"It doesn't do any harm, but patients feel better": a qualitative exploratory study on gastroenterologists' perspectives on the role of antidepressants in inflammatory bowel disease.
BACKGROUND
Interest in psychological factors in patients with inflammatory bowel disease (IBD) has increased in recent years. It has even been proposed that treating psychological co-morbidities with antidepressants may control disease activity and improve quality of life. Despite this, there is no data on gastroenterologists' attitudes to, and experiences with, antidepressant therapy in patients with IBD.


METHODS
We conducted semi-structured interviews with 18 gastroenterologists associated with metropolitan teaching hospitals. Qualitative content analysis was used to examine their responses.


RESULTS
Seventy-eight percent of gastroenterologists had treated IBD patients with antidepressants for pain, depression and/or anxiety, and insomnia. Antidepressants were reported to be useful in improving psychosocial well-being, quality of life, and self-management of the disease by patients. However, in this group of gastroenterologists, there appears to be skepticism towards psychological disorders themselves or antidepressant therapy having a central role in either the causation of IBD or its clinical course. Nevertheless, these gastroenterologists were receptive to the idea of conducting a trial of the role of antidepressants in IBD.


CONCLUSIONS
While the majority of specialists have treated IBD patients with antidepressants, there is considerable skepticism with regard to efficacy of antidepressive therapy or the role of psychological factors in the outcome of IBD patients.
Mikocka-Walus
Antonina A
AA
School of Psychology, University of Adelaide, Adelaide, SA, Australia. antonina.mikockawalus@adelaide.edu.au
Turnbull
Deborah A
DA
Moulding
Nicole T
NT
Wilson
Ian G
IG
Andrews
Jane M
JM
Holtmann
Gerald J
GJ
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005762:Gastroenterology / Q000379:methods*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000523:psychology*; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011788:Quality of Life
D000928:Antidepressive Agents