Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Current Psychiatry Reports
Published in: Current Psychiatry Reports 3/2010

01-06-2010

Inflammatory Bowel Disease in Children: Psychological and Psychiatric Issues

Authors: Parikshit Deshmukh, Gaurav Kulkarni, Jeanne Lackamp

Published in: Current Psychiatry Reports | Issue 3/2010

Login to get access

Abstract

The overlap between inflammatory bowel disease (IBD) and psychiatric disorders has been studied extensively. We reviewed the limited literature targeting the complex relationship between IBD and psychiatric disorders in children and adolescents. Findings from this review were compared with findings from available studies in adults. Results reflecting an association between IBD and psychiatric illnesses were observed in children and adolescents and were consistent with results in adults. In adults with IBD, many studies have reflected the advantages of psychotherapeutic treatment, including faster recovery, improved quality of life, and reduced health care use. Unfortunately, such studies are scarce in the child and adolescent population. Psychopharmacologic studies also are limited in adult and pediatric populations. At this time, the literature on treatment of the pediatric IBD population remains minimal, and the need to study screening and treatment modalities is critical.
Literature
1.
Verhoef M, Sutherland LR: Outpatient health care utilization of patients with inflammatory bowel disease. Dig Dis Sci 1990, 35:1276–1280.CrossRefPubMed
2.
• Kappelman MD, Rifas-Shiman SL, Kleinman K, et al.: The prevalence and geographic distribution of Crohn’s disease and ulcerative colitis in the United States. Clin Gastroenterol Hepatol 2007, 5:1424–1429. This study neatly outlines the prevalence, severity, and geographical distribution of IBD in US children.
3.
Armitage E, Drummond HE, Wilson DC, Ghosh S: Increasing incidence of both juvenile-onset Crohn’s disease and ulcerative colitis in Scotland. Eur J Gastroenterol Hepatol 2001, 13:1439–1447.CrossRefPubMed
4.
Phavichitr N, Cameron DJ, Catto-Smith AG: Increasing incidence of Crohn’s disease in Victorian children. J Gastroenterol Hepatol 2003, 18:329–332.CrossRefPubMed
5.
Szigethy EM, Levy-Warren A, Whitton S, et al.: Depressive symptoms and inflammatory bowel disease in children and adolescents: a cross-sectional study. J Pediatr Gastroenterol Nutr 2004, 39:395–403.CrossRefPubMed
6.
• Adler J, Raju S, Beveridge AS, et al.: College adjustment in University of Michigan students with Crohn’s and colitis. Inflamm Bowel Dis 2008, 14:1281–1286. In this study, the effect of IBD on adjustment of college students is reviewed, including the need for early intervention to improve future functioning.
7.
Yang YX, Lichtenstein GR: Corticosteroids in Crohn’s disease. Am J Gastroenterol 2002, 97:803–823.CrossRefPubMed
8.
Hall AS, Thorley G, Houtman PN: The effects of corticosteroids on behavior in children with nephrotic syndrome. Pediatr Nephrol 2003, 18:1220–1223.CrossRefPubMed
9.
Warrington TP, Bostwick JM: Psychiatric adverse effects of corticosteroids. Mayo Clin Proc 2006, 81:1361–1367.CrossRefPubMed
10.
Ng SC, Arebi N, Kamm MA: Medium-term results of oral tacrolimus treatment in refractory inflammatory bowel disease. Inflamm Bowel Dis 2007, 13:129–134.CrossRefPubMed
11.
Lowry PW, Weaver AL, Tremaine WJ, Sandborn WJ: Combination therapy with oral tacrolimus (FK506) and azathioprine or 6-mercaptopurine for treatment-refractory Crohn’s disease perianal fistulae. Inflamm Bowel Dis 1999, 5:239–245.PubMedCrossRef
12.
Kemper MJ, Spartà G, Laube GF, et al.: Neuropsychologic side-effects of tacrolimus in pediatric renal transplantation. Clin Transplant 2003, 17:130–134.CrossRefPubMed
13.
Hausmann J, Zabel K, Herrmann E, Schröder O: Methotrexate for maintenance of remission in chronic active Crohn’s disease: long-term single-center experience and meta-analysis of observational studies. Inflamm Bowel Dis 2009 Nov 18 (Epub ahead of print).
14.
Atzeni F, Ardizzone S, Bertani L, et al.: Combined therapeutic approach: inflammatory bowel diseases and peripheral or axial arthritis. World J Gastroenterol 2009, 15:2469–2471.CrossRefPubMed
15.
Sioka C, Kyritsis AP: Central and peripheral nervous system toxicity of common chemotherapeutic agents. Cancer Chemother Pharmacol 2009, 63:761–767.CrossRefPubMed
16.
Arfaoui D, Elloumi H, Debbebi W, et al.: Psychological disorder associated to inflammatory bowel disease [in French]. Tunis Med 2007, 85:189–191.PubMed
17.
Mackner LM, Crandall WV: Brief report: psychosocial adjustment in adolescents with inflammatory bowel disease. J Pediatr Psychol 2006, 31:281–285.CrossRefPubMed
18.
Burke P, Meyer V, Kocoshis S, et al.: Depression and anxiety in pediatric inflammatory bowel disease and cystic fibrosis. J Am Acad Child Adolesc Psychiatry 1989, 28:948–951.PubMed
19.
Burke PM, Neigut D, Kocoshis S, et al.: Correlates of depression in new onset pediatric inflammatory bowel disease. Child Psychiatry Hum Dev 1994, 24:275–283.CrossRefPubMed
20.
Engstrom I: Mental health and psychological functioning in children and adolescents with inflammatory bowel disease: a comparison with children having other chronic illnesses and with healthy children. J Child Psychol 1992, 33:563–582.CrossRef
21.
Szajnberg N, Krall V, Davis P, et al.: Psychopathology and relationship measures in children with inflammatory bowel disease and their parents. Child Psychiatry Hum Dev 1993, 23:215–232.CrossRefPubMed
22.
Burke P, Meyer V, Kocoshis S, et al.: Obsessive-compulsive symptoms in childhood inflammatory bowel disease and cystic fibrosis. J Am Acad Child Adolesc Psychiatry 1989, 28:525–527.CrossRefPubMed
23.
Burke P, Kocoshis SA, Chandra R, et al.: Determinants of depression in recent onset pediatric inflammatory bowel disease. J Am Acad Child Adolesc Psychiatry 1990, 29:608–610.CrossRefPubMed
24.
Burke PM, Kocoshis S, Neigut D, et al.: Maternal psychiatric disorders in pediatric inflammatory bowel disease and cystic fibrosis. Child Psychiatry Hum Dev 1994, 25:45–52.CrossRefPubMed
25.
Ferry GD: Quality of life in inflammatory bowel disease: background and definitions. J Pediatr Gastroenterol Nutr 1999, 28:S15–S18.CrossRefPubMed
26.
Rabbett H, Elbadri A, Thwaites R, et al.: Quality of life in children with Crohn’s disease. J Pediatr Gastroenterol Nutr 1996, 23:528–533.CrossRefPubMed
27.
De Boer M, Grootenhuis M, Derkx B, Last B: Health-related quality of life and psychosocial functioning of adolescents with inflammatory bowel disease. Inflamm Bowel Dis 2005, 11:400–406.CrossRefPubMed
28.
Engstrom I: Parental distress and social interaction in families with children with inflammatory bowel disease. J Am Acad Child Adolesc Psychiatry 1991, 30:904–912.PubMedCrossRef
29.
Nicholas DB, Swan SR, Gerstle TJ, et al.: Struggles, strengths, and strategies: an ethnographic study exploring the experiences of adolescents living with an ostomy. Health Qual Life Outcomes 2008, 6:114.CrossRefPubMed
30.
Addolorato G, Capristo E, Stefanini GF, Gasbarrini G: Inflammatory bowel disease: a study of the association between anxiety and depression, physical morbidity, and nutritional status. Scand J Gastroenterol 1997, 32:1013–1021.CrossRefPubMed
31.
Tarter RE, Switala J, Carra J, et al.: Inflammatory bowel disease: psychiatric status of patients before and after disease onset. Int J Psychiatry Med 1987, 17:173–181.PubMed
32.
Kaplan MA, Korelitz BJ: Narcotic dependence in inflammatory bowel disease. J Clin Gastroenterol 1988, 10:275–278.CrossRefPubMed
33.
Fuller-Thomson E, Sulman J: Depression and inflammatory bowel disease: findings from two nationally representative Canadian surveys. Inflamm Bowel Dis 2006, 12:697–707.CrossRefPubMed
34.
Cuntz U, Welt J, Ruppert E, Zillessen E: Determination of subjective burden from chronic inflammatory bowel disease and its psychosocial consequences. Results from a study of 200 patients. Psychother Psychosom Med Psychol 1999, 49:494–500.PubMed
35.
Andrews H, Barczak P, Allan RN: Psychiatric illness in patients with inflammatory bowel disease. Gut 1987, 28:1600–1604.CrossRefPubMed
36.
Nigro G, Angelini G, Grosso SB, et al.: Psychiatric predictors of noncompliance in inflammatory bowel disease: psychiatry and compliance. J Clin Gastroenterol 2001, 32:66–68.CrossRefPubMed
37.
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, 66:79–84.CrossRefPubMed
38.
Kurina LM, Goldacre MJ, Yeates D, Gill LE: Depression and anxiety in people with inflammatory bowel disease. J Epidemiol Community Health 2001, 55:716–720.CrossRefPubMed
39.
Walker EA, Gelfand MD, Gelfand AN, et al.: The relationship of current psychiatric disorder to functional disability and distress in patients with inflammatory bowel disease. Gen Hosp Psychiatry 1996, 18:220–229.CrossRefPubMed
40.
• Szigethy E, Kenney E, Carpenter J, et al.: Cognitive-behavioral therapy for adolescents with inflammatory bowel disease and subsyndromal depression. J Am Acad Child Adolesc Psychiatry 2007, 46:1290–1298. The authors demonstrated the efficacy of 12 to 14 weeks of cognitive-behavioral therapy in treating adolescent IBD patients with depressive symptoms.
41.
•• Deter HC, Keller W, von Wietersheim J, et al.: Psychological treatment may reduce the need for healthcare in patients with Crohn’s disease. Inflamm Bowel Dis 2007, 13:745–752. Deter and colleagues revealed the obvious benefit of implementing psychotherapy (in addition to glucocorticoid therapy) in CD patients, as it reduced health care use by decreasing in-hospital days and sick leaves (P < 0.03).
42.
•• Deter HC, von Wietersheim J, Jantschek G, et al.: High-utilizing Crohn’s disease patients under psychosomatic therapy. Biopsychosoc Med 2008, 13:18. In this prospective, multicenter study, a significant drop in health care use was observed after psychosomatic therapy in high health care–utilizing patients with CD.
43.
Schwarz SP, Blanchard EB: Evaluation of a psychological treatment for inflammatory bowel disease. Behav Res Ther 1991, 29:167–177.CrossRefPubMed
44.
Elsenbruch S, Langhorst J, Popkirowa K, et al.: Effects of mind–body therapy on quality of life and neuroendocrine and cellular immune functions in patients with ulcerative colitis. Psychother Psychosom 2005, 74:277–287.CrossRefPubMed
45.
Maunder RG, Esplen MJ: Supportive-expressive group psychotherapy for persons with inflammatory bowel disease. Can J Psychiatry 2001, 46:622–626.PubMed
46.
• Grootenhuis MA, Maurice-Stam H, Derkx BH, Last BF: Evaluation of a psychoeducational intervention for adolescents with inflammatory bowel disease. Eur J Gastroenterol Hepatol 2009, 21:430–435. In this study, nonpharmacologic methods, including psychoeducation, were observed to be important for improving IBD patients’ lives.
47.
Shepanski MA, Hurd LB, Culton K, et al.: Health-related quality of life improves in children and adolescents with inflammatory bowel disease after attending a camp sponsored by the Crohn’s and Colitis Foundation of America. Inflamm Bowel Dis 2005, 11:164–170.CrossRefPubMed
48.
Jackson JL, O’Malley PG, Tomkins G, et al.: Treatment of functional gastrointestinal disorders with antidepressant medications: a meta-analysis. Am J Med 2000, 108:65–72.CrossRefPubMed
49.
Mikocka-Walus AA, Turnbull DA, Moulding NT, et al.: It doesn’t do any harm, but patients feel better: a qualitative exploratory study on gastroenterologists’ perspectives on the role of antidepressants in inflammatory bowel disease. BMC Gastroenterol 2007, 24:38.CrossRef
50.
Kast RE, Altschuler EL: Remission of Crohn’s disease on bupropion. Gastroenterology 2001, 121:1260–1261.CrossRefPubMed
51.
Tuglu C, Kara SH, Caliyurt O, et al.: Increased serum tumor necrosis factor-alpha levels and treatment response in major depressive disorder. Psychopharmacology (Berl) 2003, 170:429–433.CrossRef
52.
Mikocka-Walus AA, Turnbull DA, Moulding NT, et al.: Antidepressants and inflammatory bowel disease: a systematic review. Clin Pract Epidemol Ment Health 2006, 2:24.CrossRef
53.
Hammad T, Laughren T, Racoosin JA: Suicidality in pediatric patients treated with antidepressant drugs. Arch Gen Psychiatry 2006, 63:332–339.CrossRefPubMed
54.
Chungh DS, Kim BN, Cho SC: Neuroleptic malignant syndrome due to three atypical antipsychotics in a child. J Psychopharmacol 2005, 19:422–425.CrossRefPubMed
55.
Birchley G: Opioid and benzodiazepine withdrawal syndromes in the paediatric intensive care unit: a review of recent literature. Nurs Crit Care 2009, 14:26–37.CrossRefPubMed
56.
Murphy TK, Segarra A, Storch EA, Goodman WK: SSRI adverse events: how to monitor and manage. Int Rev Psychiatry 2008, 20:203–208.CrossRefPubMed
57.
Findling RL: Atypical antipsychotic treatment of disruptive behavior disorders in children and adolescents. J Clin Psychiatry 2008, 69(Suppl 4):9–14.PubMed
Metadata
Title
Inflammatory Bowel Disease in Children: Psychological and Psychiatric Issues
Authors
Parikshit Deshmukh
Gaurav Kulkarni
Jeanne Lackamp
Publication date
01-06-2010
Publisher
Current Science Inc.
Published in
Current Psychiatry Reports / Issue 3/2010
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-010-0111-0

Other articles of this Issue 3/2010

Current Psychiatry Reports 3/2010 Go to the issue

ReviewPaper

The Impact of Depression in Heart Disease

ReviewPaper

Borderline Personality Disorder and Psychosis: A Review

ReviewPaper

Differentiation Between Demoralization, Grief, and Anhedonic Depression

CLINICAL TRIAL REPORT

A Newly Released SNRI for Treatment of Fibromyalgia

ReviewPaper

Excess Suicide Risk and Other External Causes of Death Among Women with Cosmetic Breast Implants: A Neglected Research Priority

ReviewPaper

The Role of the Entorhinal Cortex in Paraphrenia