Effects of Inflammatory Bowel Disease on Students' Adjustment to College

Background & Aims Successful adjustment to college is required for academic success. We investigated whether inflammatory bowel disease (IBD) activity affects this adjustment process. Methods We created an online survey that included a Student Adaptation to College Questionnaire (SACQ), a general quality of life survey (SF-12), a disease-specific short IBD quality of life survey (SIBDQ), and disease activity indices. Undergraduate students across the United States were recruited via social media. Results Surveys were completed by 65 students with Crohn's disease (CD), 28 with ulcerative colitis, and 214 healthy students (controls). Disease-specific quality of life (SIBDQ results) correlated with IBD disease activity (rho = –0.79; P 0001). High college adjustment scores (SACQ results) were associated with high SIBDQ scores. Students with IBD had lower mean SACQ scores than controls (307 vs 290; P .0001). There was a modest inverse correlation between CD activity and SACQ (rho = –0.24; P .04). Disease activity in students with CD was associated strongly with their self-reported ability to keep up with academic work ( P .0089) and confidence in their ability to meet future academic challenges ( P .0015). Students with active IBD reported feeling as if they were not academically successful ( P   .018), and students with ulcerative colitis reported irregular class attendance ( P .043). Conclusions Students with IBD do not adjust to college as well as healthy students. Disease activity affects their adjustment and attitudes about academics—especially among students with CD. Successful adjustment is important for academic success, affecting graduation rates and future economic success. Strategies to increase disease control and provide social and emotional support during college could improve adjustment to college and academic performance, and increase patients' potential.