Depression, anxiety mostly unrelated to inflammatory bowel disease

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New research shows that inflammatory bowel disease (IBD) patients are not significantly associated with most psychiatric symptoms, including depression, anxiety, and stress.

A team led by Thomas C. Mules, Christchurch Hospital, Canterbury District Health Board, Canterbury, New Zealand, correlated objective measures of disease activity with psychological symptoms in patients with IBD.

Previous research shows that people with IBD are more likely to experience symptoms of mental illness such as depression, anxiety, and stress.

“The presence of mental illness has a negative impact on quality of life and IBD-related outcomes,” the authors write. “Successful treatment of mental illness can improve quality of life and health-related outcomes, which makes diagnosis and delivery of treatment extremely important.”

The study

In the study, researchers looked at adult patients with IBD who had undergone ileocolonoscopy. The team collected various data points on demographics, mental symptoms including depression, anxiety and stress, disease activity including symptoms, biomarkers, endoscopy, and quality of life.

Each participant completed questionnaires on symptoms, mental health, and quality of life. The researchers also collected stool samples for biomarker analysis the week before their ileocolonoscopy.

Investigators also collected stool samples at the 6-month follow-up appointment and each participant completed the same questionnaires.

Researchers used one-way ANOVA and multivariable analysis to examine the relationships between disease activity and symptoms of mental illness. They also identified other predictors of mental illness and decreased quality of life.

The study included 172 patients, 107 with Crohn’s disease and 65 with ulcerative colitis.

No connection

The researchers found no significant association between objective disease activity, be it endoscopic scores, fecal calprotectin or C-reactive protein, and depression, anxiety or stress scores (P. > 0.05 for all comparisons).

On the other hand, gastrointestinal symptoms in patients with IBD disorder were significantly associated with depression, anxiety, and stress (P.

After performing the multivariable analysis, only the gastrointestinal symptoms were significantly associated with the severe symptoms of depression (OR 20.78; 95% CI 6.71-92.37; P. P. = 0.004).

Trends were also found depending on the treatment of IBD.

Both the use of anti-TNF and corticosteroids, together with the presence of severe depressive, moderate to severe stress and gastrointestinal symptoms, as well as endoscopically active IBD, were associated with a reduced quality of life (P. P.

Improving the quality of life is an important goal for clinicians, with several modifiable factors identified during the study that could be beneficial for patients with IBD.

“Objective measurements of disease activity in patients with IBD are not associated with symptoms of mental illness,” the authors write. “Physicians should consider an underlying mental illness in patients with IBD with active gastrointestinal symptoms.”

The study “The Influence of Disease Activity on Mental Symptoms and Quality of Life in Patients with Inflammatory Bowel Disease – Results of the Stress, Anxiety and Depression with Disease Activity (SADD) study” was published online in Nutritional pharmacology and therapeutics.


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