Lag Time between Stress Events and Risk of Recurrent Episodes of Inflammatory Bowel Disease

Lc, Duffy; Ma, Zielezny; Маршалл, .; Mm, Weiser; Jf, Phillips; Te, Byers; Bm, Calkins; Graham, Saxon; Pl, Ogra

doi:10.1097/00001648-199103000-00009

Cited by 40 publications

(21 citation statements)

References 10 publications

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“…In terms of the association between variables experienced in one 3-mo period and a symptomatic flare in the next 3-mo period, only psychological factors, including the occurrence of a major life event, high perceived stress, and high negative mood during a previous 3-mo period, were significantly associated with the subsequent occurrence of a flare. This study complements the growing evidence from experimental as well as clinical studies that stress exposure, including stressful events and perceived stress (the individual's view of his or her own level of demand relative to resources), may contribute to relapse risk in IBD [14][15][16][17][18] . In fact, using multivariate logistic regression analyses of these variables, only high perceived stress (adjusted OR = 2.40; 95%CI: 1.35-4.26) was associated with an increased risk of flare.…”

Section: Psychological Symptoms In Ibdsupporting

confidence: 58%

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

Filipović¹,

Filipović²

2014

WJG

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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.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Inflammatory bowel disease; Psychiatry; Treatment; Personality traits; Depression; Anxiety Core tip: The involvement of a dysfunction of brain-gut interactions in the pathogenesis of inflammatory bowel disease (IBD) is represented by a dysfunction of the autonomic nervous system, an abnormal hypothalamicpituitary-adrenal axis and cholinergic anti-inflammatory pathway, a deleterious effect of stress and depression, an abnormal coupling of the prefrontal cortex-amygdaloid complex, and an abnormal relation between the microbiota and the brain as pro-inflammatory factors. New investigations have provided a critical link between forebrain changes and abdominal pain independent of active disease and drug treatment, providing a potential basis for an explanation of the psychological symptoms and brain influence in the pathogenesis of IBD.

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Section: Psychological Symptoms In Ibdsupporting

confidence: 58%

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

Filipović¹,

Filipović²

2014

WJG

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“…We reviewed 20 eligible publications reported between 1990 and 2008 [10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29]. 2 studies were published by Levenstein et al [20, 22], 2 by Bitton et al [10, 19], and 2 by Maunder et al [12, 13], each based on different data.…”

Section: Resultsmentioning

confidence: 99%

“…Data of the latter 2 studies [12, 13], however, showed partial overlap. Duffy et al [25, 26 ]reported twice on the same data addressing different questions. Mittermaier et al [18] reported twice on the same data addressing the same question after 1 [24] and 3 years [23] of follow-up performing 5 and 10 longitudinal assessments, respectively.…”

Section: Resultsmentioning

confidence: 99%

The Role of Psychological Stress in Inflammatory Bowel Disease: Quality Assessment of Methods of 18 Prospective Studies and Suggestions for Future Research

et al. 2009

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Background: Enquiries among patients on the one hand and experimental and observational studies on the other suggest an influence of stress on inflammatory bowel diseases (IBD). However, since this influence remains hypothetical, further research is essential. We aimed to devise recommendations for future investigations in IBD by means of scrutinizing previously applied methodology. Methods: We critically reviewed prospective clinical studies on the effect of psychological stress on IBD. Eligible studies were searched by means of the PubMed electronic library and through checking the bibliographies of located sources. Results: We identified 20 publications resulting from 18 different studies. Sample sizes ranged between 10 and 155 participants. Study designs in terms of patient assessment, control variables, and applied psychometric instruments varied substantially across studies. Methodological strengths and weaknesses were irregularly dispersed. Thirteen studies reported significant relationships between stress and adverse outcomes. Conclusions: Study designs, including accuracy of outcome assessment and repeated sampling of outcomes (i.e. symptoms, clinical, and endoscopic), depended upon conditions like sample size, participants’ compliance, and available resources. Meeting additional criteria of sound methodology, like taking into account covariates of the disease and its course, is strongly recommended to possibly improve study designs in future IBD research.

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“…A number of older studies yielded mixed results and sometimes measured only the subjective symptoms. [6][7][8][9][10][11][12] Four recent studies have substantiated the role of psychological distress in the exacerbation of 'objective' IBD activity. A cross-sectional study in UC showed a correlation between stressful life events, depression and disease activity.…”

Section: Introductionmentioning

confidence: 99%

The impact of major depressive disorder on the short‐ and long‐term outcome of Crohn's disease treatment with infliximab

Persoons

Vermeire

Demyttenaere

et al. 2005

Aliment Pharmacol Ther

214

161

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Summary Background: Major depressive disorder is the most common psychiatric diagnosis in Crohn's disease. In other chronic diseases, evidence suggests that depression influences the course of the disease. Strong evidence of such a mediating role of major depressive disorder in Crohn's disease has never been found.Aim: To assess the relationship between major depressive disorder and outcome of treatment of luminal Crohn's disease with infliximab.Methods: In this prospective study, 100 consecutive unselected patients underwent assessment of psychosocial, demographical disease‐related biological and clinical parameters at baseline and at 4 weeks after infliximab. Major depressive disorder was diagnosed using the Patient Health Questionnaire. Subsequently, the patients were followed up clinically until the next flare or during 9 months.Results: The Crohn's disease responded in 75% of the patients, and remission was achieved in 60%. The presence of major depressive disorder at baseline predicted a lower remission rate (OR = 0.166, 95% CI = 0.049–0.567, P = 0.004). At follow‐up, 88% of the patients needed retreatment. At univariate regression analysis, major depressive disorder significantly decreased time to retreatment (P = 0.001). Multivariate Cox regression confirmed major depressive disorder as an independent determinant of active disease both at baseline and at re‐evaluation (hazard ratio = 2.271, 95% CI: 1.36–3.79, P = 0.002).Conclusion: Major depressive disorder is a risk factor for failure to achieve remission with infliximab and for earlier retreatment in patients with active luminal Crohn's disease. Assessment and management of major depressive disorder should be part of the clinical approach to patients with Crohn's disease.

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Lag Time between Stress Events and Risk of Recurrent Episodes of Inflammatory Bowel Disease

Cited by 40 publications

References 10 publications

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

The Role of Psychological Stress in Inflammatory Bowel Disease: Quality Assessment of Methods of 18 Prospective Studies and Suggestions for Future Research

The impact of major depressive disorder on the short‐ and long‐term outcome of Crohn's disease treatment with infliximab

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