Mental health conditions have been tied to IBD, including Crohn’s disease and ulcerative colitis, for some time. But a firm cause-and-effect hasn't yet been confirmed. Some people call the link controversial.
The University of York research team found that seven out of 12 published studies linked depression and anxiety with IBD flare-ups, but five didn't.
They attributed this to inconsistencies between the previous studies, including differences in their length, number of people included, selection methods, and the way anxiety, depression, and IBD severity were assessed.
They next looked at data from a Swiss study of over 2,000 people with IBD carried out between 2006 and 2015. The participants had answered questionnaires about any anxiety or depression symptoms, and the researchers had estimated how severe their IBD was.
A little more than half of the participants had Crohn’s disease, while the rest had ulcerative colitis or indeterminate colitis. The average age of the group was just over 40, and about 48% were men. On average they’d had IBD symptoms for roughly 7 years.
At the start of the study, about 20% of the participants had depression, and nearly 38% had anxiety. Women were slightly more likely to have anxiety than men were, but depression rates were similar between the sexes.
The people with depression or anxiety had IBD flare-ups sooner than those without the psychological conditions. The link was stronger for depression than it was with anxiety.
The new study doesn't give medical reasons for the conditions being linked, but the researchers say people with depression may be less likely to follow their IBD treatment plan.
The results suggest that doctors should screen their patients with IBD for common mental disorders and refer them to mental health professionals for treatment if needed, Antonina Mikocka-Walus, PhD, and colleagues from the University of York say.
The finding may have important implications for IBD management, two other experts -- David Gracie, from the Leeds Gastroenterology Institute, St. James’s University Hospital, and Alexander Ford from the Leeds Institute of Biomedical and Clinical Sciences, University of Leeds -- write in a letter to the journal Clinical Gastroenterology and Hepatology, commenting on the study.