The effects of psychiatric treatment on depression, anxiety, quality of life, and sexual dysfunction in patients with inflammatory bowel disease

Abstract

ObjectiveDepression and anxiety are common disorders in inflammatory bowel disease (IBD). Our aim is to prospectively determine the effect of psychiatric treatment on scores for depression, anxiety, quality of life (QoL), and sexual dysfunction in an outpatient population diagnosed with IBD and also anxiety and/or depression disorder.Patients and methodsPatients who scored higher than the cutoff point on the Hospital Anxiety Depression Scale were referred for further structured psychiatric evaluation and determination of the need for psychiatric drug treatment. Patients who underwent drug therapy completed Short Form-36 (SF-36) and the Arizona Sexual Experience Scale at baseline and after 6 months of follow-up.ResultsMajor depressive disorder and generalized anxiety disorder were the most common diagnoses. After 6 months, 47 patients had completely adhered to drug treatment (group A), whereas 20 were nonadherent (group B). In group A, all domains of SF-36, Arizona Sexual Experience Scale, depression/anxiety scores, and Crohn’s disease activity index were statistically improved after treatment when compared with the baseline. In group B, the three domains of SF-36, platelet count, and mean corpuscular volume were worse between baseline and at 6 months.ConclusionIn IBD patients having any psychiatric disorder, 6 months of antidepressant drug treatment is associated with an improvement in depression, anxiety, QoL, and sexual functioning scores, as well as an improvement in Crohn’s disease activity index. On the other hand, insufficient psychiatric treatment seems to be related to a poor QoL.

Development of a Sexual Dysfunction Scale for Women With Inflammatory Bowel Disease

“…3 Increased inflammatory bowel disease activity, abdominal and pelvic surgery, and depression have all been linked to sexual dysfunction. 35,36 Many studies have demonstrated that disease activity in IBD is strongly linked to depression and anxiety, [37][38][39] which in turn has been shown to increase symptoms of sexual dysfunction. 38,39 Active IBD in women is associated with reduced self-perception of attractiveness, sexual satisfaction, and sexual activity.…”

“…35,36 Many studies have demonstrated that disease activity in IBD is strongly linked to depression and anxiety, [37][38][39] which in turn has been shown to increase symptoms of sexual dysfunction. 38,39 Active IBD in women is associated with reduced self-perception of attractiveness, sexual satisfaction, and sexual activity. 40 However, data regarding disease activity as a reason for sexual dysfunction are conflicting.…”

Surgery, stomas, and anxiety and depression in inflammatory bowel disease: a retrospective cohort analysis of privately insured patients

“…Cognitive behavioural therapy has been found to improve symptoms of depression and quality of life among IBD patients . Pharmacological therapy in the form of selective serotonin reuptake inhibitors and tricyclic antidepressants has improved psychiatric symptoms, quality of life and IBD disease activity . Given the existence of effective treatments with the potential for significant clinical and psychological impact, interventions targeting screening and treatment for anxiety and depression at both the preoperative and postoperative surgical visits may be of significant clinical utility.…”

The Effect of Antidepressants on the Course of Inflammatory Bowel Disease

“…Thus, pharmacological therapy for mood disorders may have the potential to alter the natural history of CD and UC. Limited data, to date, have suggested improvements in mood, inflammatory activity, and quality of life with antidepressant therapy [ 23 , 38 ]. Our own longitudinal follow-up data did not show any statistically significant differences in the proportion of patients experiencing endpoints consistent with inflammatory activity, according to use of antidepressants at baseline.…”