Psychological aspects and psychotherapy of inflammatory bowel disease and irritable bowel syndrome in children

Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University, University Hospital Olomouc, Czech Republic.
Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia (Impact Factor: 1.2). 12/2010; 154(4):307-14. DOI: 10.5507/bp.2010.046
Source: PubMed


Despite holistic approach to psychosomatic medicine, gastroenterological disorders (GI) tend to be categorized broadly into "functional" and "organic". Major GI illnesses are Inflammatory bowel diseases (IBD) include ulcerative colitis and Crohn's disease. Both are chronic, with remissions and relapses over the years while irritable bowel syndrome (IBS) is a common, often disabling functional gastrointestinal disorder.
A literature review was performed using the National Library of Medicine PubMed database, including all resources within the period 1991-2008, additional references were found through bibliography reviews of relevant articles.
Psychological problems: Higher scores of neuroticism, depression, inhibition, and emotional instability, are typical for many patients with chronic diseases and nonspecific for chronic gastroenterological disorders. Patients with chronic gastrointestinal disorders have impaired health-related quality. Psychological treatments: There have been few adequate psychological treatment trials in IBD. These achieved lower demands for health care rather than a reduction of anxiety or depression. Psychotherapy with chronic gastrointestinal disorders could lead to improve the course of the disease, changing psychological factors such as depression and dysfunctional coping and improving the patient's quality of life.
There seem to be "risk patients" in whom psychosocial components have a bigger influence on the course of disease than in other patients; and those would probably benefit from psychotherapeutic treatment. Psychological treatments help patients manage the psychological distress which worsens bowel symptoms and quality of life.

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    • "According to Costa and McCrae,[35] elevated scores on this dimension represent emotional instability with overwhelming negative emotions. Findings of this study were consistent with the findings of previous studies.[9–1136] Eyneck believed that neuroticism is a function of the activity of limbic system and researches showed that a high score on this trait is associated with a more sympathetic nervous system reactivity and more sensitivity to environmental stimulation.[37] "
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    ABSTRACT: Psychological factors such as personality traits may affect the adjustment capacity and Quality of Life (QOL) in Ulcerative Colitis (UC) patients. Type D personality has some similarities with general personality traits of UC patients. The aims of this study were to compare NEO personality profile and type D personality between healthy normal group and UC patients; and to determine the possible relationship between type D personality and QOL in UC patients. The sample of study comprised of 58 UC patients and 59 healthy control subjects (from their family members). All participants were requested to fill out NEO-FFI, Type D personality (Ds14) Scale and WHO-Quality of Life Questionnaire. The findings indicated that UC patients scored higher in neuroticism (P<0/01); lower in extraversion (P<0/01) and openness (P<0/05) than healthy controls but their differentiation were not significant in agreeableness and conscientiousness. The findings showed that 59% of UC patients and 33% of the control subjects had type D personality; and the differences in frequency of type D between the two groups were significant (P<0/05). The mean QOL scores of type D personality in UC patients was significantly lower than patients without type D personality (F= 7/55, P<0/01). Type D personality could better predict QOL of UC patients than NEO dimensions. Differences were observed between UC patients and their healthy family members, in terms of personality factors. Type D personality may be regarded as an important factor that may bring about some adverse effects in QOL among UC patients.
    No preview · Article · Oct 2012 · Journal of research in medical sciences
    • "Various social factors, such as mental stress, depression, and anxiety neurosis, are associated with the pathogenesis of FD and IBS. Substantial studies showed that GI symptoms were significantly relieved in these patients with the use of psychotherapies, thus indicating a close relationship between the GI system and the psychomental status.[910] A systematic review of 1717 FD patients studied the medication of axiomatic agents and/or antidepressants, concluding that the use of axiomatic agents and/or antidepressants appear to be obviously beneficial compared with placebo.[11] "
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    • "In addition to sociodemographic variables, others have noted that psychological factors can also affect HRQOL in these diseases. In this regard, more psychological disturbance and the presence of anxiety or depression contribute to poorer HRQOL, regardless of severity of the IBD [43, 59, 74]. Furthermore, Moreno-Jiménez et al. [44] and Boye et al. [45] suggest that factors such as personality traits may influence psychological well-being and HRQOL; in their studies, neuroticism and greater difficulty in describing feelings to others were related to poorer HRQOL. "
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    ABSTRACT: Inflammatory bowel disease (IBD) including Crohn's disease (CD) and ulcerative colitis (UC) is a chronic and disabling disease with unknown etiology. There have been some controversies regarding the role of psychological factors in the course of IBD. The purpose of this paper is to review that role. First the evidence on role of stress is reviewed focusing on perceived stress and patients' beliefs about it in triggering or exacerbating the course of IBD. The possible mechanisms by which stress could be translated into IBD symptoms, including changes in motor, sensory and secretory gastrointestinal function, increase intestinal permeability, and changes in the immune system are, then reviewed. The role of patients' concerns about psychological distress and their adjustment to disease, poor coping strategies, and some personality traits that are commonly associated with these diseases are introduced. The prevalence rate, the timing of onset, and the impact of anxiety and depression on health-related quality of life are then reviewed. Finally issues about illness behavior and the necessity of integrating psychological interventions with conventional treatment protocols are explained.
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