Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

World J Gastroenterol. 2014 Apr 7;20(13):3552-63. doi: 10.3748/wjg.v20.i13.3552.


Ulcerative colitis and Crohn's disease, commonly known as inflammatory bowel disease (IBD), draw attention from specialists of various disorders, including gastroenterology, psychiatry, and radiology. The involvement of a cortical influence in the brain-gut axis as well as the interaction of the hypothalamic-pituitary-adrenal axis and the peripheral nervous system provide an initial explanation of the psychological symptoms associated with IBD. The involvement of structures the limbic system, such as the anterior cingulate cortex, the prefrontal cortex, and the amygdala, paves the way for the discovery of the mechanisms underlying depression depression, anxiety, alexithymia, personality traits, and other psychological impairments following the onset of IBD. Psychiatric therapy in IBD patients is almost as important as the gastroenterological approach and consists of pharmacological treatment and psychotherapy. Neither of the available psychiatric treatment methods is considered the golden standard because both methods have side effects, and psychotropic medication can provoke the worsening of IBD symptoms. Thus, both approaches must be applied with awareness of the possibility of side effects. We suggest that psychiatrists and gastroenterologists work together to reach a consensus on IBD therapy to ensure success and to reduce side effects and relapse to the lowest possible rates.

Keywords: Anxiety; Depression; Inflammatory bowel disease; Personality traits; Psychiatry; Treatment.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Anxiety / complications
  • Cognition Disorders / complications
  • Comorbidity
  • Depression / complications
  • Humans
  • Inflammatory Bowel Diseases / complications*
  • Inflammatory Bowel Diseases / psychology*
  • Inflammatory Bowel Diseases / therapy
  • Mental Disorders / complications*
  • Mental Disorders / therapy
  • Personality
  • Psychotherapy / methods
  • Quality of Life
  • Recurrence
  • Severity of Illness Index
  • Sleep Deprivation