Evidence-Based Medicine
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World J Gastroenterol. Apr 7, 2014; 20(13): 3663-3671
Published online Apr 7, 2014. doi: 10.3748/wjg.v20.i13.3663
Psychosocial issues in evidence-based guidelines on inflammatory bowel diseases: A review
Winfried Häuser, Gabriele Moser, Petra Klose, Antonina Mikocka-Walus
Winfried Häuser, Department of Internal Medicine I, Klinikum Saarbrücken, D-66119 Saarbrücken, Germany
Winfried Häuser, Department Psychosomatic Medicine and Psychotherapy, Technische Universität München, D-81675 München, Germany
Gabriele Moser, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, 1090 Vienna, Austria
Petra Klose, Department Internal Medicine V (Integrative Medicine), Kliniken Essen-Mitte, Essen, D-45276 Essen, Germany
Antonina Mikocka-Walus, Department of Health Sciences, University of York, Heslington, York, YO105DD, United Kingdom
Author contributions: Häuser W and Klose P performed the search of the literature; Häuser W designed the study and prepared the first draft of the manuscript; all authors were involved in extracting data and in editing the manuscript; all authors provided feedback on drafts and approved the final version of the manuscript.
Correspondence to: Winfried Häuser, MD, Department of Internal Medicine I, Klinikum Saarbrücken, Winterberg 1, D-66119 Saarbrücken, Germany. whaeuser@klinikum-saarbruecken.de
Telephone: +49-681-9632020 Fax: +49-681-9632022
Received: August 26, 2013
Revised: January 27, 2014
Accepted: February 26, 2014
Published online: April 7, 2014
Abstract

AIM: 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.

CONCLUSION: 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.

Keywords: Anxiety, Depression, Guidelines, Inflammatory bowel diseases, Psychological, Psychotherapy, Smoking, Stress

Core tip: A search of the literature found 13 evidence-based guidelines on the management of inflammatory bowel diseases (IBD). Three guidelines were prepared in Asia, eight in Europe and two in the United States. Mental health care specialists participated in establishing six guidelines and representatives of patient support groups participated in establishing seven guidelines. 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 they can influence its course. IBD-patients should be screened for psychological distress. If indicated, psychotherapy and/or psychopharmacological therapy should be recommended.