Stress resilience in adolescence and subsequent inflammatory bowel disease risk in adulthood

• Objective: Psychosocial stress may increase the risk of systemic inflammation. As subclinical inflammatory bowel disease (IBD) – Crohn's disease (CD) and ulcerative colitis (UC) – can exist over many years, stress may result in conversion to symptomatic disease through its inflammatory influence. Low stress resilience may result in a greater risk of chronic stress arousal due to the normal stresses of everyday life. We investigated the association of stress resilience in adolescence with subsequent risk of IBD, independent of other risks.Design: Swedish registers provided information on 242,999 men who underwent military conscription assessments in late adolescence (1969 – 1976) with follow-up until 2009 (up to age 57 years). Stress resilience was evaluated through semi-structured interviews. Cox regression assessed the association of stress resilience with CD (n = 1,082) and UC (1,922) in separate models. The models included adjustment for socioeconomic characteristics in childhood and height, BMI and erythrocyte sedimentation rate (indicating inflammation) as indicators of subclinical disease activity in adolescence.Results: Low stress resilience in adolescence was associated with increased risk of IBD after adjustment for potential confounding factors, with hazard ratios (95% confidence intervals) of 1.50 (1.24-1.81) and 1.21 (1.06-1.39), for CD and UC respectively. The associations attenuated somewhat by further adjustment for markers of subclinical disease to 1.38 (1.14-1.67) and 1.19 (1.04-1.36).Conclusions: low stress resilience is associated with an elevated subsequent IBD risk. Stress may increase the risk of symptomatic IBD, although there is also evidence of a potentially modest effect of subclinical disease activity on stress resilience.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Psykiatri (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Psychiatry (hsv//eng)

Nyckelord

Psychiatry

Psykiatri

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