Journal Article Annotations
2025, 3rd Quarter

GI Psychiatry

Annotations by Ashwini Nadkarni, MD
September, 2025

Type D personality, insomnia severity, perceived stress, and health-related quality of life in inflammatory bowel disease: A case–control study.

PUBLICATION #1 — GI Psychiatry

Type D personality, insomnia severity, perceived stress, and health-related quality of life in inflammatory bowel disease: A case–control study.

Hassan Mohammed Sonbol, Mona Metwally El-Sayed, Mahmoud Abdelwahab Khedr, Mohamad Abulhassan Ibrahim, Manar Osama, Asmaa Adel Abdel-Sattar, Hiam Fathy Elsaied, Eman Abdeen Ali, Shorouk Mohsen, Alaa Salah Abdel Mawgoud.

Abstract: J Psychosom Res. 2025 Aug:195:112199. doi: 10.1016/j.jpsychores.2025.112199. Epub 2025 Jun 24.

Background
Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), is associated with significant psychological distress. This study aimed to investigate the relationships between Type D personality, insomnia severity, and perceived stress in IBD patients and a matched control group.

Methods
A case–control study was conducted with 132 patients with IBD and 132 age- and sex-matched controls at the outpatient IBD clinic of Main Internal Medicine University Hospitals, Egypt. The participants completed the DS14 (Type D Personality Scale), PSS-10 (Perceived Stress Scale), ISI (Insomnia Severity Index), SIBDQ (Short Inflammatory Bowel Disease Questionnaire), and GSRS (Gastrointestinal Symptom Rating Scale). For disease severity assessment, the DSI (Disease Severity Index) was employed. Logistic regression analysis was conducted only among IBD patients to identify independent predictors of perceived stress and insomnia.

Results
Compared with controls, patients with IBD presented significantly higher Type D personality scores (total score: 28 vs. 9, p < 0.001), increased insomnia severity (severe insomnia: 9.1 % vs. 3.1 %, p < 0.001), and higher perceived stress levels (high stress: 34.1 % vs. 6.8 %, p < 0.001). Logistic regression revealed that Type D personality (OR: 30.9, 95 % CI: 5.9–160.1, p < 0.001) and urban residency (OR: 3.1, 95 % CI: 1.5–6.7, p = 0.001) were significant predictors of perceived stress, whereas Crohn’s disease was associated with greater insomnia severity (OR: 3.6, 95 % CI: 1.6–7.9, p = 0.001).

Conclusion
The findings highlight the significant impact of Type D personality, insomnia, and perceived stress on patients with IBD. These results emphasize the need for integrated care approaches that address both psychological and physical health to improve patient outcomes and quality of life.

Annotation

The finding:
This case–control study aimed to investigate the associations between Type D personality traits (distressed personality traits), insomnia severity, perceived stress levels, and health-related quality of life in patients with inflammatory bowel disease (IBD) and healthy controls. The study found that patients with IBD demonstrated notably higher levels of Type D personality traits, which include negative affectivity and social inhibition, greater frequency of severity of insomnia, and crucial relationships between perceived stress and insomnia and perceived stress and disease activity.

Strength and weaknesses:
By examining interrelated factors such as personality, insomnia and perceived stress, this study enhances an understanding of the psychological dimensions of IBD, ultimately informing more effective treatment strategies that address both mental and physical health needs. The study had a cross-sectional design thus limiting causal inference, and the single-centre setting may have affected generalizability. Although matching was successful, controls were selected from patients’ family members, introducing potential selection bias.

Relevance:
The high prevalence of psychological symptoms and comorbidities, including Type D personality traits, moderate-to-severe insomnia, and elevated perceived stress levels, underscores the need for routine psychiatric screening and integrated mental health support within IBD care settings.