The emerging role of mood disorders in inflammatory bowel diseases

Inflammatory bowel diseases (IBD) are chronic, devastating conditions of the gastrointestinal tract characterized by a complex pathogenesis, increasing worldwide prevalence, a wide spectrum of extraintestinal manifestations, and a reduced health-related quality of life (HRQoL). Furthermore, mood disorders, specifically anxiety and depression, are more prevalent among IBD patients compared to the general population. The connection between mental disorders and IBD is compound, bidirectional and still not fully understood. The IBD may impact psychological health, whereas anxiety and depression are associated with a more aggressive course of IBD. The inflammation process, gut microbiota alterations and drug side effects are factors that influence the mental state of patients with IBD. Importantly, despite the high prevalence of depression and anxiety in IBD, many of the current guidelines do not include clear recommendation for assessment of mental problems in patients and further management. Therefore, monitoring for mood disorders should become a part of the multi-disciplinary and holistic approach to patients with IBD. This review is based on current literature searched in PubMed, mainly considering publications from the last 10 years.