Impact of depressive mood on relapse in patients with inflammatory bowel disease: A prospective 18-month follow-up study
Abstract
OBJECTIVE: There is evidence of an interaction between psychological factors and activity of inflammatory bowel disease (IBD). We examined the influence of depressive mood and associated anxiety on the course of IBD over a period of 18 months in a cohort of patients after an episode of active disease. METHODS: In this prospective, longitudinal, observational study, 60 patients (37 women and 23 men) with clinically inactive IBD (Crohn disease, n = 47, 78%; ulcerative colitis, n = 13, 22%) were enrolled after a flare of disease. Psychological status, health-related quality of life (HRQOL), and disease activity were evaluated at baseline and then every 3 months for a period of 18 months by means of clinical and biological parameters, the Beck Depression Inventory (BDI), the Spielberger State-Trait Anxiety Inventory, the Inflammatory Bowel Disease Questionnaire, the Perceived Stress Questionnaire, and the Rating Form of Inflammatory Bowel Disease Patients Concerns. RESULTS: At baseline, depression (BDI > or = 13 points) was found in 17 of 60 (28%) patients. Thirty-two patients (59%) experienced at least one relapse during the 18 months of follow-up. Regression analysis showed a significant correlation between BDI scores at baseline and the total number of relapses after 12 (p <.01) and 18 months (p <.01) of follow-up. Furthermore, depression scores at baseline correlated with the time until the first recurrence of the disease (p <.05). Anxiety and low HRQOL were also related with more frequent relapses during follow-up (p <.05 and p <.01, respectively). CONCLUSIONS: Psychological factors such as a depressive mood associated with anxiety and impaired HRQOL may exert a negative influence on the course of IBD. Therefore, assessment and management of psychological distress should be included in clinical treatment of patients with IBD.
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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].”
Patients with anxiety appeared to have an increased recurrence frequency.
“In particular, patients with anxiety appeared to have an increased recurrence frequency (93).”
From Stress triggers flare of inflammatory bowel disease in children and adults (2019) · cites this paper as [93]
In a prospective longitudinal study of 60 patients with quiescent IBD followed up to 18 months, baseline depression score was connected with the first recrudescence time.
“Moreover, in a prospective longitudinal study, 60 patients with quiescent IBD were followed-up for up to 18 months. The baseline depression score was found to be connected with the first recrudescence time.”
From Stress triggers flare of inflammatory bowel disease in children and adults (2019) · cites this paper as [93]
When left untreated, mental disorders in IBD have been linked to more severe IBD symptoms and more frequent IBD flares.
“When left untreated, these mental disorders have been linked to more severe IBD symptoms and more frequent IBD flares (7), higher hospitalisation rates (10), and lower compliance with treatment (11) than for individuals without these co-morbidities.”
From Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases (2016) · cites this paper as [7]
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- Authors
- Mittermaier, C., Dejaco, C., Waldhoer, T., Oefferlbauer-Ernst, A., Miehsler, W., Beier, M., Tillinger, W., Gangl, A., & Moser, G.
- Affiliations
- University of Vienna (AT)
- Corresponding author
- Dejaco, Clemens
- Venue
- Psychosomatic Medicine
- Published
- 2004-01
- Volume
- 66
- Issue
- 1
- Pages
- 79-84
- ISSN
- 0033-3174 (ISSN-L)
- OpenAlex
- W2047170682
- Cited by
- 532
- References
- 44
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 19 · 2023: 15 · 2022: 28 · 2021: 30 · 2020: 18 · 2019: 27 · 2018: 38 · 2017: 34 · 2016: 35 · 2015: 36 · 2014: 26 · 2013: 28 · 2012: 31
- FWCI
- 10.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- inflammatory bowel disease, depressive mood, depression, anxiety, relapse, Crohn's disease, ulcerative colitis, health-related quality of life, psychological distress, disease activity
- MeSH terms
- Adult, Affect, Colitis, Ulcerative, Crohn Disease, Depression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Psychological Tests, Quality of Life, Recurrence, Severity of Illness Index, Inflammatory Bowel Diseases, Disease Progression
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