Perceived stigma, illness intrusiveness and quality of life in men and women with irritable bowel syndrome

Illness intrusiveness--illness-induced disruptions to lifestyles, activities and interests--compromises quality of life (QOL) in chronic disease. Illness intrusiveness derives from aspects of disease (e.g. severity of symptoms) and treatment and its impact is moderated by psychological, social factors and biological sex/gender. The present study tested: (A) the validity of the illness intrusiveness framework in irritable bowel syndrome (IBS) and (b) the hypothesis that the psychosocial impact of IBS differs between men and women. A mail survey, completed by 117 national charity members, included the Illness Intrusiveness Ratings Scale and self-report QOL measures. Results indicated that both the severity of IBS symptoms and perceived stigma correlated significantly with QOL. As hypothesized, illness intrusiveness mediated these relationships and sex differences were evident. Although symptom severity was associated with a more powerful QOL impact among women as compared to men, perceived stigma was associated with a greater QOL impact in men. A sex 2 illness intrusiveness interaction indicated that QOL decreased more precipitously among men than women as illness intrusiveness increased. Illness intrusiveness was also a more powerful mediator of the relation between symptom severity and QOL among men than women: reduced QOL was related more directly to symptom severity among women than men. These results bear on the ways in which gender socialization shapes sex differences in the wider experience of IBS and raise implications for general versus sex-specific treatments.