title: Pediatric inflammatory bowel disease and depression: treatment implications.
abstract: OBJECTIVE
  Depression in pediatric inflammatory bowel disease is increasingly recognized to be a heterogeneous condition with diverse underlying predisposing and precipitating factors. Although there is a growing awareness regarding the benefits of integrating behavioral health into medical care, the way psychiatric treatments can best target different aspects of depression and related dysfunction has not been systematically explored.
  
  
  RESULTS
  This review discusses neurobiological risk factors for depression in inflammatory bowel disease including inflammation, associated anti-inflammatory treatment with corticosteroids, pain, and sleep disturbance, as well as psychosocial factors including reactions to illness, illness perception, and disease and environmental stressors with an emphasis on how these factors can influence treatment decisions. Empirically supported psychosocial and psychopharmacological interventions are discussed within this context.
  
  
  CONCLUSIONS
  Understanding the diverse pathways that can lead to depression in youths with inflammatory bowel disease can lead to the development of more targeted interventions and better integration of psychosocial care into the medical treatment of inflammatory bowel disease.
authors.affiliation: aUniversity of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania bDepartment of Psychiatry, Boston Children's Hospital, Boston, Massachusetts cDepartment of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Divya
authors.initials: D
authors.lastname: Keethy
authors.forename: Christine
authors.initials: C
authors.lastname: Mrakotsky
authors.forename: Eva
authors.initials: E
authors.lastname: Szigethy
mesh_terms: D015746:Abdominal Pain / Q000150:complications / Q000523:psychology*; D000293:Adolescent; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003863:Depression / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006801:Humans; D007249:Inflammation / Q000150:complications; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000523:psychology* / Q000628:therapy; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D011613:Psychotherapy / Q000379:methods; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000209:etiology / Q000523:psychology* / Q000628:therapy
chemical_list: D000928:Antidepressive Agents