title: Psychological disorders in gastrointestinal disease: epiphenomenon, cause or consequence?
abstract: BACKGROUND
  Psychological disorders have been associated with irritable bowel syndrome (IBS) for decades in the absence of other objective etiology. However, such associations are also evident in other chronic diseases with more clearly defined pathogenesis such as ulcerative colitis. In this study, we examined the prevalence and severity of psychological disorders among IBS and ulcerative colitis (UC) patients relative to healthy controls.
  
  
  METHODS
  A review was conducted of English-language literature to identify case-control studies reporting the prevalence of depression or anxiety in IBS and UC populations relative to healthy controls. Our primary endpoint was the pooled prevalence or average score of depression or anxiety in an IBS or UC population relative to healthy control.
  
  
  RESULTS
  Seven case-control studies evaluating IBS and three evaluating UC were included. All IBS and UC studies reported excess prevalence and severity of depression as well as anxiety, relative to healthy controls. The prevalence of depression in excess of healthy controls was 39% in UC case-control trials and 33% in IBS studies, and excess anxiety was present in UC (42%) and IBS (19%) case-control trials as well. Anxiety and depression scores were higher (representing more severe symptoms) in both UC and IBS patients compared to healthy controls.
  
  
  CONCLUSIONS
  Anxiety and depressive disorders are associated with both IBS and UC. The non-specific association between these psychological and gastrointestinal disorders could suggest that chronic gastrointestinal illness might affect psychosocial behavior.
authors: GI Motility Program Cedars-Sinai Medical Center, Los Angeles, CA (Eric Shah, Ali Rezaie, Mark Pimentel), USA.
authors: Eric
authors: E
authors: Shah
authors: GI Motility Program Cedars-Sinai Medical Center, Los Angeles, CA (Eric Shah, Ali Rezaie, Mark Pimentel), USA.
authors: Ali
authors: A
authors: Rezaie
authors: Enteric Diseases Department, Naval Medical Research Center, Silver Spring, Maryland (Mark Riddle), USA.
authors: Mark
authors: M
authors: Riddle
authors: GI Motility Program Cedars-Sinai Medical Center, Los Angeles, CA (Eric Shah, Ali Rezaie, Mark Pimentel), USA.
authors: Mark
authors: M
authors: Pimentel
keywords: Mood disorders; colitis; irritable bowel syndrome; ulcerative