Depression and anxiety in inflammatory bowel disease: A review of comorbidity and management
Abstract
While there has been a great deal of speculation over the years on the importance of emotional factors in inflammatory bowel disease (IBD), it is only in the last decade or so that studies with stronger designs have been available to clarify the nature of this relationship. This review considers recent evidence on the prevalence of anxiety and depressive disorders in IBD, the role of these disorders as a risk factor for IBD onset, the degree to which they affect the course of the IBD, and the contribution of corticosteroid treatment to psychiatric symptom onset. There is evidence that anxiety and depression are more common in patients with IBD and that the symptoms of these conditions are more severe during periods of active disease. The few studies that address the issue of anxiety and depression as risk factors for IBD do not yet provide enough information to support definite conclusions. There is evidence, however, that the course of the disease is worse in depressed patients. Treatment with corticosteroids can induce mood disorders or other psychiatric symptoms. The second part of the review focuses on patient management issues for those with comorbid anxiety or depression. Practical approaches to screening are discussed, and are recommended for routine use in the IBD clinic, especially during periods of active disease. We review evidence-based pharmacological and psychological treatments for anxiety and depression and discuss practical considerations in treating these conditions in the context of IBD to facilitate overall management of the IBD patient.
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Individuals with rheumatoid arthritis and inflammatory bowel disease are 2 to 3 times more likely to have major depression than the general population.
“individuals with rheumatoid arthritis and inflammatory bowel disease are 2 to 3 times more likely to have major depression than the general population”
From From stress to inflammation and major depressive disorder: A social signal transduction theory of depression. (2014) · cites this paper as Graff, Walker, & Bernstein, 2009
Comorbid psychological difficulties in IBD are associated with disease activity, flares, treatment response, and the necessity of surgical intervention.
“Indeed, comorbid psychological difficulties are associated with disease activity, flares, treatment response, and the necessity of surgical intervention [2,6,8,9,10,11,12,13,14,15].”
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- Authors
- Graff, L. A., Walker, J. R., & Bernstein, C. N.
- Affiliations
- University of Manitoba (CA)
- Venue
- Inflammatory Bowel Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-07
- Volume
- 15
- Issue
- 7
- Pages
- 1105-1118
- ISSN
- 1078-0998 (ISSN-L)
- OpenAlex
- W1965651011
- Cited by
- 586
- References
- 142
- Citations by year
- 2026: 12 · 2025: 27 · 2024: 19 · 2023: 18 · 2022: 39 · 2021: 58 · 2020: 43 · 2019: 42 · 2018: 50 · 2017: 38 · 2016: 50 · 2015: 45 · 2014: 35 · 2013: 41 · 2012: 26
- FWCI
- 2.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Inflammatory Bowel Diseases (publishedVersion)
- PubMed (publishedVersion)
- Mspace (University of Manitoba) (submittedVersion)
- Funders
- Crohn's and Colitis Foundation
- Crohn's and Colitis Foundation of Canada
- Canadian Institutes of Health Research
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- inflammatory bowel disease, depression
- MeSH terms
- Adrenal Cortex Hormones, Anxiety, Depression, Humans, Risk Factors, Inflammatory Bowel Diseases, Comorbidity, Prevalence
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