Ganit Goren

Background and Objective: Crohn’s Disease (CD) is a chronic inflammatory condition with significant physical and psychological impacts, often requiring comprehensive self-management. This study examines the effects of COBMINDEX (Cognitive–Behavioral and Mindfulness Intervention with Daily Exercise) on coping strategies and life satisfaction in CD patients, focusing on gender-specific responses. Study objectives were to assess the impact of COBMINDEX on adaptive and maladaptive coping strategies and life satisfaction in CD patients, and to examine gender differences in these outcomes. Materials and Methods: A pre-planned secondary analysis of a randomized controlled trial, conducted from 2018 to 2021, at two public tertiary hospitals in Israel. A total of 120 CD patients (45 men and 75 women) were randomly assigned to either theCOBMINDEX group or a wait-list control group. Participants were assessed at baseline and post-intervention for coping strategies, mindfulness, psychological symptoms, and life satisfaction using validated scales. Quantile regression explored the gender-specific predictors of life satisfaction. This study was registered at ClinicalTrials.gov (NCT05085925) and Israel Ministry of Health (MOH_2020- 02- 24_008721. asp). Results: Both genders showed significant improvements in mindfulness, emotion-focused coping, and active coping (p < 0.05). Women exhibited reduced dysfunctional coping and greater emotional support use. For men, emotion-focused coping and mindfulness positively predicted life satisfaction, while for women, reductions in psychological symptoms and dysfunctional coping were significant predictors (p < 0.01). Conclusions: COBMINDEX enhances coping strategies and life satisfaction in CD patients, with notable gender differences. These findings highlight the importance of gender-tailored psychological interventions to improve overall patient well-being.

Summary: Background: Chronic abdominal pain and fatigue are characteristics of Crohn's disease (CD) and contribute to functional impairments.Aims: To examine whether CD‐tailored cognitive‐behavioural and mindfulness intervention (COBMINDEX) is effective in reducing abdominal pain and fatigue in patients with CD and whether changes in abdominal pain and fatigue mediate any beneficial effects of COBMINDEX on impairments in work productivity and daily activities.Methods: This is a secondary analysis of a parallel‐group multicentre randomised controlled trial. Patients with mild‐to‐moderate CD (n = 142) were randomised into either intervention group receiving COBMINDEX, or control group receiving treatment‐as‐usual for 3 months followed by COBMINDEX. Complete data were collected from 120 patients (34.0 ± 10.7 years, 62.5% female, intervention = 60, control = 60). Analysis of covariance assessed group differences in 3‐month follow‐up scores, controlling for baseline scores. Multiple parallel mediation analysis assessed the proposed mechanisms for the entire sample.Results: The intervention group demonstrated significantly lower levels of abdominal pain (F = 17.46, p < 0.001, η²_p = 0.13), fatigue (F = 7.26, p = 0.008, η²_p = 0.06) and impairments at work (F = 4.82, p = 0.032, η²_p = 0.07) and daily activities (F = 6.26, p = 0.014, η²_p = 0.05), compared with treatment‐as‐usual. Moreover, changes in abdominal pain and fatigue significantly mediated the beneficial effects of COBMINDEX on patients' work productivity (b = −9.90, SE = 2.86, 95% CI: −16.11 to −4.94) and daily activities (b = −9.65, SE = 1.91, 95% CI: −13.77 to 6.35), independent of changes in disease activity.Conclusions: COBMINDEX is effective at reducing abdominal pain and fatigue in patients with CD, which in turn leads to improvement in functioning. Clinicians should incorporate screening for severe abdominal pain and fatigue and consider offering cognitive‐behavioural and mindfulness training.ClinicalTrials.gov, Number: NCT05085925. Ministry of Health in Israel (https://my.health.gov.il/CliniTrials/Pages/MOH_2020‐02‐24_008721.aspx).

Medical and psychological factors contribute to the heightened psychological distress and reduced health-related quality of life in patients with Crohn’s disease. Whether Social Support plays a role in this scenario is unknown. We used the Multidimensional Scale of Perceived Social Support (MSPSS) to investigate whether Social Support associates with psychological distress and quality of life in Crohn’s disease. Consecutive adult patients with Crohn’s disease, presenting at specialist gastroenterology services or recruited by advertising, with mild to moderate disease activity by the Harvey-Bradshaw Index (HBI), were enrolled into the study. Patients completed the 12-item MSPSS questionnaire that measures psychological support in three categories: Family, Friends and Significant Other, and provides individual category scores and a total score (range of all scores 1–7; a higher score indicates more social support). Patients also completed the following questionnaires: psychological distress (Brief Symptom Inventory, with Global Severity Index, GSI), quality of life (Short Inflammatory Bowel Disease Questionnaire, SIBDQ), satisfaction with life (SWLS), family stress (Family Assessment Device, FAD), coping strategies (Brief-COPE), and presenteeism and work activity (WPAI). Statistics: Spearman rho. *p<0.05, **p<0.01. The cohort comprised 126 patients, mean (SD) age 33.7 (10.6) years, females 79%, HBI 8.4 (2.5), CRP 1.2 (2.3), calprotectin 394 (674). MSPSS scores were as follows: Total score 5.72 (1.14), Friends 5.36 (1.34), Family 5.73 (1.14), and Significant Other 6.07 (1.15); Cronbach’s α ≥ .877. MSPSS scores correlated negatively with family stress measure FAD: Friends -.258**, Family -.732**, Significant Other -.401**; and with GSI psychological stress measure: Friends -305**, Family -.352**, Significant Other -.245**. MSPSS correlated positively with SIBDQ quality of life: Friends .300**, Family .188*, Significant Other .200*; and with satisfaction with life SWLS: Friends .379**, Family .333**, Significant Other .245**. MSPSS correlations with emotion-focused coping were: Friends -.337**, Family -.263**, Significant Other -.329**. MSPSS Family score correlated negatively with WPAI presenteeism -.270*, and WPAI work activity -.294**. In mild to moderate Crohn’s disease, strong social support was associated with better quality of life, more satisfaction with life, and better performance in the work arena. Social support was associated with reduced psychological distress, reduced family stress, and less use of emotion-focused coping. This research shows the importance of social support in improving the psychological condition of patients with Crohn’s disease.

The Brief Symptom Inventory (BSI) is a self-report measure of psychological symptoms in clinical and non-clinical populations. However, norms for BSI are lacking for patients with chronic illness, ...

Postpartum depression (PPD) has detrimental effects on the health of the mother, child and family. Socio-demographic variables can influence PPD. Sense of coherence (SOC) is a personal resource that mitigates the experience of stressful events. We hypothesized that SOC would have a protective effect against PPD over time. The aim was to investigate the effects of socio-demographic factors and SOC on PPD at birth (T1) and nine months postpartum (T2). A longitudinal study of primiparous women (n = 114; age range 18–47 years) measured PPD, SOC and socio-demographics at T1 and T2. The majority were married, had no economic difficulties and were employed before birth. Results showed that PPD at T1 (15.8%) declined to 6.2% (T2). Job status was positively associated with SOC at T1. The structured equation model accounted for 27% of the variance in PPD (T2). In the first pathway, job status was linked to PPD (T2) via SOC at T1 and T2. In the second, SOC and PPD (T1) and SOC (T2) mediated the link between job status and PPD (T2). Results and clinical implications are discussed in the context of the theory of conservation of resources. An intervention for enhancing SOC is recommended for woman at risk of PPD.