Depression and IBD

2018

2018


We hope that understanding how the brain and Crohn's and Colitis interact will improve both the physical and mental wellbeing of people living with these conditions.

Dr Richard Pollok
St George’s, University of London

What is this research looking at?  

People with Crohn’s or Colitis are more likely to experience depression than the general population. But the relationship between symptoms, use of antidepressants, flares and the impact of bowel surgery on mental health are not well-understood.

To find out who might be most at risk of depression and how it is treated, the researchers will answer the following questions:  

  • How common is depression in people with Crohn’s and Colitis? 
  • What factors make depression more likely? 
  • How are antidepressants used to treat people with depression and Crohn’s and Colitis?  
  • Has this changed over the past 10 years, and if so, how? 

Small studies have suggested that antidepressant medicines may reduce the number of flares and the need for steroid treatment.  The researchers will explore whether people with depression and Crohn’s and Colitis experience more flares, and they’ll look at the impact of antidepressant use on flares and the need for steroids.  

Bowel surgery can be a necessary treatment option for people with Crohn’s and Colitis. But the impact of surgery on mental health, particularly for people considering a stoma, is unknown. The researchers will investigate the relationship is between having surgery – in particular having a stoma - and developing depression.

To answer these questions, the team will examine the medical records of more than 19,500 people with Crohn’s and Colitis from the Clinical Practice Research Datalink database. 

What do the researchers think this could mean for people with IBD?  

Understanding what influences depression in people with Crohn’s and Colitis and the effect depression can have on symptoms will help health professionals address the mental health needs of people with these conditions. 

Findings could also lead to more effective support in shared decision-making regarding surgery, especially for people considering a stoma. And a greater understanding of how antidepressant medicines impacts flares could suggest a novel treatment approach to flare management.

Scientific publications resulting from this research project

Prevalence and duration of gastrointestinal symptoms before diagnosis of Inflammatory Bowel Disease and predictors of timely specialist review: a population-based study (full paper available to read for free)

Main findings

  • 1 in 10 people with Crohn’s or Colitis waited 5 years for their diagnosis after first reporting symptoms to their doctor.
  • Only 6 in 100 people had an appointment with a gastroenterologist (a specialist doctor in digestive diseases) within 4 weeks – the timeframe set by the UK IBD Standards.
  • People with a previous diagnosis of depression or Irritable Bowel Syndrome (IBS) were at a higher risk of experiencing a delay in seeing a gastroenterologist.
  • There is a pressing need to improve healthcare pathways to speed up the diagnosis of Crohn’s and Colitis.

Read our news story for more information.

Who is leading the research: Dr Richard Pollok, St George’s, University of London 
Award amount: £89,670 
Duration: 18 months  
Official title of the application: Depression and antidepressant medications: their relationship to clinical outcomes in IBD