Despite a higher prevalence of psychosocial morbidity in Inflammatory Bowel Disease (IBD), the association between depressive state and disease course in IBD is poorly understood.
Dr Pollok and colleagues from the United Kingdom investigated the impact of depressive state on disease course in IBD.
The researchers conducted a systematic review in MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews and PsychINFO for prospective studies evaluating the impact of baseline depressive state on subsequent disease course in adult IBD.
The team identified 11 studies that matched the entry criteria, representing 3194 patients with IBD.
The researchers found that 3 reported on patients with ulcerative colitis (UC), 4 included patients with Crohn's disease (CD) exclusively, and 4 studies included both UC and CD.
|In only 50% of cases further action was taken by gastroenterologists during consultation for distressed patients|
|Alimentary Pharmacology & Therapeutics|
The team noted that 5 studies reported an association between depressive state and disease course.
None of the UC-specific studies found any association.
In 3 of 4 CD-specific studies, a relationship between depressive state and worsening disease course was found.
The researchers found that in 4 of 5 studies including patients in remission at baseline, no association between depressive state and disease course was found.
Pooled analysis of IBD studies with patients in clinical remission at baseline identified no association between depressive state and disease course.
Dr Pollok's team comments, "There is limited evidence to support an association between depressive state and subsequent deterioration in disease course in IBD, but what data that exist are more supportive of an association with CD than UC."
"Baseline disease activity may be an important factor in this relationship."
"Further studies are needed to understand the relationship between mental health and outcomes in IBD."