The main determinants of disability in IBD and its relationship to optimism

Background and aim: inflammatory bowel disease (IBD) is a potentially disabling chronic disease that negatively affects many aspects of the patients' life. This study aimed to assess the IBD-associated disability in the outpatient setting and analyze how optimism and disability are related. Methods: a cross-sectional study was performed via the application of the Portuguese version of the IBD-Disability Index (PT-IBD-DI) and the Revised Life Orientation Test (PT-LOT-R) for the assessment of disability and optimism, respectively. Results: a total of 143 patients were analyzed, the mean age was 38 +/- 13 years, 50% were females and 51% had UC. The mean PT-IBD-DI score was 22 +/- 17, which was classified as follows: 0-20: no disability; 20-35: mild disability; 35-50: moderate disability; and 50-100: severe disability. There were no significant differences between Crohn's disease (CD) and ulcerative colitis (UC) (p = 0.944). Female gender (p = 0.001), low level of education (p = 0.018), the number of days out of work (p = 0.020), rheumatologic manifestations (p = 0.005), the number of comorbidities (p = 0.002), the use psychotropic drugs (p = 0.043) and low PT-LOT-R scores (p < 0.001) were associated with higher IBD-DI scores according to the univariate analysis. According to the linear regression analysis, only female sex (p = 0.001), the number of comorbidities (p = 0.034) and low PT-LOT-R scores (p < 0.001) were associated with higher PT-IBD-DI scores. Optimism correlated inversely with PT-IBD-DI scores ( = -0.345, p < 0.001). Conclusion: IBD outpatients reported low levels of IBD-disability (mild disability: PT-IBD-DI score 20-35). Comorbidities and psychological factors (optimism) emerged as the main predictive factors of increased disability, reinforcing the importance of a multidisciplinary approach for these patients.