Impact of sense of coherence and social support on disease activity in Crohn's disease: a network analysis.

Background: Sense of coherence (SOC) and social support are key factors in managing chronic diseases, but their specific impact on disease activity in Crohn's disease (CD) remains unclear. Network analysis provides a novel approach to understanding the complex relationships among psychological and clinical variables. Objective: This study aimed to use network analysis to explore the relationship between SOC and social support and disease activity in CD patients across different body weight categories, considering that body weight influences disease prognosis, nutritional status, and treatment needs. Methods: A cross-sectional study was conducted among 276 hospitalized CD patients from a tertiary hospital in Zhejiang. Participants were categorized as underweight, normal weight, or overweight based on BMI. SOC (SOC-13), social support (MSPSS), and disease activity (simplified CDAI) were assessed using validated tools. Disease activity was measured using a simplified Crohn's Disease Activity Index (CDAI), which is an abbreviated version of the full CDAI with a reduced number of items (5 instead of 8). Partial correlation networks were constructed for each BMI group using graphical LASSO and visualized via the Fruchterman-Reingold algorithm. Centrality and bridge expected influence were calculated to identify key variables, and Network Comparison Tests were conducted across BMI groups. Results: Comprehensibility and family support emerged as central nodes in normal and overweight groups, while manageability was central in underweight patients. Bridge analyses indicated that manageability and family support linked SOC, social support, and disease activity. No significant structural differences were found among BMI groups (p > 0.05), suggesting consistent interrelations regardless of BMI. Conclusion: Manageability and family support were identified as central and bridging factors in CD patients, regardless of BMI. Targeted interventions to strengthen these factors may enhance disease management and patient outcomes. However, given the exploratory nature of the results, which is needed to confirm these findings.