Comprehensive Lifestyle Modification Influences Medium-Term and Artificially Induced Stress in Ulcerative Colitis—A Sub-Study within a Randomized Controlled Trial Using the Trier Social Stress Test

Anna K Koch; Margarita Schöls; Heidemarie Haller; Dennis Anheyer; Zehra Cinar; Ronja Eilert; Kerstin Kofink; Harald Engler; Sigrid Elsenbruch; Holger Cramer; Gustav Dobos; Jost Langhorst

doi:10.3390/jcm10215070

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Comprehensive Lifestyle Modification Influences Medium-Term and Artificially Induced Stress in Ulcerative Colitis—A Sub-Study within a Randomized Controlled Trial Using the Trier Social Stress Test

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Comprehensive Lifestyle Modification Influences Medium-Term and Artificially Induced Stress in Ulcerative Colitis—A Sub-Study within a Randomized Controlled Trial Using the Trier Social Stress Test

Anna K Koch, Margarita Schöls, Heidemarie Haller, Dennis Anheyer, Zehra Cinar, Ronja Eilert, Kerstin Kofink, Harald Engler, Sigrid Elsenbruch, Holger Cramer, …

Journal of Clinical Medicine, Vol.10(21), 5070

29/10/2021

DOI: https://doi.org/10.3390/jcm10215070

PMID: 34768588

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Abstract

Stress

ulcerative colitis

comprehensive lifestyle modification

Trier Social Stress Test

clinical research

Objective: The present study presents long-term results of stress-related outcomes of a prospective RCT that evaluated effects of a ten-week comprehensive lifestyle-modification program (LSM) in patients with inactive ulcerative colitis (UC). In addition, exploratory results of a sub-study applying a laboratory stress protocol (Trier Social Stress Test; TSST) conducted within the RCT are reported. Methods: Ninety-seven patients with inactive UC were randomized to LSM (n = 47; 50.28 ± 11.90 years; 72.3% female) or self-care (n = 50; 45.54 ± 12.49 years; 70% female). Patients’ perceived stress, anxiety, flourishing and depression were assessed at week 0, 12, 24 and 48. After the respective intervention, 16 female patients (LSM: n = 8; 44.6 ± 14.3 years; Self-care: n = 8; 49.25 ± 4.30 years) additionally underwent the TSST. State anxiety, blood pressure, pulse, complete blood counts, adrenocorticotropic hormone (ACTH), cortisol, adrenalin and noradrenalin were measured at baseline (−15 min), stress (+10 min), recovery1 (+20 min) and recovery2 (+55 min). Statistical significance was set at p < 0.05; for the exploratory sub-study using the TSST, p-values < 0.10 were considered significant. Results: Patients’ perceived stress declined significantly after the LSM (p < 0.001) compared with control. This lasted until week 24 (p = 0.023) but did not persist until week 48 (p = 0.060). After 48 weeks, patients’ flourishing was significantly increased compared with control (p = 0.006). In response to the TSST, significant group differences were evident for pulse (p = 0.015), adrenaline (p = 0.037) and anxiety (p = 0.066). After 55 min, group differences were found for ACTH (p = 0.067) and systolic blood pressure (p = 0.050). Conclusions: LSM has a medium-term positive effect on perceived stress. First indications show that it is promising to investigate these effects further under laboratory conditions. It is also desirable to find out how the effects of LSM can be maintained in the long term.

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Title: Comprehensive Lifestyle Modification Influences Medium-Term and Artificially Induced Stress in Ulcerative Colitis—A Sub-Study within a Randomized Controlled Trial Using the Trier Social Stress Test
Creators: Anna K Koch - University of Duisburg-Essen
Margarita Schöls - University of Duisburg-Essen
Heidemarie Haller - University of Duisburg-Essen
Dennis Anheyer - University of Duisburg-Essen
Zehra Cinar - University of Duisburg-Essen
Ronja Eilert - University of Duisburg-Essen
Kerstin Kofink - University of Duisburg-Essen
Harald Engler - University of Duisburg-Essen
Sigrid Elsenbruch - Ruhr University Bochum
Holger Cramer - University of Duisburg-Essen
Gustav Dobos - Sozialstiftung Bamberg
Jost Langhorst - Sozialstiftung Bamberg
Publication Details: Journal of Clinical Medicine, Vol.10(21), 5070
Publisher: MDPI AG
Identifiers: 991012978267002368
Copyright: Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Academic Unit: National Centre for Naturopathic Medicine
Language: English
Resource Type: Journal article

Comprehensive Lifestyle Modification Influences Medium-Term and Artificially Induced Stress in Ulcerative Colitis—A Sub-Study within a Randomized Controlled Trial Using the Trier Social Stress Test

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