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P708 Determinants of job stress in patients with inflammatory bowel disease

P. Schreiner*1, L. Biedermann2, J.-B. Rossel3, V. Pittet4, R. von Känel5

1UniversityHospital of Zurich, Internal Medicine, Zurich, Switzerland, 2UniversityHospital of Zurich, Gastroenterology and Hepatology, Zurich, Switzerland, 3Lausanne University Hospital, Lausanne, Switzerland, 4Lausanne University Hospital, Institute of Social & Preventive Medicine, Lausanne, Switzerland, 5Clinic Barmelweid, Department of Psychosomatic Medicine, Barmelweid, Switzerland

Background

Psychosocial factors have been shown to predict a poor disease course in patients with inflammatory bowel disease (IBD), but whether this also applies to job stress is currently unknown. As a first step to address this issue, we determined the correlates of job stress in a large cohort of IBD patients.

Methods

Study participants were 905 patients with Crohn’s disease (CD) and 751 patients with ulcerative colitis/indeterminate colitis (UC/IC) who enrolled in the Swiss Inflammatory Bowel Disease Cohort Study (SIBDCS) between 2006 and 2015. Job stress was measured with the self-report Effort-Reward-Imbalance (ERI) and Overcommitment to Work questionnaire, using continuously scaled scores. Sociodemographic, lifestyle, psychosocial, and disease-related factors were assessed by clinical interviews and self-report measures.

Results

As ERI and OC scores did not significantly differ between CD and UC/IC patients, multivariate regression models were not stratified by IBD diagnoses. The mean age of the sample was 39.9 ± 11.6 years (51.5% men). Only 91 (5.7%) of patients had an ERI ratio >1 with 26.9% of patients reaching a reward score equal to its maximum value. ERI scores were higher in full-time vs partial-time employed participants (B = 0.050, p = 0.002), directly associated with greater OC scores (B = 0.034, p < 0.001), and inversely related to absence from the work place in the previous 3 months (B = -0.049, p = 0.010). Greater OC scores were found in women than in men (B = 0.568, p = 0.014), and in those living with a partner (B = 0.805, p = 0.001), with higher level of occupation (director vs trainee: B = 1.447, p < 0.001), full-time employment (B = 0.906, p < 0.001), with absence from the workplace in the previous 3 months (B = 1.062, p < 0.001), and with extra-intestinal manifestations (B = 0.623, p = 0.005); previous hospitalisations were associated with lower OC scores (B = 0.560, p = 0.038).

Conclusion

The average level of job stress appears to be remarkably low in patients from the SIBDCS. Associations with disease-specific variables may suggest that OC might contribute to extraintestinal manifestations of IBD, while also preventing patients from seeking in-patient care. However, prospective studies are needed to test whether the inability to sufficiently unwind from perceived job obligations adversely affects the course of IBD.