{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:36:00Z","timestamp":1787319360708,"version":"build-2736575974"},"reference-count":68,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T00:00:00Z","timestamp":1686268800000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000033","name":"Institute of Musculoskeletal Health and Arthritis","doi-asserted-by":"publisher","award":["THC-135234"],"award-info":[{"award-number":["THC-135234"]}],"id":[{"id":"10.13039\/501100000033","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007658","name":"Crohn's and Colitis Canada","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100007658","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,5,31]]},"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Among people with immune-mediated inflammatory disease (IMID), including multiple sclerosis (MS), inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) most research has focused on mental illness rather than on mental health. We assessed dimensions of mental health among persons with IMID and compared them across IMID. We also evaluated demographic and clinical characteristics associated with flourishing mental health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Participants: Adults with an IMID (MS, 239; IBD, 225; RA 134; total 598) who were participating in a cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary care centre in Manitoba, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>Participants completed the Mental Health Continuum Short-Form (MHC-SF), which measures emotional, psychological and social well-being, and identifies flourishing mental health. This outcome was added midway through the study on the advice of the patient advisory group. Depression, anxiety, pain, fatigue and physical function were also assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Total MHC-SF and subscale scores were similar across IMID groups. Nearly 60% of participants were considered to have flourishing mental health, with similar proportions across disease types (MS 56.5%; IBD 58.7%; RA 59%, p=0.95). Older age was associated with a 2% increased odds of flourishing mental health per year of age (OR 1.02; 95%\u2009CI: 1.01 to 1.04). Clinically meaningful elevations in anxiety (OR 0.25; 95%\u2009CI: 0.12 to 0.51) and depressive symptoms (OR 0.074; 95%\u2009CI: 0.009 to 0.61) were associated with lower odds. Higher levels of pain, anxiety and depressive symptoms were associated with lower total Mental Health Continuum scores at the 50th quantile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Over half of people with MS, IBD and RA reported flourishing mental health, with levels similar across the disease groups. Interventions targeting symptoms of depression and anxiety, and upper limb impairments, as well as resilience training may help a higher proportion of the IMID population achieve flourishing mental health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-073782","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T10:14:10Z","timestamp":1686305650000},"page":"e073782","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Well-being and flourishing mental health in adults with inflammatory bowel disease, multiple sclerosis and rheumatoid arthritis in Manitoba, Canada: a cross-sectional study"],"prefix":"10.1136","volume":"13","author":[{"given":"Shaza","family":"Almweisheer","sequence":"first","affiliation":[{"name":"Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles N","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley A","family":"Graff","sequence":"additional","affiliation":[{"name":"Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott B","family":"Patten","sequence":"additional","affiliation":[{"name":"Community Health Sciences & Psychiatry, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Bolton","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D","family":"Fisk","sequence":"additional","affiliation":[{"name":"Nova Scotia Health Authority, Halifax, Nova Scotia, Canada"},{"name":"Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5547-3268","authenticated-orcid":false,"given":"Carol A","family":"Hitchon","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Manitoba College of Medicine, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J","family":"Marriott","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Manitoba College of Medicine, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1855-5595","authenticated-orcid":false,"given":"Ruth Ann","family":"Marrie","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Manitoba College of Medicine, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"key":"2025121402474449000_13.6.e073782.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2016.06.001"},{"key":"2025121402474449000_13.6.e073782.2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458514564487"},{"key":"2025121402474449000_13.6.e073782.3","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket169"},{"key":"2025121402474449000_13.6.e073782.4","unstructured":"Canadian Institute for Health Information . 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