, Volume 4, Issue 4, pp 296–300 | Cite as

Relationship of Mindfulness, Quality of Life, and Psychiatric Symptoms Among Patients with Ulcerative Colitis

  • Sharon JedelEmail author
  • Patricia Merriman
  • Arthur Hoffman
  • Barbara Swanson
  • Louis F. Fogg
  • Ali Keshavarzian


Inflammatory bowel disease (IBD) is a significant health problem. IBD patients have an exaggerated response to stress, which is also implicated as a flare-up trigger. Stress management techniques can potentially prevent flare-ups and improve quality of life. This study examines the relationship between dispositional mindfulness and perceived stress, quality of life, and psychiatric distress. Participants with ulcerative colitis (UC) completed questionnaires and were classified into two groups: asymptomatic and symptomatic. Independent samples t tests determined whether the groups differed significantly on mindfulness and psychosocial variables. Pearson's bivariate correlations were used to test for linear relationships between scores on the mindfulness measure and scores on psychosocial variables. In the asymptomatic group, mindfulness scores were significantly and inversely correlated with anxiety, depression, and perceived stress scores, and significantly but positively correlated with quality of life. In the symptomatic group, mindfulness was significantly and inversely correlated with perceived stress scores and was not significantly correlated with other psychosocial variables. Our data suggest that mindfulness training, which can be incorporated into a stress management program, may be an important component in treating UC, by improving physical and psychiatric functioning. Randomized, placebo-controlled trials are necessary to determine whether MBSR is useful in managing UC.


Ulcerative colitis Mindfulness Depression Anxiety Stress Psychiatric symptoms 


  1. Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27–45.PubMedCrossRefGoogle Scholar
  2. Beck, A. T. (1996). BDI-II, beck depression inventory: manual. Boston: Harcourt Brace Publishers.Google Scholar
  3. Bishop, S. R. (2002). What do we really know about mindfulness-based stress reduction? Psychosomatic Medicine, 64, 71–84.PubMedGoogle Scholar
  4. Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822–848.PubMedCrossRefGoogle Scholar
  5. Carlson, L. E., & Brown, K. W. (2005). Validation of the mindful attention awareness scale in a cancer population. Journal of Psychosomatic Research, 58, 29–33.PubMedCrossRefGoogle Scholar
  6. Carlson, L. E., Speca, M., Patel, K. D., & Goody, E. (2004). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology, 29, 448–474.PubMedCrossRefGoogle Scholar
  7. Carmody, J., & Baer, R. A. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. Journal of Behavioral Medicine, 31, 23–33.PubMedCrossRefGoogle Scholar
  8. Cohen, R. (2002). The quality of life in patients with Crohn’s disease. Alimentary Pharmacology & Therapeutics, 16, 1603–1609.CrossRefGoogle Scholar
  9. Evans, S., Ferrando, S., Carr, C., & Haglin, D. (2010). Mindfulness-based stress reduction (MBSR) and distress in a community-based sample. Clinical Psychology & Psychotherapy. doi: 10.1002/cpp.727. Published online in Wiley Online Library (
  10. Farhadi, A., Keshavarzian, A., Van de Kar, L. D., Jakate, S., Domm, A., Zhang, L., et al. (2005). Heightened responses to stressor in patients with inflammatory bowel disease. American Journal of Gastroenterology, 100, 1796–1804.PubMedCrossRefGoogle Scholar
  11. Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: a meta-analysis. Journal of Psychosomatic Research, 57, 35–43.PubMedCrossRefGoogle Scholar
  12. Irvine, E. J. (1997). Quality of life issues in patients with inflammatory bowel disease. American Journal of Gastroenterology, 92, 18S–24S.PubMedGoogle Scholar
  13. Jowett, S. L., Seal, C. J., Barton, J. R., & Welfare, M. R. (2001). The short inflammatory bowel disease questionnaire is reliable and response to clinically important change in ulcerative colitis. American Journal of Gastroenterology, 96, 2921–2928.PubMedCrossRefGoogle Scholar
  14. Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your body and mind to face stress, pain and illness. New York: Delacorte Press.Google Scholar
  15. Kane, S. V., Cohen, R., Aikens, J. E., & Hanauer, S. B. (2001). Predictors of non-compliance with mesalamine in quiescent ulcerative colitis. American Journal of Gastroenterology, 96, 2929–2933.PubMedCrossRefGoogle Scholar
  16. Kearney, D. J., McDermott, K. M., Martinez, M., & Simpson, T. L. (2011). Association of participation in a mindfulness programme with bowel symptoms, gastrointestinal symptom-specific anxiety and quality of life. Alimentary Pharmacology & Therapeutics, 34, 363–373.CrossRefGoogle Scholar
  17. Levenstein, S., Prantera, C., Varvo, V., Scribano, M. L., Berto, E., Luzi, C., et al. (1993). Development of the perceived stress questionnaire: a new tool for psychosomatic research. Journal of Psychosomatic Research, 37, 19–32.PubMedCrossRefGoogle Scholar
  18. Levenstein, S., Prantea, C., Varvo, V., Scribano, M. L., Andreoli, A., & Luzi, C. (2000). Stress and exacerbation in ulcerative colitis: a prospective study of patients enrolled in remission. American Journal of Gastroenterology, 95, 1213–1219.PubMedCrossRefGoogle Scholar
  19. Maunder, R. G., & Levenstein, S. (2008). The role of stress in the development and clinical course of inflammatory bowel disease: epidemiological evidence. Current Molecular Medicine, 8, 247–252.PubMedCrossRefGoogle Scholar
  20. Mawdsley, J. E., Macey, M. G., Feakins, R. M., Langmead, L., & Rampton, D. S. (2006). The effect of acute psychologic stress on systemic and rectal mucosal measures of inflammation in ulcerative colitis. Gastroenterology, 131, 410–419.PubMedCrossRefGoogle Scholar
  21. Mikocka-Walus, A. A., Turnbull, D. A., Moulding, N. T., Wilson, I. G., Andrews, J. M., & Holtmann, G. J. (2007). Controversies surrounding the comorbidity of depression and anxiety in inflammatory bowel disease patients: a literature review. Inflammatory Bowel Diseases, 13, 225–234.PubMedCrossRefGoogle Scholar
  22. Navarro, F., & Hanauer, S. (2003). Treatment of inflammatory bowel disease: safety and tolerability issues. American Journal of Gastroenterology, 98, S18–S23.PubMedCrossRefGoogle Scholar
  23. Pradhan, E. K., Baumgarten, M., Langenberg, P., Handwerger, B., Gilpin, A. K., & Magyari, T. (2007). Effect of mindfulness-based stress reduction in rheumatoid arthritis patients. Arthritis and Rheumatism, 57, 1134–1142.PubMedCrossRefGoogle Scholar
  24. Praissman, S. (2008). Mindfulness-based stress reduction: a literature review and clinician’s guide. Journal of the American Academy of Nurse Practitioners, 20, 212–216.PubMedCrossRefGoogle Scholar
  25. Reibel, D. K., Greeson, J. M., Brainard, G. C., & Hojat, M. (2001). Mindfulness-based stress reduction and health-related quality of life in a heterogeneous patient population. General Hospital Psychiatry, 23, 183–192.PubMedCrossRefGoogle Scholar
  26. Reynolds, W. M., & Gould, J. W. (1981). A psychometric investigation of the standard and short form Beck Depression Inventory. Journal of Consulting and Clinical Psychology, 49, 306–307.PubMedCrossRefGoogle Scholar
  27. Santorelli, S.F. (1992). A qualitative case analysis of mindfulness meditation training in an outpatient stress reduction clinic, and its implications for self-knowledge. Doctoral Dissertation, University of Massachusetts School of Education. University Microfilms International, Kalamazoo, MI.Google Scholar
  28. Schroeder, K. W., Tremaine, W. J., & Ilstrup, D. M. (1987). Coated oral 5-aminosalcylic acid therapy for mildly to moderately active ulcerative colitis. New England Journal of Medicine, 317, 1625–1629.PubMedCrossRefGoogle Scholar
  29. Shale, M. J., & Riley, S. A. (2003). Studies of compliance with delayed-release mesalazine therapy in patients with inflammatory bowel disease. Alimentary Pharmacology & Therapeutics, 18, 191–203.CrossRefGoogle Scholar
  30. Shapiro, S. L., Oman, D., Thoresen, C. E., Plante, T. G., & Flinders, T. (2008). Cultivating mindfulness: effects on well-being. Journal of Clinical Psychology, 64, 840–862.PubMedCrossRefGoogle Scholar
  31. Spielberger, C. D. (1983). Manual for the State-Trait Anxiety Inventory STAI. Palo Alto: Consulting Psychologists Press.Google Scholar
  32. Spielberger, C. D., & Sydeman, S. J. (1994). State-trait anxiety inventory and state-trait anger inventory. In M. Maruish (Ed.), The use of psychological testing for treatment planning and outcome assessment (pp. 292–321). Hillsdale: Erlbaum.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Sharon Jedel
    • 1
    Email author
  • Patricia Merriman
    • 2
  • Arthur Hoffman
    • 3
  • Barbara Swanson
    • 4
  • Louis F. Fogg
    • 4
  • Ali Keshavarzian
    • 1
  1. 1.Department of Medicine, Division of Digestive Disease and NutritionRush University Medical CenterChicagoUSA
  2. 2.Department of AnesthesiologyRush University Medical CenterChicagoUSA
  3. 3.Department of Internal MedicineRush University Medical CenterChicagoUSA
  4. 4.Adult Health and Gerontological NursingRush University Medical CenterChicagoUSA

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