The impact of anxiety and depression on relapse in patients with inflammatory bowel disease

Objectives: An interaction between psychological factors and inflammatory bowel disease (IBD) course has been suggested, but the impact of anxiety and depression on recurrence of IBD is unclear. We sought to determine whether suffering anxiety and depressive disorders among patients with inactive disease would increase the risk of subsequent relapses. Methods: In this prospective study, 112 patients with inactive IBD were evaluated by the Semi-Structured Clinical Interview for Axis 1 Disorders (SCID-1) of Diagnostic and Statistical Manual of Mental Disorders, fourth edition, and the IBD activity was assessed monthly up to the end of the study (6 months) or up to the occurrence of a relapse using the Harvey-Bradshaw Index or the Simple Colitis Activity Index. Biological factors associated with an increased risk of relapse were identified in patients who relapsed. Results: Follow-up was completed in 107 IBD patients. Forty patients relapsed (37.3%) and 67 (66.7%) remained under remission. At least one psychiatric disorder was found in 31.1% of patients. The more prevalent psychiatric disorders were anxiety (17.9%) and depressive disorders (11.6%). Logistic regression analysis showed that depressive and anxiety disorders were not independent predictors of recurrence in the 6-months of follow-up. Conclusions: This study suggests that depressive and anxiety disorders do not increase the risk of relapses in IBD. (C) 2008 Elsevier Espana, S.L. All rights reserved.