From Physical Frailty to Psychosocial Maladaptation: Predicting Mental Reserve and Quality of Life in Patients with Inflammatory Bowel Diseases

Iryna  Romash; Ihor  Sarapuk; Ivan  Romash; Oleksandr  Kudyn; Vasyl  Mishchuk

doi:10.56508/mhgcj.v8i1.343

Authors

Iryna Romash Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine https://orcid.org/0000-0002-9749-7783
Ihor Sarapuk Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine https://orcid.org/0000-0001-8250-5843
Ivan Romash Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine https://orcid.org/0000-0002-6591-6613
Oleksandr Kudyn Bogomolets National Medical University. Kyiv, Ukraine https://orcid.org/0000-0002-1336-8555
Vasyl Mishchuk Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine https://orcid.org/0000-0003-0428-3856

DOI:

https://doi.org/10.56508/mhgcj.v8i1.343

Keywords:

mental health, psychosocial maladaptation, Clinical Frailty Scale, general physical vulnerability, comorbidity, mental well-being, inflammatory bowel disease, Quality of life

Abstract

Introduction: Inflammatory bowel diseases (IBD) are a serious challenge for global health care systems, as they affect not only the physical condition but also the psychological resilience and social adaptation of patients. Frailty syndrome, traditionally considered a problem of geriatrics, is increasingly being diagnosed in adult patients with chronic conditions such as IBDs, acting as a critical predictor of depletion of mental reserve and significant deterioration in quality of life (QofL).

Purpose:To evaluate the possibilities of the adapted use of the "Clinical Frailty Scale" as a tool for predicting psychosocial well-being in adult patients with inflammatory bowel diseases by verifying its prognostic significance in comparison with the comorbidity level and indicators of quality of life

Methodology: The study included 248 patients with IBD: 117 with Crohn's disease (Group I), 131 with ulcerative colitis (Group II) and 82 healthy volunteers (Control group). The average age is 43.34 ± 21.57 years. A multidisciplinary assessment approach was used: "Clinical Frailty Scale" (CFS) to determine functional reserve; the CIRS scale for assessing the severity of comorbidity; and the SF-36 questionnaire for QofL analysis, with a particular focus on the relationship between physical and mental health components.

Results: The obtained data confirmed a significant depletion of functional and psychoemotional resources in patients with IBD compared to the control group. The average CFS score in patients with ulcerative colitis (4.2±0.6) and Crohn's disease (3.1±1.2) was 1.5–2.0 times higher than in healthy subjects (2.1±0.97, p<0.05). A high level of comorbidity (according to the CIRS-IS and CIRS-CI scales) showed a strong correlation with a decrease in mental health scores according to the SF-36 questionnaire. The results of the correlation analysis show that frailty in IBD is not just an isolated physical symptom, but a complex psychosocial burden caused by a long-term chronic disease that leads to the loss of "mental reserve".

Conclusion: The obtained results emphasize the urgent need to implement an integrated approach in managing IBD. The use of frailty assessment in routine clinical practice enables the timely detection of risks associated with psychological maladjustment in patients. To overcome the challenge of IBD, medical systems must focus on holistic care models — this involves a transition from purely biological treatment to taking into account all aspects of a person's life. Such models should be aimed at preserving both physical functionality and mental well-being and QofL of patients

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