Resilience in Pediatric-Onset Inflammatory Bowel Disease: Associations with Age, Therapy Change, and Health-Related Quality of Life

Background: Resilience is associated with improved outcomes in adult inflammatory bowel disease (IBD), yet little is known about its relationship to health-related quality of life and disease characteristics in pediatric-onset IBD. Methods: This prospective, cross-sectional study enrolled pediatric-onset IBD patients (≥12 years) at Cleveland Clinic Children’s. Participants completed the Connor–Davidson Resilience Scale (CD-RISC-10) and an age-appropriate health-related quality of life (HRQOL) survey. Measure: IMPACT-III (ages 12–17) or SF-36 (≥18). Demographic and clinical data were collected via chart review. Associations between resilience, HRQOL, and clinical variables were analyzed. Results: Seventy participants completed the study (35 adolescents and 35 young adults). Young adults had significantly higher resilience scores than adolescents (31 ± 4.6 vs. 27 ± 5.3; p = 0.007). Resilience scores were significantly lower among patients who had experienced a change in IBD therapy within the prior year (27 vs. 30; p = 0.045). No significant associations were found between resilience and age at diagnosis, disease duration, HRQOL, or prior surgery. Use of pharmacologic treatment for mental health conditions was higher in young adults compared to adolescents (22.9% vs. 14.3%; p = 0.015), despite similar rates of diagnosed mental health comorbidities. Conclusions: Resilience in pediatric-onset IBD patients varies by age and is lower in the context of recent therapy changes, suggesting a potential vulnerability during periods of disease instability. Routine assessment of resilience may help identify patients who could benefit from early psychosocial intervention to support coping and improve long-term outcomes.