The effect of functional gastrointestinal disorders on psychological comorbidity and quality of life in patients with inflammatory bowel disease

Mikocka‐Walus, Antonina; Turnbull, Deborah; Andrews, Jane M.; Moulding, Nicole; Holtmann, Gerald

doi:10.1111/j.1365-2036.2008.03754.x

Cited by 52 publications

(43 citation statements)

References 37 publications

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“…This effect was not observed in the control group. Although this report of decreased symptoms may simply reflect the report of fewer functional gastrointestinal symptoms when patients are in better psychological health [61,62] , it may also indicate an inflammation-specific benefit from antidepressants. Thus, it is clear that randomized controlled trials are justified and needed to provide a definitive answer regarding the efficacy of antidepressants in IBD.…”

Section: Psychiatric Therapy In Ibdmentioning

confidence: 99%

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

Filipović¹,

Filipović²

2014

WJG

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Ulcerative colitis and Crohn's disease, commonly known as inflammatory bowel disease (IBD), draw attention from specialists of various disorders, including gastroenterology, psychiatry, and radiology. The involvement of a cortical influence in the brain-gut axis as well as the interaction of the hypothalamic-pituitary-adrenal axis and the peripheral nervous system provide an initial explanation of the psychological symptoms associated with IBD. The involvement of structures the limbic system, such as the anterior cingulate cortex, the prefrontal cortex, and the amygdala, paves the way for the discovery of the mechanisms underlying depression depression, anxiety, alexithymia, personality traits, and other psychological impairments following the onset of IBD. Psychiatric therapy in IBD patients is almost as important as the gastroenterological approach and consists of pharmacological treatment and psychotherapy. Neither of the available psychiatric treatment methods is considered the golden standard because both methods have side effects, and psychotropic medication can provoke the worsening of IBD symptoms. Thus, both approaches must be applied with awareness of the possibility of side effects. We suggest that psychiatrists and gastroenterologists work together to reach a consensus on IBD therapy to ensure success and to reduce side effects and relapse to the lowest possible rates.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Inflammatory bowel disease; Psychiatry; Treatment; Personality traits; Depression; Anxiety Core tip: The involvement of a dysfunction of brain-gut interactions in the pathogenesis of inflammatory bowel disease (IBD) is represented by a dysfunction of the autonomic nervous system, an abnormal hypothalamicpituitary-adrenal axis and cholinergic anti-inflammatory pathway, a deleterious effect of stress and depression, an abnormal coupling of the prefrontal cortex-amygdaloid complex, and an abnormal relation between the microbiota and the brain as pro-inflammatory factors. New investigations have provided a critical link between forebrain changes and abdominal pain independent of active disease and drug treatment, providing a potential basis for an explanation of the psychological symptoms and brain influence in the pathogenesis of IBD.

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Section: Psychiatric Therapy In Ibdmentioning

confidence: 99%

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

Filipović¹,

Filipović²

2014

WJG

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“…Anxiety is reported to be present in up to 40% of patients with IBD [11, 14, 31] and is more likely to be present in patients with active disease [13, 14, 16, 17]. There are few reports of how anxiety may change over time or with change in disease activity.…”

Section: Discussionmentioning

confidence: 99%

“…Previous literature suggests that anxiety is present in up to 40% of adults with CD [9, 11-13] and that up to 10% suffer from depression [11, 13-15]. Active CD is associated with greater symptoms of anxiety and depression [13, 14, 16, 17], and the achievement of disease remission mostly results in a reduction in symptoms of anxiety and depression [10].…”

Section: Introductionmentioning

confidence: 99%

Newly Diagnosed Crohn’s Disease Treated with Standard Care or Enteral Nutrition: Psychological Outcomes over 6 Months

et al. 2019

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Background and Aim: Impaired health-related quality of life and higher rates of anxiety and depression are observed in patients with Crohn’s disease. This single center study aimed to describe and compare longitudinal psychological outcomes of newly diagnosed Crohn’s disease patients treated with standard care or enteral nutrition to induce remission. Methods:Two separate cohorts of patients were recruited from one center and treated with standard care (n = 22) or enteral nutrition (n = 18) to induce disease remission. Disease activity, quality of life, anxiety, and depression were assessed at diagnosis and month 6. Results:At baseline, quality of life (n = 40) was not correlated with disease activity; symptoms of anxiety and depression were present in 15 (38%) and 5 (13%) of the 40 patients, respectively. Significant improvements in quality of life (p <0.0001) and anxiety scores (p = 0.002) were observed after 2 weeks of exclusive enteral nutrition, and at month 6 significant improvements in all psychological outcomes were observed. At month 6, patients who received standard care had a significant improvement in quality of life (p = 0.004), but not in anxiety or depression scores, and there were no differences in psychological outcomes between the treatment groups. Overall, 34/40 (85%) patients were in clinical remission at month 6, and a clinically significant quality of life score was achieved by 31/40 (78%). Conclusions:Patient health-related quality of life and symptoms of anxiety and depression improved as disease activity improved, and 6 months after diagnosis psychological outcomes were similar in patients treated with standard care or enteral nutrition to initially induce remission.

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“…Two of these publications refer to the same IBD cohort [34,49] , leaving 18 prevalence estimations. Two studies explore IBS symptoms in IBD patients regardless their inflammatory activity status [42,47] . The 16 remaining studies are summarized in Table 1.…”

Section: How Many Ibd Patients In Remission Have Ibs-like Symptoms?mentioning

confidence: 99%

“…From 1983 until 2014 a total of 19 studies have measured the prevalence of IBS-like symptoms in IBD [1][2][3][4][5][33][34][35][42][43][44][45][46][47][48][49][50][51][52] . Two of these publications refer to the same IBD cohort [34,49] , leaving 18 prevalence estimations.…”

Section: How Many Ibd Patients In Remission Have Ibs-like Symptoms?mentioning

confidence: 99%

Diagnosis and management of functional symptoms in inflammatory bowel disease in remission

Teruel

Garrido

Mesonero

2016

WJGPT

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it in the present work. We describe a problematic that comprises physiopathological uncertainties, diagnostic difficulties, as IBS-like symptoms are very similar to those produced by an inflammatory flare, and the necessity of appropriate management of these patients, who, although in remission, have impaired quality of life. Ultimately, from almost a philosophical point of view, the presence of IBS-like symptoms in IBD patients in remission supposes a challenge to the traditional functional-organic dichotomy, suggesting the need for a change of paradigm. Core tip: Many inflammatory bowel disease patients in remission suffer from ongoing gastrointestinal symptoms that resemble those of irritable bowel syndrome and that hinder their quality of life. We review the pathogenesis of these symptoms, their prevalence and the best management strategies. Author contributions: All authors contributed equally to this work. Conflict-of-interest statement:The authors declare no conflicts of interest. AbstractInflammatory bowel disease (IBD) patients in remission may suffer from gastrointestinal symptoms that resemble irritable bowel syndrome (IBS). Knowledge on this issue has increased considerably in the last decade, and it is our intention to review and summarize REVIEWSubmit a

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The effect of functional gastrointestinal disorders on psychological comorbidity and quality of life in patients with inflammatory bowel disease

Abstract: SUMMARY BackgroundSymptoms of functional gastrointestinal disorders (FGIDs) are common in patients with inflammatory bowel disease (IBD). Psychological comorbidities of anxiety and depression are also highly prevalent in IBD.

Cited by 52 publications

References 37 publications

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

Newly Diagnosed Crohn’s Disease Treated with Standard Care or Enteral Nutrition: Psychological Outcomes over 6 Months

Diagnosis and management of functional symptoms in inflammatory bowel disease in remission

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