Background Psychological morbidity in inflammatory bowel disease is common with significant impact on quality of life and health outcomes, but factors which predict the development of psychological morbidity are unclear.
Aim To undertake a systematic literature review of the predictors of psychological morbidity in patients with inflammatory bowel disease.
Methods Electronic searches for English-language articles were performed with keywords relating to psychological morbidity according to the Diagnostic and Statistical Manual of Mental Disorders IV and subsequent criteria, and inflammatory bowel disease; in MEDLINE, PsychInfo, Web of Science and EMBASE for studies published from January 1997 to 25 January 2019.
Results Of 660 studies identified, seven met the inclusion criteria. All measured depression, with three also measuring anxiety. Follow-up duration was variable (median of 18 months range 6–96 months). Risk factors identified for development of psychological morbidity included physical factors: aggressive disease (HR 5.77, 95% CI 1.89 to 17.7) and greater comorbidity burden (OR 4.31, 95% CI 2.83 to 6.57) and psychological risk factors: degree of gratitude (r=−0.43, p<0.01) and parenting stress (R-change=0.03, F(1,58)=35.6, p<0.05). Age-specific risk was identified with young people (13–17 years) at increased risk.
Conclusions Identifiable risks for the development of psychological morbidity in inflammatory bowel disease include physical and psychological factors. Further research is required from large prospective studies to enable early interventions in those at risk and reduce the impact of psychological morbidity.
- inflammatory bowel disease
- psychological stress
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Contributors ABH reviewed the literature and prepared the manuscript. AJL, AJB and ABH reviewed study eligibility and designed the study. ABH, AJL, AJB and GR prepared the final version of the manuscript. All authors approved the final version of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests AJL: Speaker fees, Consultancy or Advisory Board member for MSD, Abbvie, Pfizer, Janssen, Takeda UK, Vifor Pharma, Shield Therapeutics and Medtronic. AJB: Speaker fees, Janssen.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.