Review
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World J Gastrointest Pharmacol Ther. Apr 6, 2010; 1(2): 64-71
Published online Apr 6, 2010. doi: 10.4292/wjgpt.v1.i2.64
Treatment of psychological co-morbidities in common gastrointestinal and hepatologic disorders
Antonina A Mikocka-Walus
Antonina A Mikocka-Walus, School of Nursing and Midwifery, University of South Australia, Adelaide 5001, SA, Australia; School of Psychology, University of Adelaide, Adelaide 5005, SA, Australia; Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide 5000, Australia
Author contributions: Mikocka-Walus AA solely contributed to this paper.
Correspondence to: Antonina A Mikocka-Walus, MA, PhD, MAPS, Research Fellow, School of Nursing and Midwifery, University of South Australia, Adelaide 5001, SA, Australia. antonina.mikocka-walus@unisa.edu.au
Telephone: +61-8-83022468 Fax: +61-8-83022168
Received: October 30, 2009
Revised: January 20, 2010
Accepted: January 27, 2010
Published online: April 6, 2010
Abstract

Anxiety and depressive disorders frequently coexist with gastrointestinal and hepatologic conditions. Despite their high prevalence, approach to treating these co-morbidities is not always straightforward. This paper aims to review the current literature into etiology of psychological co-morbidities and their treatment in three conditions commonly encountered at gastroenterology outpatient clinics, namely inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and chronic hepatitis C (HepC). The paper demonstrates that although psychotherapy (and cognitive-behavioural therapy in particular) has been established as an effective treatment in IBS, more studies are needed in HepC and IBD. Antidepressants have been recognized as an effective treatment for psychological and somatic symptoms in IBS and for depression in HepC, but good quality studies in IBD are lacking despite the promising preliminary findings from animal models and case studies. Further studies in this area are needed.

Keywords: Inflammatory bowel disease; Irritable bowel syndrome; Hepatitis C; Psychological co-morbidities; Antidepressants; Psychotherapy