Background: Depression and anxiety have been identified as symptoms of inflammatory bowel disease (IBD). An association between disease severity and depressive symptoms has been observed. Corticosteroids are used to treat IBD flares but frequently causes neuropsychiatric adverse effects that are expressed as hypomania, anxiety, and psychosis. There is a gap in literature pertaining to the effect of steroids on mood changes in patients with IBD. This scholarly research project aims to investigate this relationship.
Methods: A systematic review was performed by a graduate nursing student under faculty supervision. Terms such as "inflammatory bowel disease," "Crohn's Disease," "ulcerative colitis," "mood," "mental health," "psychiatric," "depression," "anxiety," "corticosteroids" and "steroids" were searched for in online databases of PubMed, CINHAL, PsychInfo, Medline, and Google Scholar. Eligibility was established by predetermined inclusion and exclusion criteria.
Results: Ten research articles were critiqued, and the data was synthesized into themes of comorbid anxiety and depression with IBD, effects of antidepressant therapy on IBD, corticosteroid induced mood changes, and populations at risk.
Conclusion: Patients with IBD and concurrent anxiety/depression experience improved IBD symptoms with antidepressant therapy. However, patients on antidepressants are more likely to experience neuropsychiatric adverse effects from corticosteroids such as hypomania, insomnia, and anxiety. Providers should be aware of the potential benefits and risks of prescribing antidepressants and corticosteroids in patients with IBD. Future research can clarify benefits and risks by investigating if corticosteroids are required less in IBD patients who take antidepressants.
Copyright © 2021 by The American College of Gastroenterology.