Outcome of antidepressant therapy in affective disorders comorbidity in infiammatory bowel diseases (IBD): Clinical results and psychometric variables after one year of treatment

OBJECTIVES: Assessing the effect of antidepressant therapy (AD) on the abdominal symptomatology in Inflammatory Bowel Disease (IBD) patients with mood or anxiety disorders. METHODS: 58 IBD patients in clinical remission and without known psychiatric disorder but with positive scores in the Hospital Anxiety Depression Scale (HADS) were evaluated for the presence of anxiety and mood disorders (DSM-5 criteria) and administered the Self-report Symptoms Inventory, Revised (SCL-90-R), the Brief Coping Orientation to Problems Experienced (Brief-COPE), the Short Form-36 Health Survey (SF-36), the Hamilton Rating Scale for Anxiety (HAM-A) and Depression (HAM-D). Rectal bleeding and abdominal pain severity and evacuation frequency were evaluated. Patients with affective disorders underwent AD therapy. We analyzed and compared clinical and psychometric findings at baseline, before therapy, and at 3–6–9–12 months follow-up. RESULTS: Of 58 patients enrolled 56,9% were diagnosed with anxiety or mood disorders. Compared to patients without psychiatric comorbidity, IBD-affective patients presented higher HAM-D and HAM-A scores, lower scores in "vitality" (SF-36), and "general anxiety” (SCL-90r) domains, poorer "positive restructuring" and "use of instrumental support" coping strategies, and increased evacuations. In the treated sample, AD therapy significantly reduced anxiety and depressive domains (HAM-A, HAM-D scores) and the data suggest a reduction of evacuation frequency. CONCLUSION: Comorbid IBD-affective patients show decreased levels of self-perceived health and of several coping mechanisms; Although they are in clinical remission most of them present increased number of bowel movements at the baseline, which decreased during AD therapy.