Psychological factors in IBD

Evidence suggests that the brain and digestive tract have a reciprocal relationship (Gut-brain axis). That is, gastrointestinal symptoms are associated with psychological distress, such as anxiety and depression, and that people with symptoms of psychological distress (e.g., anxiety depression) are more likely to go on to develop gastrointestinal symptoms. Unsurprisingly, psychological factors play appear to play a significant role in the health and wellbeing of IBD patients. IBD patients report high rates of report high rates of anxiety and depressive symptoms, as well as concerns about losing energy and control, their body-image (e.g., medication side effects, having a stoma), and feeling isolated or afraid.

Psychological distress – what are the risk factors?

The research to date tells us that psychological distress and disease activity are interrelated –those with active IBD are more likely to report symptoms of psychological distress (i.e., depression, anxiety), than both the general population and IBD patients in remission. This is not surprising given that active disease can come with significant physical discomfort and disruption to one’s life. Similarly, we know thatstress is a significant risk factor for anxiety and depression in those with IBD.Emotion-focused coping also appears to be a risk factor for psychological distress. This occurs when a person tries to reduce the negative emotions associated with a problem as opposed to trying to address the problem itself (i.e., problem-focused coping). Patients that lack information regarding their illness/treatment may also be at greater risk of developing psychological distress. Other risk factors include a lack of social support, experiencing feelings of consistent anger or denial, and feeling ‘out of control’.

Psychological distress is often associated with active IBD, however, depression and anxiety symptoms are still common in patients in remission. Monitoring your mental health and taking steps to reduce psychological distress—even if you’re ‘well’—isan important part of reducing the impact of IBD.