By using our site, you agree to our collection of information through the use of cookies. To learn more, view our Privacy Policy. To browse Academia. A specifi c gene-expression signature quantifi es the degree of hepatic fi brosis in patients with chronic liver disease. Depression and anxiety are comorbidities of inflammatory bowel disease IBD. Though previous studies have proposed a relationship between anxiety, depression, and IBD, causality and directionality are largely unknown.
Current and future research in these areas is aimed at exploring the biological underpinnings of this relationship, specifically pertaining to small molecule metabolism, such as tryptophan. Tryptophan is acquired through the diet and is the precursor to several vital bioactive metabolites including the hormone melatonin, the neurotransmitter serotonin, and vitamin B3.
In this review, we discuss previous findings relating mental health comorbidities with IBD and underline ongoing research of tryptophan catabolite analysis. While there has been a great deal of speculation over the years on the importance of emotional factors in inflammatory bowel disease IBD , it is only in the last decade or so that studies with stronger designs have been available to clarify the nature of this relationship. This review considers recent evidence on the prevalence of anxiety and depressive disorders in IBD, the role of these disorders as a risk factor for IBD onset, the degree to which they affect the course of the IBD, and the contribution of corticosteroid treatment to psychiatric symptom onset.
There is evidence that anxiety and depression are more common in patients with IBD and that the symptoms of these conditions are more severe during periods of disease activity. The few studies that address the issue of anxiety and depression as risk factors for IBD do not yet provide enough information to support definite conclusions. There is evidence, however, that the course of the disease is worse in depressed patients. Treatment with corticosteroids can induce mood disorders or other psychiatric symptoms.
The second part of the review focuses on patient management issues for those with comorbid anxiety or depression. Practical approaches to screening are discussed, and are recommended for routine use in the IBD clinic, especially during periods of active disease. We review evidence-based pharmacological and psychological treatments for anxiety and depression, and discuss practical considerations in treating these conditions in the context of IBD, to facilitate overall management of the IBD patient.
