IBD-related mental health disorders: where do we go from here?

Abstract

Inflammatory bowel disease is a complex and debilitating disease which is known to cause mental burden for patients. Even though few studies look at mental health disease in this cohort of patients, there is growing evidence of a correlation between disease activity and prevalence of mental health conditions such as anxiety, depression and post-traumatic stress disorder. In this literature review, the relationship between inflammatory bowel disease and mental health disorders is explored, with an emphasis on recognition, screening and therapeutic options and special considerations for these complex comorbidities. The relationship between medical and psychological disease is not often considered and less well understood and there is a need for further research in these fields. Patients would have much to gain both medically and psychologically from a multidisciplinary approach to this chronic disease association.

Keywords: IBD; inflammatory bowel disease; psychological stress; psychology; surgery for IBD.

Figure 1

PTSD/PTS common symptoms. PTS, post-traumatic stress; PTSD, post-traumatic stress disorder. Women, minority ethnic groups and less than college-educated individuals are disproportionally affected and twice as likely to suffer with these symptoms.

Figure 2

IBD holistic care. IBD, inflammatory bowel disease; MHD, mental health disease.

Figure 3

IBD-associated MHD pathway for clinicians. IBD, inflammatory bowel disease; LIPS-IBD, Luebeck interview for psychosocial screening in patients with IBD; MHD, mental health disease; PC-PTSD-5, primary care post-traumatic stress disorder for Diagnostic and Statistical Manual of Mental Disorders, fifth edition; PHQ, Patient Health Questionnaire; PTS/PTSD, post-traumatic stress/disorder; TSQ, Trauma Screening Questionnaire.