The effects of psychiatric treatment on depression, anxiety, quality of life, and sexual dysfunction in patients with inflammatory bowel disease

O Yanartas, H T Kani, E Bicakci, I Kilic, M Banzragch, C Acikel, O Atug, K Kuscu, N Imeryuz, H Akin, O Yanartas, H T Kani, E Bicakci, I Kilic, M Banzragch, C Acikel, O Atug, K Kuscu, N Imeryuz, H Akin

Abstract

Objective: Depression and anxiety are common disorders in inflammatory bowel disease (IBD). Our aim is to prospectively determine the effect of psychiatric treatment on scores for depression, anxiety, quality of life (QoL), and sexual dysfunction in an outpatient population diagnosed with IBD and also anxiety and/or depression disorder.

Patients and methods: Patients who scored higher than the cutoff point on the Hospital Anxiety Depression Scale were referred for further structured psychiatric evaluation and determination of the need for psychiatric drug treatment. Patients who underwent drug therapy completed Short Form-36 (SF-36) and the Arizona Sexual Experience Scale at baseline and after 6 months of follow-up.

Results: Major depressive disorder and generalized anxiety disorder were the most common diagnoses. After 6 months, 47 patients had completely adhered to drug treatment (group A), whereas 20 were nonadherent (group B). In group A, all domains of SF-36, Arizona Sexual Experience Scale, depression/anxiety scores, and Crohn's disease activity index were statistically improved after treatment when compared with the baseline. In group B, the three domains of SF-36, platelet count, and mean corpuscular volume were worse between baseline and at 6 months.

Conclusion: In IBD patients having any psychiatric disorder, 6 months of antidepressant drug treatment is associated with an improvement in depression, anxiety, QoL, and sexual functioning scores, as well as an improvement in Crohn's disease activity index. On the other hand, insufficient psychiatric treatment seems to be related to a poor QoL.

Keywords: anxiety; depression; inflammatory bowel disease; psychiatric treatment; sexual dysfunction.

Figures

Figure 1
Figure 1
Flow chart of the study: the effects of psychiatric treatment in inflammatory bowel disease patients. Notes: *HADS anxiety score >7 described as depression and anxiety score >10 described as anxiety. Abbreviations: ASEX, Arizona Sexual Experience Scale; CD, Crohn’s disease; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, fourth edition; HADS, Hospital Anxiety and Depression Scale; IBD, inflammatory bowel disease; SCID, Structured Clinical Interview for DSM-IV Axis I Disorders; SF-36, Short Form-36; UC, ulcerative colitis.

References

    1. Cohen RD. The quality of life in patients with Crohn’s disease. Aliment Pharmacol Ther. 2002;16(9):1603–1609.
    1. Agostini A, Moretti M, Calabrese C, et al. Attachment and quality of life in patients with inflammatory bowel disease. Int J Colorectal Dis. 2014;29(10):1291–1296.
    1. Kappelman MD, Rifas-Shiman SL, Porter CQ, et al. Direct health care costs of Crohn’s disease and ulcerative colitis in US children and adults. Gastroenterology. 2008;135(6):1907–1913.
    1. Graff LA, Walker JR, Bernstein CN. Depression and anxiety in inflammatory bowel disease: a review of comorbidity and management. Inflamm Bowel Dis. 2009;15(7):1105–1118.
    1. Filipovic BR, Filipovic BF. Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease. World J Gastroenterol. 2014;20(13):3552–3563.
    1. Marín L, Mañosa M, Garcia-Planella E, et al. Sexual function and patients’ perceptions in inflammatory bowel disease: a case-control survey. J Gastroenterol. 2013;48(6):713–720.
    1. Panara AJ, Yarur AJ, Rieders B, et al. The incidence and risk factors for developing depression after being diagnosed with inflammatory bowel disease: a cohort study. Aliment Pharmacol Ther. 2014;39(8):802–810.
    1. Agostini A, Rizzello F, Ravegnani G, et al. Adult attachment and early parental experiences in patients with Crohn’s disease. Psychosomatics. 2010;51(3):208–215.
    1. Maunder RG, Lancee WJ, Hunter JJ, Greenberg GR, Steinhart AH. Attachment insecurity moderates the relationship between disease activity and depressive symptoms in ulcerative colitis. Inflamm Bowel Dis. 2005;11(10):919–926.
    1. Goodhand JR, Greig FI, Koodun Y, et al. Do antidepressants influence the disease course in inflammatory bowel disease? A retrospective case-matched observational study. Inflamm Bowel Dis. 2012;18(7):1232–1239.
    1. Yanartas O, Bicakci E, Senkal Z, et al. Assessment of psychiatric symptoms and quality of life in patients with inflammatory bowel disease. JMOOD. 2014;4(3):115–121.
    1. Hauser W, Janke KH, Klump B, Hinz A. Anxiety and depression in patients with inflammatory bowel disease: comparisons with chronic liver disease patients and the general population. Inflamm Bowel Dis. 2011;17:621–632.
    1. Nikolaus S, Schreiber S. Diagnostics of inflammatory bowel disease. Gastroenterology. 2007;133(5):1670–1689.
    1. First MB, Spitzer RL, Gibbon M, Williams JBW. User’s Guide for the Structured Clinical Interview for DSM-IV Axis I Disorders SCID-I: Clinician Version. New York: American Psychiatric Press; 1997.
    1. Özkürkçügil A, Aydemir Ö, Yıldız M, Esen Danacı A, Köroğlu E. DSM-IV eksen I bozuklukları için yapılandırılmış klinik görüşmenin Türkçe’ye uyarlanması ve güvenilirlik çalışması. [Structured clinical interview for DSM-IV axis I disorders-clinical version (SCID-CV) in Turkish: study of reliability] İlaç ve Tedavi Dergisi. 1999;12(3):233–236. Turkish.
    1. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–370.
    1. Aydemir Ö, Güvenir T, Küey L, Kültür S. [Vailidity and reliability of Turkish version of Hospital Anxiety and Depression Scale]. Hastane anksiyete ve depresyon ölçeği Türkçe formunun geçerlilik ve güvenilirliği. Türk Psikiyatri Dergisi. 1997;8(4):280–287. Turkish.
    1. Ware JE, Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–483.
    1. Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş A. [Validity and reliability of Turkish version of short form 36 (SF-36)]. Kısa Form 36 (KF–36)’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. Ilaç ve tedavi dergisi. 1999;12(2):102–106. Turkish.
    1. McGahuey CA, Gelenberg AJ, Laukes CA, et al. The Arizona Sexual Experience Scale (ASEX): reliability and validity. J Sex Marital Ther. 2000;26(1):25–40.
    1. Soykan A. The reliability and validity of Arizona sexual experiences scale in Turkish ESRD patients undergoing hemodialysis. Int J Impot Res. 2004;16(1):531–534.
    1. Best WR, Becktel JM, Singleton JW. Rederived values of the eight coefficients of the Crohn’s Disease Activity Index (CDAI) Gastroenterology. 1979;77(4):843–846.
    1. Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med. 1987;317(26):1625–1629.
    1. Lewis JD, Chuai S, Nessel L, Lichtenstein GR, Aberra FN, Ellenberg JH. Use of the noninvasive components of the Mayo score to assess clinical response in ulcerative colitis. Inflamm Bowel Dis. 2008;14(12):1660–1666.
    1. Fuller-Thomson E, Sulman J. Depression and inflammatory bowel disease: findings from two nationally representative Canadian surveys. Inflamm Bowel Dis. 2006;12(8):697–707.
    1. Walker EA, Gelfand MD, Gelfand AN, Creed F, Katon WJ. The relationship of current psychiatric disorder to functional disability and distress in patients with inflammatory bowel disease. Gen Hosp Psychiatry. 1996;18(4):220–229.
    1. Mittermaier C, Dejaco C, Waldhoer T, et al. Impact of depressive mood on relapse in patients with inflammatory bowel disease: a prospective 18-month follow-up study. Psychosom Med. 2004;66(1):79–84.
    1. Nigro G, Angelini G, Grosso SB, Caula G, Sategna-Guidetti C. Psychiatric predictors of noncompliance in inflammatory bowel disease: psychiatry and compliance. J Clin Gastroenterol. 2001;32(1):66–68.
    1. Walker JR, Ediger JP, Graff LA, et al. The Manitoba IBD cohort study: a population-based study of the prevalence of lifetime and 12-month anxiety and mood disorders. Am J Gastroenterol. 2008;103(8):1989–1997.
    1. Vidal A, Gómez-Gil E, Sans M, et al. The impact of anxiety and depression on relapse in patients with inflammatory bowel disease. Med Clin (Barc) 2009;132(8):298–302.
    1. Mikocka-Walus AA, Gordon AL, Stewart BJ, Andrews JM. The role of antidepressants in the management of inflammatory bowel disease (IBD): a short report on a clinical case-note audit. J Psychosom Res. 2012;72(2):165–167.
    1. DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000;24(14):2101–2107.
    1. Mikocka-Walus A, Andrews JM. Attitudes towards antidepressants among people living with inflammatory bowel disease: an online Australia-wide survey. J Crohns Colitis. 2014;8(4):296–303.
    1. Timmer A, Kemptner D, Bauer A, Takses A, Ott C, Fürst A. Determinants of female sexual function in inflammatory bowel disease: a survey based cross-sectional analysis. BMC Gastroenterol. 2008;3(8):1–10.
    1. Woolley SB, Fredman L, Goethe JW, Lincoln AK, Heeren T. Hospital patients’ perceptions during treatment and early discontinuation of serotonin selective reuptake inhibitor antidepressants. J Clin Psychopharmacol. 2010;30(6):716–719.

Source: PubMed

Patrocinadores e Colaboradores

Condições médicas

Intervenções de drogas

3
Se inscrever