Article

Inflammatory Bowel Disease: A Study of the Association between Anxiety and Depression, Physical Morbidity, and Nutritional Status

Institute of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.
Scandinavian Journal of Gastroenterology (Impact Factor: 2.33). 10/1997; 32(10):1013-21. DOI: 10.3109/00365529709011218
Source: PubMed

ABSTRACT The etiology of inflammatory bowel disease is unclear, and the role played by anxiety and depression is highly controversial. Anxiety and depression in patients with inflammatory bowel disease could be secondary to disabling symptoms, but the interaction between physical morbidity and psychologic illness in these subjects has not been sufficiently investigated. Patients with inflammatory bowel disease are nevertheless frequently undernourished, but there are no studies on the association between anxiety and depression and malnutrition. This study was designed to characterize anxiety and depression in subjects affected by inflammatory bowel disease and to establish the influence of physical morbidity and/or nutritional status on psychologic disorders.
Seventy-nine consecutive patients, 43 with Crohn's disease (CD) and 36 with ulcerative colitis (UC), were enrolled in the study. An index of the disease activity and physical morbidity was obtained by the simplified Crohn's Disease Activity Index and Truelove-Witts criteria and using the Clinical Rating Scale. Thirty-six healthy volunteers were studied as controls. All the subjects were given the State and Trait Anxiety Inventory (STAI) test and the Zung self-rating Depression Scale.
The percentage of subjects with state anxiety was significantly higher in the CD (P < 0.001) and UC (P < 0.001) groups than in control subjects. There was no significant difference in trait anxiety among groups. The percentage of subjects with depression was significantly higher in the CD (P < 0.05) and UC (P < 0.05) groups than in control subjects. State anxiety and depression were significantly associated with physical morbidity and correlated with malnutrition in CD and UC patients.
Anxiety and depression in patients with inflammatory bowel disease could be reactive to the disabling symptoms and to malnutrition. As measured with the STAI, personality trait of anxiety does not seem to play an important role in inflammatory bowel disease.

2 Followers
 · 
107 Views
  • Source
    • "A diferencia de los trastornos psicológicos, en los cuales los estudios han sido escasos, las investigaciones sobre síntomas psicopatológicos en las EII han sido más abundantes y han generado un gran interés en esta área. En tal sentido, la evidencia proveniente de diversos estudios indica que los pacientes con EII tienden a tener mayores niveles de ansiedad (Magni et ál., 1991; Schwarz et ál., 1993; Addolorato et ál., 1997; Whitehead et ál., 2002) y depresión (Magni et ál., 1991; Whitehead et ál., 2002) que los individuos sanos. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The inflammatory diseases of the intestine (IDI) are chronic disorders that cause inflammation as well as destruction of the intestinal tissue. The IDI are divided into two types: Crohn's disease (CD) and Ulcerative Colitis (UC). The etiology of both diseases is rarely mentioned, and their course is influenced by multiple bio-psychosocial factors. Diverse investigations are providing evidence of the implication psychological factors have in the course of the IDI, such as: psycho-social stress, coping of strategies, psychopathology symptoms, personality traits and social support.
    Avances en Psicologia Latinoamericana 12/2007; 25(2):83-97.
  • Source
    • "A diferencia de los trastornos psicológicos, en los cuales los estudios han sido escasos, las investigaciones sobre síntomas psicopatológicos en las EII han sido más abundantes y han generado un gran interés en esta área. En tal sentido, la evidencia proveniente de diversos estudios indica que los pacientes con EII tienden a tener mayores niveles de ansiedad (Magni et ál., 1991; Schwarz et ál., 1993; Addolorato et ál., 1997; Whitehead et ál., 2002) y depresión (Magni et ál., 1991; Whitehead et ál., 2002) que los individuos sanos. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The inflammatory diseases of the intestine (IDI) are chronic disorders that cause inflammation as well as destruction of the intestinal tissue. The IDI are divided into two types: Crohn’s disease (CD) and Ulcerative Colitis (UC). The etiology of both diseases is rarely mentioned, and their course is influenced by multiple bio-psychosocial factors. Diverse investigations are providing evidence of the implication psychological factors have in the course of the IDI, such as: psycho-social stress, coping of strategies, psychopathology symptoms, personality traits and social support.
    Avances en Psicologia Latinoamericana 01/2007;
  • Source
    • "Secondary causes of IBS are unlikely to account for a majority of cases, however, as it is men who most readily alter their health-related behaviour under stress (Mechanic, 1976; Horwitz & Raskin-White, 1987). A recent paper by Addolorato et al. (1997). however, on patients with inflammatory bowel disease, reported the inverse relationship, with anxiety and depression occumng as a result of malnutrition, itself presumably occumng as a result of bowel symptoms impairing adequate nutrition. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Irritable bowel syndrome (IBS) is a frequently occurring, benign functional gastrointestinal disorder with a complex poorly understood pathology which appears to be multifactorial in nature. There is no association with structural or biochemical abnormalities in the gastrointestinal tract. Functional variations in myoelectrical activity, visceral hypersensitivity and illness behaviours have all been observed in patients experimentally. In conjunction with environmental, psychological and alimentary factors, these mechanisms have been proposed as the major determinants of symptom genesis. Certainly, dietary factors are frequently perceived by sufferers as powerful symptom triggers, with many reporting multiple food intolerance. Physicians, however, remain divided upon the relevance of food to the disorder, with many eschewing a nutritional connection. This is unsurprising as, despite much experimental work to determine the clinical relevance of food intolerance and allergy to the aetiology of the disorder, the vast range of foodstuffs available for testing, inherent procedural problems with test foods, methodological insufficiencies and the continually evolving knowledge of the disorder, particularly the subgrouping of sufferers, have restricted the scientific validity of current findings. At the present time, it is difficult to make informed judgement upon the importance of food in IBS, and rigorously designed, large scale trials devised in the light of recent knowledge are required before conclusions can be drawn.
    Nutrition Research Reviews 01/1999; 11(2):279-309. DOI:10.1079/NRR19980019 · 3.86 Impact Factor
Show more