Does psychological status influence clinical outcomes in patients with inflammatory bowel disease (IBD) and other chronic gastroenterological diseases: An observational cohort prospective study

Abstract

BackgroundWhether there is a temporal relationship between psychological problems and clinical outcomes in patients with diseases of the digestive tract has not been widely researched. Thus, our aims were 1) To observe and compare prospectively clinical outcomes in relation to psychological co-morbidity in patients with inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and chronic hepatitis C (HCV) and, 2) To test the hypothesis that patients with psychological co-morbidities are less likely to have a satisfactory response to standard treatment at 12 months.MethodsOverall, 139 patients were enrolled in this observational cohort prospective study. Over the ensuing year, physical and psychological measures were made at baseline and after 12 months (HADS, SCL90, SF-12 and disease activity measures). A logistic regression was conducted to observe any relationship between baseline characteristics and patients' clinical outcomes after 12 months.ResultsOverall, there was no relationship between psychological status and quality of life at baseline and relapse at 12 months (p > 0.05). However, patients with inactive disease at baseline were at lower risk of relapse after 12 months (OR = 0.046, CI: 0.012–0.178). No significant relationship was found between psychological problems such as depression/anxiety and a total number of relapses in the IBD group. However, interestingly, patients with an active disease at baseline tended to have a greater number of relapses (OR = 3.07, CI: 1.650–5.738) and CD participants were found at lower risk of relapse than UC participants (OR = 0.382, CI: 0.198–0.736).ConclusionIn contrast to previous investigations, this study suggests that there is no temporal relationship between psychological problems at baseline and clinical outcomes over time. Longer and larger prospective studies are needed to better understand this result.

The Role of Psychological Stress in Inflammatory Bowel Disease: Quality Assessment of Methods of 18 Prospective Studies and Suggestions for Future Research

“…We reviewed 20 eligible publications reported between 1990 and 2008 [10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29]. 2 studies were published by Levenstein et al [20, 22], 2 by Bitton et al [10, 19], and 2 by Maunder et al [12, 13], each based on different data.…”

Stress Coping, Distress, and Health Perceptions in Inflammatory Bowel Disease and Community Controls

“…It has recently been questioned whether there is any relationship between psychological functioning and disease status 59 . However, studies that were more adequately powered to detect differences have found that distress levels change in parallel with disease activity 11,16,60 , and those in relapse have poorer quality of life than those in remission 61,62 .…”

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

“…Gastroenterologists reported that antidepressants were successful in reducing pain, gut irritability, and urgency of defecation. In the most recent retrospective case-note audit of 287 patients, 83 (28.9%) patients had used an antidepressant at some time in their life [56][57][58][59] . Nonetheless, the design of the study does not allow a firm statement to be made about whether antidepressants improved the course of IBD.…”