Psychological and Social Aspects

Psychological factors can have an impact on every medical condition, if only because a patient’s state of mind will affect how assiduously he or she will take the prescribed medications. Psychophysiological phenomena vary in their importance according to the disease, and are arguably strongest in the so-called functional disorders. In irritable bowel syndrome, for example, symptoms are highly vulnerable to the effects of psychological distress on bowel motility and on the threshold for perceiving internal phenomena as painful. But such mechanisms can be important in “organic” conditions as well — watching your national soccer team play in the World Cup can bring on a myocardial infarction [1] — so the severity of Crohn’s disease (CD) does not exclude an impact of psychological factors on onset and clinical evolution.