Psychosocial issues in evidence-based guidelines on inflammatory bowel diseases: a review

Abstract

Aim: To study statements and recommendations on psychosocial issues as presented in international evidence-based guidelines on the management of inflammatory bowel diseases (IBD).

Methods: MEDLINE, guidelines International Network, National Guideline Clearing House and National Institute for Health and Care Excellence were searched from January 2006 to June 30, 2013 for evidence-based guidelines on the management of IBD.

Results: The search yielded 364 hits. Thirteen guidelines were included in the review, of which three were prepared in Asia, eight in Europe and two in the United States. Eleven guidelines made statements and recommendations on psychosocial issues. The guidelines were concordant in that mental health disorders and stress do not contribute to the aetiology of IBD, but that they can influence its course. It was recommended that IBD-patients should be screened for psychological distress. If indicated, psychotherapy and/or psychopharmacological therapy should be recommended. IBD-centres should collaborate with mental health care specialists. Tobacco smoking patients with Crohn's disease should be advised to quit.

Conclusion: Patients and mental health specialists should be able to participate in future guideline groups to contribute to establishing recommendations on psychosocial issues in IBD. Future guidelines should acknowledge the presence of psychosocial problems in IBD-patients and encourage screening for psychological distress.

Keywords: Anxiety; Depression; Guidelines; Inflammatory bowel diseases; Psychological; Psychotherapy; Smoking; Stress.

Figure 1

Preferred reporting items for systematic reviews and meta-analyses flow diagram. G-I-N: Guidelines International Network; NGC: National Guideline Clearing House; NICE: National Institute for Health and Care Excellence.