New research shows that patients with inflammatory bowel disease (IBD) are not significantly related to 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 IBD patients.
Previous research shows that IBD patients are more likely to suffer from symptoms of psychological illnesses, including depression, anxiety, and stress.
“The presence of psychological illness has negative impacts on quality of life and IBD-related outcomes,” the authors wrote. “Successful treatment of psychological illness can improve quality of life and health outcomes, which makes diagnosis and implementation of treatment extremely important. “
In the study, investigators looked at adult IBD patients who underwent ileocoloscopies. The team collected different data points on demographics, psychological symptoms including depression, anxiety and stress, disease activity including symptoms, biomarkers, endoscopy and quality of life.
Each participant completed questionnaires on symptoms, psychological health and quality of life. Investigators also collected stool samples for biomarker analysis during the week before their ileocoloscopy.
Investigators also collected stool samples during the 6-month follow-up appointment and each participant responded to the same questionnaires.
The researchers used one-way ANOVA and multivariate analyzes to examine associations between disease activity and symptoms of psychological disease. They also identified other predictors of mental illness and reduced quality of life.
The study included 172 patients, including 107 with Crohn’s disease and 65 patients with ulcerative colitis.
Researchers did not find a significant link between objective disease activity, whether it was endoscopic scores, fecal calprotectin, or C-reactive protein, and scores for depression, anxiety, or of stress (P > 0.05 for all comparisons).
On the other hand, gastrointestinal symptoms were significantly associated with depression, anxiety and stress in patients with IBD (P
After the implementation of the multivariate analysis, only gastrointestinal symptoms were significantly related to severe symptoms of depression (OR, 20.78; 95% CI, 6.71-92.37; P P = 0.004).
Trends were also observed depending on the treatment used for IBD.
The use of anti-TNF and corticosteroids, as well as the presence of severe depressive symptoms, moderate to severe stress and gastrointestinal symptoms, and endoscopically active IBD have been associated with reduced quality of life (P P
Improving quality of life is a key goal for clinicians, with several modifiable factors identified during the study that may be of benefit for patients with IBD.
“Objective measures of disease activity are not associated with symptoms of psychological disease in IBD patients,” the authors wrote. “Clinicians should consider an underlying mental illness in IBD patients with active gastrointestinal symptoms. “
The study, “The impact of disease activity on psychological symptoms and quality of life in patients with inflammatory bowel disease – Study results on stress, anxiety and depression with disease activity (SADD) ”, was published online in Food and therapeutic pharmacology.