A diagnosis of Crohn’s disease can alter many aspects of your life, from the physical to the psychological. Crohn’s may impact your lifestyle, your relationships, your work, and your mental health.  

Why should you care? 

Due to the strong impact Crohn’s can have on one’s life, people with Crohn’s have an increased likelihood of experiencing anxiety and depression as compared to people without the diagnosis. So, the impact Crohn’s has on a person’s psychological health is especially important to think about, consider, and bring into the conversation! 

What do we know so far? 

Many scientific review papers have been published looking at Crohn’s disease and psychological symptoms and disorders like depression and anxiety. A review paper means that the author has examined all relevant published studies on a certain topic to try and describe overall trends and patterns that we see from individual scientific findings. 

So, review papers can help us make sense of the overall state of the science surrounding Crohn’s and depression and anxiety. Recent review papers have shown: 

• Individuals with IBD have a high prevalence of anxiety and depression, with up to 33% of patients experiencing anxiety symptoms and up to 25% experiencing symptoms of depression 
• Those with active as opposed to inactive IBD have even higher rates of anxiety and depression  
• Having anxiety or depression also affects healthcare outcomes. People with IBD and anxiety or depression have increased emergency department visits, use of outpatient services, and hospital admissions 

What can help? 

Empirically supported psychological treatments (meaning that there is scientific evidence showing that these treatments perform better than other treatments, placebo, and/or no treatment at all) have robust scientific support for reducing symptoms of mental health.  

One of the most common empirically supported treatments for treating anxiety or depression in people with IBD is Cognitive Behavioral Therapy (often called “CBT”). 

In addition to helping with symptoms of mental health (reducing depression and anxiety), these psychological treatments may also be associated with reduced healthcare utilization. Studies are also examining whether non-pharmacological treatments may alter physical symptoms. However, more research is needed on these topics! 

Looking Forward 

In sum, bringing mental health symptoms into the conversation of IBD care is important! When speaking with your Care Team, never hesitate to bring up your mental health. 

In addition, despite all these findings, not everyone who has IBD is being screened for mental health symptoms, and not everyone who has IBD has access to mental health services! There is a need for mental-health services to be integrated into IBD care. 

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References 

Barberio, B., Zamani, M., Black, C. J., Savarino, E. V., & Ford, A. C. (2021). Prevalence of symptoms of anxiety and depression in patients with inflammatory bowel disease: a systematic review and meta-analysis. The Lancet Gastroenterology & Hepatology. 

Dubinsky, M. C., Dotan, I., Rubin, D. T., Bernauer, M., Patel, D., Cheung, R., … & Keefer, L. (2021). Burden of comorbid anxiety and depression in patients with inflammatory bowel disease: a systematic literature review. Expert Review of Gastroenterology & Hepatology, 1-13. 

Mikocka-Walus, A. A., Turnbull, D., Holtmann, G., & Andrews, J. M. (2012). An integrated model of care for inflammatory bowel disease sufferers in Australia: development and the effects of its implementation. Inflammatory bowel diseases, 18(8), 1573-1581. 

Mikocka-Walus, A., Knowles, S. R., Keefer, L., & Graff, L. (2016). Controversies revisited: a systematic review of the comorbidity of depression and anxiety with inflammatory bowel diseases. Inflammatory bowel diseases, 22(3), 752-762.