Prognostic Implications of Psychiatric Diagnosis in Ulcerative Colitis

Abstract

The interaction of the psychologic and physical aspects of ulcerative colitis is frequently discussed in the literature, but no assessment has been made of the basic psychiatric diagnosis and its relationship to the course of the disease. The study presented matches 40 schizophrenic ulcerative colitis patients to 40 nonschizophrenic control patients in order to evaluate this relationship. Criteria for determining the course of colitis in the 2 groups were recorded proctoscopic and symptomatic ratings and surgical and mortality rates. The findings indicate that schizophrenics have a decidedly less favorable prognosis than patients with psychoneurosis, personality disorder, or no overt psychiatric disturbance. A comparison of the psychologic and physical course revealed that in the great majority of patients, an increase in psychic symptoms was simultaneous with an exacerbation of the colitis. A direct correlation was found between the degree of emotional disturbance and the severity of the colitis.