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Journal of Crohn's and Colitis: 9 (12)


Laurence J. Egan, Ireland

Associate Editors

Maria T. Abreu, USAShomron Ben-Horin, IsraelSilvio Danese, ItalyPeter Lakatos, HungaryMiles Parkes, UKGijs van den Brink, NLSéverine Vermeire, Belgium


Published on behalf of

Do Inflammatory Bowel Disease patients with anxiety and depressive symptoms receive the care they need?

F. Bennebroek Evertsz', N.A.M. Thijssens, P.C.F. Stokkers, M.A. Grootenhuis, C.L.H. Bockting, P.T. Nieuwkerk, M.A.G. Sprangers
DOI: http://dx.doi.org/10.1016/j.crohns.2011.07.006 68-76 First published online: 1 February 2012


Background and aims: Inflammatory Bowel Disease (IBD) patients with anxiety and/or depressive symptoms may not receive the care they need. Provision of care requires insight into the factors affecting these psychiatric symptoms. The study was designed to examine the extent to which: (1) IBD patients with anxiety and/or depressive symptoms receive mental treatment and (2) clinical and socio-demographic variables are associated with these symptoms.

Methods: 231 adult IBD patients (79% response rate), attending a tertiary care center, completed standardized measures on anxiety and depressive symptoms (HADS), quality of life (SF-12) and mental health care use (TIC-P). Diagnosis and disease activity were determined by the gastroenterologist.

Results: 43% had high levels of anxiety and/or depressive symptoms, indicative of a psychiatric disorder (HADS ≥ 8), of whom 18% received psychological treatment and 21% used psychotropic medication. In multivariate analysis, high disease activity was associated with anxiety (OR = 2.72 | p < 0.03) and depression (OR = 3.36 | p < 0.01), while Crohn's disease was associated with anxiety (OR = 2.60 | p < 0.03).

Conclusions: Despite high levels of anxiety and depressive symptoms and poor quality of life, psychiatric complaints in IBD patients were undertreated. Screening for and treatment of psychiatric symptoms should become an integral part of IBD medical care.

Highlights: ► 18 % of IBD patients with high levels of anxiety and depression receive mental help. ► Higher levels of depression and anxiety are associated with having active disease. ► Screening should become an integral part of IBD medical care. ► Psychological interventions for anxiety and depression in IBD patients are needed.

  • Inflammatory Bowel Disease
  • Anxiety
  • Depression
  • Psychological treatment
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