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P320. What's the evidence-base for treating mental health co-morbidities in IBD?

A. Mikocka-Walus1, J. Andrews2, 1University of South Australia, Nursing and Midwifery, Adelaide, Australia, 2Royal Adelaide Hospital, Gastroenterology and Hepatology, Adelaide, Australia

Background

Depression and anxiety are highly prevalent in patients with inflammatory bowel disease (IBD). Recent studies have linked mental health co-morbidities with active disease, more frequent disease flares and increased hospitalisation. Studies also demonstrate poor treatment compliance in IBD sufferers with unmanaged mental health problems. However, there is a controversy on which treatment modalities are most effective to manage depression and anxiety in IBD and thus this paper aims to review most up-to-date data on psychotherapy and antidepressants in IBD.

Methods

A review of the evidence-base for psychotherapy and antidepressant use based on studies from various groups world-wide and ongoing trials conducted in Adelaide, Australia.

Results

Studies demonstrate the need for screening for depression and anxiety in IBD as part of standard IBD care. Psychotherapy has been found to offer a limited benefit for health related quality of life, coping, emotional state and disease activity in IBD population. Yet, cognitive-behavioural therapy (CBT), the most effective psychotherapy modality, has not been extensively investigated in IBD and the ongoing trials indicate its efficacy particularly with symptom management. Preliminary studies on antidepressants indicate their potential efficacy in treating mental health but also physical symptoms of the disease.

Conclusion

IBD sufferers commonly experience symptoms of anxiety and depression and they may have an impact on patient clinical outcomes. Regular screening for these co-morbidities is essential for good management. CBT shows promise in helping with somatic symptoms of IBD. More studies are needed on antidepressants specifically in IBD but they are overall well tolerated by patients and can be prescribed as per other populations.