The Stressometer: A Simple, Valid, and Responsive Measure of Psychological Stress in Inflammatory Bowel Disease Patients

Abstract

BACKGROUND AND AIMS: Psychological stress is associated with inflammatory bowel disease [IBD], but the nature of this relationship is complex. At present, there is no simple tool to screen for stress in IBD clinical practice or assess stress repeatedly in longitudinal studies. Our aim was to design a single-question 'stressometer' to rapidly measure stress and validate this in IBD patients. METHODS: In all, 304 IBD patients completed a single-question 'stressometer'. This was correlated with stress as measured by the Depression Anxiety Stress Scales [DASS-21], quality of life, and disease activity. Test-retest reliability was assessed in 31 patients who completed the stressometer and the DASS-21 on two occasions 4 weeks apart. RESULTS: Stressometer levels correlated with the DASS-21 stress dimension in both Crohn's disease [CD] (Spearman's rank correlation coefficient [rs] 0.54; p < 0.001) and ulcerative colitis [UC] [rs 0.59; p < 0.001]. Stressometer levels were less closely associated with depression and anxiety [rs range 0.36 to 0.49; all p-values < 0.001]. Stressometer scores correlated with all four Short Health Scale quality of life dimensions in both CD and UC [rs range 0.35 to 0.48; all p-values < 0.001] and with disease activity in Crohn's disease [rs 0.46; p < 0.001] and ulcerative colitis [rs 0.20; p = 0.02]. Responsiveness was confirmed with a test-retest correlation of 0.43 [p = 0.02]. CONCLUSIONS: The stressometer is a simple, valid, and responsive measure of psychological stress in IBD patients and may be a useful patient-reported outcome measure in future IBD clinical and research assessments.