). The DT and the PCS-C scores were significantly associated (ρ 0.46). CONCLUSIONS Distress and pain catastrophizing have a significative impact on HRQoL in young patients with IBD. Physicians should recognise the role of these psychological factors and consider cognitive-behavioural therapy to optimise the patient's health.