"Role of Psychosocial Factors on the Course of Inflammatory Bowel Disease and Associated Psychotherapeutic Approaches. A Fresh Perspective and Review"

Abstract

In this review article we seek to provide a fresh prospective on the role of psychosocial factors such as stress, anxiety, and depression, in the course of Inflammatory Bowel Diseases (IBD). IBD patients suffer from depression and anxiety at higher rates than the general population. Psychological stressors adversely affect the course of IBD through activation and possible dysfunction of the Brain-Gut-Axis. The mechanisms by which psychological factors increase mucosal inflammation, disrupt the intestinal barrier, and thereby worsen IBD symptoms are not well understood. This is a new and upcoming area of research that needs more attention because of its importance in managing and treating patients with IBD while also reducing costs associated with these disorders. Therefore, in this article we also seek to explore treatment options that target these psychological factors. Interventions include both pharmacological and nonpharmacological psychotherapeutic approaches. Whereas some of these therapies improve IBD symptoms, many also improve depression, anxiety, stress symptoms, fatigue, relapse rate, and Quality of Life (QOL) in both adults and children with IBD. These psychological factors are important determinants of health related quality of life (HRQOL) and therefore are important symptoms to treat alongside the IBD symptoms.

A Phenomenological Investigation of Trauma in 18 Adults Living With Inflammatory Bowel Disease

“…Like anxiety and depression, exposure to stress is a major risk factor impacting IBD and is also linked to adverse patient outcomes, such as reduced QoL (Van de Star & Banan, 2015) and psychological well-being (Melinder et al, 2017; van der Sloot et al, 2020). In a recent systematic review involving 13 of 18 prospective studies ( n = 1,283), Cámara et al (2009) concluded that stress was linked to exacerbating IBD activity.…”

Investigation of Effective Factors on the Quality of Life of Patients Suffering from Ulcerative Colitis in Remission

“…Previous studies have shown that the health-related quality of life (HRQOL) in patients suffering from UC is lower compared to the healthy individuals (8,9). Many studies have shown that the medical treatment (corticosteroids and immunosuppressive-drugs) (8), extra-intestinal manifestations (10) and employment status (11) are among the factors which reduce the HRQOL of patients suffering from UC (12,13). In addition, there are contradictory data in regard to the effect of therapeutic regimens of UC on HRQOL.…”