The personality traits activity, self-reproach, and negative affect jointly predict clinical recurrence, depressive symptoms, and low quality of life in inflammatory bowel disease patients
Authors: Jordi Sebastian Bruno Ulrich , Lang Brian Matthew , Wyss Jacqueline , Auschra Bianca , Yilmaz Bahtiyar , Krupka Niklas , Greuter Thomas , Schreiner Philipp , Biedermann Luc , Preisig Martin , von Känel Roland , Rogler Gerhard , Begré Stefan , Misselwitz Benjamin ,   The Swiss IBD cohort study group, Anderegg Claudia , Bauerfeind Peter , Beglinger Christoph , Begré Stefan , Belli Dominique , Bengoa José M. , Biedermann Luc , Bigler Beat , Binek Janek , Blattmann Mirjam , Boehm Stephan , Borovicka Jan , Braegger Christian P. , Brunner Nora , Bühr Patrick , Burnand Bernard , Burri Emanuel , Buyse Sophie , Cremer Matthias , Criblez Dominique H. , de Saussure Philippe , Degen Lukas , Delarive Joakim , Doerig Christopher , Dora Barbara , Dorta Gian , Egger Mara , Ehmann Tobias , El-Wafa Ali , Engelmann Matthias , Ezri Jessica , Felley Christian , Fliegner Markus , Fournier Nicolas , Fraga Montserrat , Frei Pascal , Frei Remus , Fried Michael , Froehlich Florian , Funk Christian , Furlano Raoul Ivano , Gallot-Lavallée Suzanne , Geyer Martin , Girardin Marc , Golay Delphine , Grandinetti Tanja , Gysi Beat , Haack Horst , Haarer Johannes , Helbling Beat , Hengstler Peter , Herzog Denise , Hess Cyrill , Heyland Klaas , Hinterleitner Thomas , Hiroz Philippe , Hirschi Claudia , Hruz Petr , Iwata Rika , Jost Res , Juillerat Pascal , Brondolo Vera Kessler , Knellwolf Christina , Knoblauch Christoph , Köhler Henrik , Koller Rebekka , Krieger-Grübel Claudia , Kullak-Ublick Gerd , Künzler Patrizia , Landolt Markus , Lange Rupprecht , Lehmann Frank Serge , Macpherson Andrew , Maerten Philippe , Maillard Michel H. , Manser Christine , Manz Michael , Marbet Urs , Marx George , Matter Christoph , McLin Valérie , Meier Rémy , Mendanova Martina , Meyenberger Christa , Michetti Pierre , Misselwitz Benjamin , Moradpour Darius , Morell Bernhard , Mosler Patrick , Mottet Christian , Müller Christoph , Müller Pascal , Müllhaupt Beat , Münger-Beyeler Claudia , Musso Leilla , Nagy Andreas , Neagu Michaela , Nichita Cristina , Niess Jan , Noël Natacha , Nydegger Andreas , Obialo Nicole , Oneta Carl , Oropesa Cassandra , Peter Ueli , Peternac Daniel , Petit Laetitia Marie , Piccoli-Gfeller Franziska , Pilz Julia Beatrice , Pittet Valérie , Raschle Nadia , Rentsch Ronald , Restellini Sophie , Richterich Jean-Pierre , Rihs Sylvia , Ritz Marc Alain , Roduit Jocelyn , Rogler Daniela , Rogler Gerhard , Rossel Jean-Benoît , Sagmeister Markus , Saner Gaby , Sauter Bernhard , Sawatzki Mikael , Schäppi Michela , Scharl Michael , Schelling Martin , Schibli Susanne , Schlauri Hugo , Uebelhart Sybille Schmid , Schnegg Jean-François , Schoepfer Alain , Seibold Frank , Seirafi Mariam , Semadeni Gian-Marco , Semela David , Senning Arne , Sidler Marc , Sokollik Christiane , Spalinger Johannes , Spangenberger Holger , Stadler Philippe , Steuerwald Michael , Straumann Alex , Straumann-Funk Bigna , Sulz Michael , Thorens Joël , Tiedemann Sarah , Tutuian Radu , Vavricka Stephan , Viani Francesco , Vögtlin Jürg , von Känel Roland , Vonlaufen Alain , Vouillamoz Dominique , Vulliamy Rachel , Wermuth Jürg , Werner Helene , Wiesel Paul , Wiest Reiner , Wylie Tina , Zeitz Jonas , Zimmermann Dorothee 
Published: July 2022

Abstract
Background
The bidirectional “gut-brain axis” has been implicated in the pathogenesis of inflammatory bowel diseases (IBD). While the influence of stress and depressive symptoms on IBD is well-characterized, the role of personality remains insufficiently investigated.

Methods
Personality was assessed in 1154 Swiss IBD cohort study (SIBDCS) patients via the NEO-Five-Factor Inventory (NEO-FFI) as well as in 2600 participants of the population-based CoLaus¦PsyCoLaus cohort study (NEO-FFI-revised). The NEO-FFI subcomponents activity, self-reproach and negative affect were associated with higher IBD disease activity and were combined to a NEO-FFI risk score. This risk score was validated and its effect on clinical IBD course and psychological endpoints was analysed in time-to-event and cumulative incidence analyses.

Results
In time-to-event analyses, a high NEO-FFI risk score was predictive for the clinical endpoints of new extraintestinal manifestation [EIM, adjusted hazard ratio (aHR) = 1.64, corrected p value (q) = 0.036] and two established composite flare endpoints (aHR = 1.53–1.63, q = 0.003–0.006) as well as for the psychological endpoints depressive symptoms (aHR = 7.06, q < 0.001) and low quality of life (aHR = 3.06, q < 0.001). Furthermore, cumulative incidence analyses showed that patients at high NEO-FFI risk experienced significantly more episodes of active disease, new EIMs, one of the flare endpoints, depressive episodes and low disease-related quality of life. Personalities of IBD patients showed only minor differences from the general population sample (Pearson’s r = 0.03–0.14).

Conclusions
Personality assessed by the NEO-FFI contained considerable predictive power for disease recurrence, depressive symptoms and low quality of life in IBD patients. Nevertheless, the personalities of IBD patients did not substantially differ from the general population.