Stigmatisation and resilience in inflammatory bowel disease

Abstract

Inflammatory bowel disease, which includes Crohn's disease and ulcerative colitis, is an immune-mediated, chronic relapsing disorder characterised by severe gastrointestinal symptoms that dramatically impair patients' quality of life, affecting psychological, physical, sexual, and social functions. As a consequence, patients suffering from this condition may perceive social stigmatisation, which is the identification of negative attributes that distinguish a person as different and worthy of separation from the group. Stigmatisation has been widely studied in different chronic conditions, especially in mental illnesses and HIV-infected patients. There is a growing interest also for patients with inflammatory bowel disease, in which the possibility of disease flare and surgery-related issues seem to be the most important factors determining stigmatisation. Conversely, resilience represents the quality that allows one to adopt a positive attitude and good adjustments despite adverse life events. Likewise, resilience has been studied in different populations, age groups, and chronic conditions, especially mental illnesses and cancer, but little is known about this issue in patients with inflammatory bowel disease, even if this could be an interesting area of research. Resilience can be strengthened through dedicated interventions that could potentially improve the ability to cope with the disease. In this paper, we focus on the current knowledge of stigmatisation and resilience in patients with inflammatory bowel disease.

Keywords: Crohn’s disease; Quality of life; Ulcerative colitis.

Fig. 1

Flow diagram of paper selection that was performed through Pubmed for articles written in English. The main research question regarded the evaluation of stigmatisation and resilience in patients suffering from inflammatory bowel disease. The medical subject heading terms “Crohn’s disease” and “ulcerative colitis” were also used. More general articles dealing with how to define and how to measure stigmatisation and resilience were used to provide background for the purpose of the review

Fig. 2

Summary of the most relevant features of stigmatisation and resilience and their influencing factors. Low resilience may favour stigmatisation, whilst resistance to stigma may strengthen resilience. Inflammatory bowel disease is burdened by a number of disease-specific issues that favour social stigmatisation and may affect resilience