Psychosocial issues in evidence-based guidelines on inflammatory bowel diseases: a review.
OBJECTIVE
To study statements and recommendations on psychosocial issues as presented in international evidence-based guidelines on the management of inflammatory bowel diseases (IBD).


METHODS
MEDLINE, guidelines International Network, National Guideline Clearing House and National Institute for Health and Care Excellence were searched from January 2006 to June 30, 2013 for evidence-based guidelines on the management of IBD.


RESULTS
The search yielded 364 hits. Thirteen guidelines were included in the review, of which three were prepared in Asia, eight in Europe and two in the United States. Eleven guidelines made statements and recommendations on psychosocial issues. The guidelines were concordant in that mental health disorders and stress do not contribute to the aetiology of IBD, but that they can influence its course. It was recommended that IBD-patients should be screened for psychological distress. If indicated, psychotherapy and/or psychopharmacological therapy should be recommended. IBD-centres should collaborate with mental health care specialists. Tobacco smoking patients with Crohn's disease should be advised to quit.


CONCLUSIONS
Patients and mental health specialists should be able to participate in future guideline groups to contribute to establishing recommendations on psychosocial issues in IBD. Future guidelines should acknowledge the presence of psychosocial problems in IBD-patients and encourage screening for psychological distress.
Winfried Häuser, Department of Internal Medicine I, Klinikum Saarbrücken, D-66119 Saarbrücken, Germany.
Winfried
W
Häuser
Winfried Häuser, Department of Internal Medicine I, Klinikum Saarbrücken, D-66119 Saarbrücken, Germany.
Gabriele
G
Moser
Winfried Häuser, Department of Internal Medicine I, Klinikum Saarbrücken, D-66119 Saarbrücken, Germany.
Petra
P
Klose
Winfried Häuser, Department of Internal Medicine I, Klinikum Saarbrücken, D-66119 Saarbrücken, Germany.
Antonina
A
Mikocka-Walus
D015897:Comorbidity; D019317:Evidence-Based Medicine; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology*; D017410:Practice Guidelines as Topic; D011600:Psychopharmacology / Q000379:methods; D011613:Psychotherapy / Q000379:methods; D011788:Quality of Life; D016896:Treatment Outcome
Anxiety; Depression; Guidelines; Inflammatory bowel diseases; Psychological; Psychotherapy; Smoking; Stress