AccScience Publishing / EJMO / Online First / DOI: 10.36922/ejmo.8596
ORIGINAL RESEARCH ARTICLE

Understanding ulcerative colitis: Insights from locus of control, expressed emotion, and quality of life

Shaini Suraj1,2* Anand Prakash3,4 Pradeep Patil5 Deepa Sangolkar6
Show Less
1 Department of Psychology, Amity Institute of Behavioural and Allied Sciences, Amity University Rajasthan, Jaipur, Rajasthan, India
2 Adjuvant Faculty, School of Allied Health Sciences, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Nagpur, India
3 Department of Clinical Psychology, Amity Institute of Clinical Psychology, Amity University Rajasthan, Jaipur, Rajasthan, India
4 Department of Clinical Psychology and Behavioural Sciences, Xavier University School of Medicine, Faculty of Medicine, Aruba, Netherlands
5 Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, Maharashtra, India
6 Department of Psychiatry, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Nagpur, Maharashtra, India
Submitted: 19 January 2025 | Revised: 15 February 2025 | Accepted: 24 February 2025 | Published: 24 March 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

Patients suffering from ulcerative colitis (UC) experience periods of remission and relapse that could affect their mental health. The study aimed to use logistic regression analysis in a novel way by incorporating locus of control (LOC), expressed emotion (EE), and quality of life (QOL) as predictors of UC. This study involved 100 individuals with UC and 100 healthy controls, focusing on LOC groups (internal, chance, powerful others), EE, and QOL. This model also helped to better understand how these psychological variables interact to predict the likelihood of a UC diagnosis. The results revealed all significant predictors. EE corelates positively with UC probability (Estimate: 0.191, p < 0.001), whereas QOL corelates inversely (Estimate: −0.150, p < 0.001). The model had a classification accuracy of 82.5%. While trends in LOC groups warrant further exploration, the model contributes to understanding psychological risk factors in UC. This research suggests the potential use of these factors as predictive markers. It adds to the existing literature on how psychological factors influence health results, offering practical implications for clinical care and guiding future investigations to improve the management and comprehension of UC.

Keywords
Expressed emotions
Locus of control
Psychological variables
Quality of life
Regression analysis
Ulcerative colitis
Funding
None.
Conflict of interest
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
References
  1. Ungaro R, Mehandru S, Allen PB, Peyrin-Biroulet L, Colombel JF. Ulcerative colitis. Lancet. 2017;389(10080): 1756-1770. doi: 10.1016/S0140-6736(16)32126-2

 

  1. Ordás I, Eckmann L, Talamini M, Baumgart DC, Sandborn WJ. Ulcerative colitis. Lancet. 2012;380(9853):1606-1619. doi: 10.1016/S0140-6736(12)60150-0

 

  1. Kobayashi T, Siegmund B, Le Berre C, et al. Ulcerative colitis. Nat Rev Dis Primers. 2020;6(1):74. doi: 10.1038/s41572-020-0205-x

 

  1. Danese S, Fiocchi C. Ulcerative colitis. N Engl J Med. 2011;365(18):1713-1725. doi: 10.1056/NEJMra1102942

 

  1. Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med. 1987;317(26):1625-1629. doi: 10.1056/NEJM198712243172603

 

  1. Gajendran M, Loganathan P, Jimenez G, et al. A comprehensive review and update on ulcerative colitis. Dis Mon. 2019;65(12):100851. doi: 10.1016/j.disamonth.2019.02.004

 

  1. Park SC, Jeen YT. Current and emerging biologics for ulcerative colitis. Gut Liver. 2015;9(1):18-27. doi: 10.5009/gnl14226

 

  1. Kayal M, Shah S. Ulcerative colitis: Current and emerging treatment strategies. J Clin Med. 2019;9(1):94. doi: 10.3390/jcm9010094

 

  1. Mohammed N, Subramanian V. Clinical relevance of endoscopic assessment of inflammation in ulcerative colitis: Can endoscopic evaluation predict outcomes? World J Gastroenterol. 2016;22(42):9324-9332. doi: 10.3748/wjg.v22.i42.9324

 

  1. Lynch WD, Hsu R. Ulcerative colitis. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2018. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459282 [Last accessed on 2024 Oct 16].

 

  1. Rotter JB. Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr. 1966;80(1):1-28. doi: 10.1037/h0092976

 

  1. Kornbluth A, Sachar DB, Practice Parameters Committee of the American College of Gastroenterology. Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee [Published correction appears in Am J Gastroenterol. 2010;105(3):500]. Am J Gastroenterol. 2010;105(3):501-524. doi: 10.1038/ajg.2009.727

 

  1. Goddard N. Chapter 5 - Psychology. In: Wright P, Stern J, Phelan M, editors. Core Psychiatry. 3rd ed. United States: W. B. Saunders; 2012. p. 63-82. doi: 10.1016/B978-0-7020-3397-1.00005-7

 

  1. Almond S, Knapp M, Francois C, Toumi M, Brugha T. Relapse in schizophrenia: Costs, clinical outcomes and quality of life. Br J Psychiatry. 2004;184:346-351. doi: 10.1192/bjp.184.4.346

 

  1. Kandel ER. A new intellectual framework for psychiatry. Am J Psychiatry. 1998;155(4):457-469. doi: 10.1176/ajp.155.4.457

 

  1. Weaver IC, Meaney MJ, Szyf M. Maternal care effects on the hippocampal transcriptome and anxiety-mediated behaviors in the offspring that are reversible in adulthood. Proc Natl Acad Sci U S A. 2006;103(9):3480-3485. doi: 10.1073/pnas.0507526103

 

  1. Amaresha AC, Venkatasubramanian G. Expressed emotion in schizophrenia: An overview. Indian J Psychol Med. 2012;34(1):12-20. doi: 10.4103/0253-7176.96149

 

  1. Miklowitz DJ, Goldstein MJ, Doane JA, et al. Is expressed emotion an index of a transactional process? I. Parents’ affective style. Fam Process. 1989;28(2):153-167. doi: 10.1111/j.1545-5300.1989.00153.x

 

  1. Strachan AM, Feingold D, Goldstein MJ, Miklowitz DJ, Nuechterlein KH. Is expressed emotion an index of a transactional process? II. Patient’s coping style. Fam Process. 1989;28(2):169-181. doi: 10.1111/j.1545-5300.1989.00169.x

 

  1. Wuerker AM. Relational control patterns and expressed emotion in families of persons with schizophrenia and bipolar disorder. Fam Process. 1994;33(4):389-407. doi: 10.1111/j.1545-5300.1994.00389.x

 

  1. Wuerker AM. Communication patterns and expressed emotion in families of persons with mental disorders. Schizophr Bull. 1996;22(4):671-690. doi: 10.1093/schbul/22.4.671

 

  1. Janke KH, Klump B, Gregor M, Meisner C, Haeuser W. Determinants of life satisfaction in inflammatory bowel disease. Inflamm Bowel Dis. 2005;11(3):272-286. doi: 10.1097/01.mib.0000160809.38611.f7

 

  1. Bernstein CN, Singh S, Graff LA, Walker JR, Miller N, Cheang M. A prospective population-based study of triggers of symptomatic flares in IBD. Am J Gastroenterol. 2010;105(9):1994-2002. doi: 10.1038/ajg.2010.140

 

  1. Singh S, Graff LA, Bernstein CN. Do NSAIDs, antibiotics, infections, or stress trigger flares in IBD? Am J Gastroenterol. 2009;104(5):1298-1314. doi: 10.1038/ajg.2009.15

 

  1. Langhorst J, Hofstetter A, Wolfe F, Häuser W. Short-term stress, but not mucosal healing nor depression was predictive for the risk of relapse in patients with ulcerative colitis: A prospective 12-month follow-up study. Inflamm Bowel Dis. 2013;19(11):2380-2386. doi: 10.1097/MIB.0b013e3182a192ba

 

  1. Levenstein S, Prantera C, Varvo V, et al. Stress and exacerbation in ulcerative colitis: A prospective study of patients enrolled in remission. Am J Gastroenterol. 2000;95(5):1213-1220. doi: 10.1111/j.1572-0241.2000.02012.x

 

  1. Rotter JB. Social Learning and Clinical Psychology. New York: Prentice-Hall; 1954.

 

  1. Dubinsky MC, Watanabe K, Molander P, et al. Ulcerative colitis narrative global survey findings: The impact of living with ulcerative colitis-patients’ and physicians’ view. Inflamm Bowel Dis. 2021;27(11):1747-1755. doi: 10.1093/ibd/izab016

 

  1. López-Sanromán A, Carpio D, Calvet X, et al. Perceived emotional and psychological impact of ulcerative colitis on outpatients in Spain: UC-LIFE survey. Dig Dis Sci. 2017;62(1):207-216. doi: 10.1007/s10620-016-4363-3

 

  1. Exarchos G, Gklavas A, Metaxa L, Papaconstantinou I. Quality of life of ulcerative colitis patients treated surgically with proctocolectomy and J-pouch formation: A comparative study before surgery and after closure of the defunctioning ileostomy. Ann Gastroenterol. 2018;31(3):350-355. doi: 10.20524/aog.2018.0247

 

  1. Peppas S, Pansieri C, Piovani D, et al. The brain-gut axis: Psychological functioning and inflammatory bowel diseases. J Clin Med. 2021;10(3):377. doi: 10.3390/jcm10030377

 

  1. Gracie DJ, Hamlin PJ, Ford AC. The influence of the brain-gut axis in inflammatory bowel disease and possible implications for treatment. Lancet Gastroenterol Hepatol. 2019;4(8):632-642. doi: 10.1016/S2468-1253(19)30089-5

 

  1. Husain A, Triadafilopoulos G. Communicating with patients with inflammatory bowel disease. Inflamm Bowel Dis. 2004;10(4):444-451. doi: 10.1097/00054725-200407000-00020

 

  1. Ko CW, Singh S, Feuerstein JD, et al. AGA clinical practice guidelines on the management of mild-to-moderate ulcerative colitis. Gastroenterology. 2019;156(3):748-764. doi: 10.1053/j.gastro.2018.12.009

 

  1. Boye B, Jahnsen J, Mokleby K, et al. The INSPIRE study: Are different personality traits related to disease-specific quality of life (IBDQ) in distressed patients with ulcerative colitis and Crohn’s disease? Inflamm Bowel Dis. 2008;14(5):680-686. doi: 10.1002/ibd.20367

 

  1. Engström I, Lindquist BL. Inflammatory bowel disease in children and adolescents: A somatic and psychiatric investigation. Acta Paediatr Scand. 1991;80(6-7):640-647. doi: 10.1111/j.1651-2227.1991.tb11923.x

 

  1. Bahmani S, Mujemnari AK. Comparing coping strategies in people between inflammatory bowel disease and healthy people in terms of health locus of control. J Res Health. 2023;13:209-218.

 

  1. Robertson N, Gunn S, Piper R. Psychological and social factors associated with pain in inflammatory bowel disease: A systematic literature review of the evidence in adult and pediatric studies. Crohns Colitis 360. 2019;1(1):otz003. doi: 10.1093/crocol/otz003

 

  1. Robertson N, Gunn S, Piper R. The experience of self-conscious emotions in inflammatory bowel disease: A thematic analysis. J Clin Psychol Med Settings. 2022;29(2):344-356. doi: 10.1007/s10880-021-09778-0

 

  1. Atanassova A, Georgieva A. Circulating miRNA- 16 in inflammatory bowel disease and some clinical correlations - a cohort study in Bulgarian patients. Eur Rev Med Pharmacol Sci. 2022;26(17):6310-6315. doi: 10.26355/eurrev_202209_29655

 

  1. Knowles SR, Graff LA, Wilding H, Hewitt C, Keefer L, Mikocka-Walus A. Quality of life in inflammatory bowel disease: A systematic review and meta-analyses-part I. Inflamm Bowel Dis. 2018;24(4):742-751. doi: 10.1093/ibd/izx100

 

  1. Vivan TK, Santos B, Santos CH. Quality of life of patients with inflammatory bowel disease. J Coloproctol. 2017;37:279-284. doi: 10.1016/j.jcol.2017.06.009

 

  1. Iglesias-Rey M, Barreiro-de Acosta M, Caamaño-Isorna F, et al. Psychological factors are associated with changes in the health-related quality of life in inflammatory bowel disease. Inflamm Bowel Dis. 2014;20(1):92-102. doi: 10.1097/01.MIB.0000436955.78220.bc

 

  1. Cooney R, Tang D, Barrett K, Russell RK. Children and young adults with inflammatory bowel disease have an increased incidence and risk of developing mental health conditions: A UK population-based cohort study. Inflamm Bowel Dis. 2024;30(8):1264-1273. doi: 10.1093/ibd/izad169

 

Share
Back to top
Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing