Table 2

 Summary of studies assessing association between stress and disease exacerbations in inflammatory bowel disease (IBD)

CD, Crohn’s disease; UC, ulcerative colitis; IBD, inflammatory bowel disease; PSQ, perceived stress questionnaire.
Adverse life events
    Retrospective analysis of life events preceding disease onset60 patients with UCPositive associationFava72
    Retrospective 2 year analysis of life events preceding disease relapse70 patients with CD, 44 patients with UCPositive correlation with relapse in CD but not UCPaar71
    Analysis of life events preceding relapse30 patients with UCPositive associationBach77
    Prospective 6 months of life events preceding exacerbation124 patients with IBDPositive association with no lag timeDuffy78
    Prospective 2 year analysis of life events preceding disease relapse32 patients with IBDNo associationNorth73
    Prospective 1 year analysis of adverse life events and disease relapse108 patients with IBDNo associationVon Wietersheim74
    Retrospective analysis of incidence of adverse life events in preceding 12 months in patients with UC and healthy controls122 patients with UCGreater incidence of life events in preceding 12 months in patients with UCTocchi79
    1 year prospective analysis of life events and disease relapse60 patients with UCPositive association of life events and relapse in the following monthBitton75
    Retrospective 16 year analysis of prevalence of IBD in patients who lost a child and controls21 062 parents who lost a childNo increased prevalence of IBDLi80
    Prospective 2 year analysis of depression and life events and disease relapse18 patients with CDPositive association of depression and (less so) life events with disease relapse simultaneously and at 8–12 weeksMardini76
Chronic perceived stress
    Prospective 2 year analysis of PSQ score and disease exacerbation62 patients with UCIncreased risk of exacerbation with increased PSQ scoreLevenstein81
    Analysis of mucosal endoscopic appearance and PSQ score46 patients with asymptomatic UCIncreased PSQ score in patients with mucosa abnormalitiesLevenstein82
Daily stress
    Prospective 28 days of daily stress with self rated disease severity10 patients with CDPositive association in some individualsGarrett83
    Prospective 1 year analysis of stress with disease exacerbation11 patients with IBDPositive associationGreene84