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Crohn's Disease Forum » Books, Multimedia, Research & News » Psychiatric co-morbidity is associated with increased risk of surgery in Crohn's disease


01-25-2013, 09:53 AM   #1
Igor_Passau
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Psychiatric co-morbidity is associated with increased risk of surgery in Crohn's disease

sychiatric co-morbidity, in particular major depression and anxiety, is common in patients with Crohn's disease and ulcerative colitis.

Prior studies examining this may be confounded by the co-existence of functional bowel symptoms.

Limited data exist examining an association between depression or anxiety and disease-specific endpoints such as bowel surgery.

Dr Ananthakrishnan and colleagues examined the frequency of depression and anxiety in a large multi-institution electronic medical record (EMR)-based cohort of Crohn's disease and ulcerative colitis patients.

The team defined the independent effect of psychiatric co-morbidity on risk of subsequent surgery or hospitalization in Crohn's disease and ulcerative colitis , and identified the effects of depression and anxiety on healthcare utilization,

Using a multi-institution cohort of patients with Crohn's disease and ulcerative colitis, the team identified those who also had co-existing psychiatric co-morbidity.


20% had either major depressive disorder or generalized anxiety
Alimentary Pharmacology & Therapeutics
The team of doctors included a total of 5405 Crohn's disease, and 5429 ulcerative colitis patients.

The researchers found that 20% had either major depressive disorder or generalized anxiety.

After the team adjusted for potential confounders and the propensity score, presence of mood or anxiety co-morbidity was associated with a 28% increase in risk of surgery in Crohn's disease.

The researchers found that the psychiatric co-morbidity was associated with increased healthcare utilization.

Dr Ananthakrishnan's team concluded, "Depressive disorder or generalized anxiety is associated with a modestly increased risk of surgery in patients with Crohn's disease."

"Interventions addressing this may improve patient outcomes."
http://www.gastrohep.com/news/news.asp?id=109352
01-25-2013, 11:45 AM   #2
mnsun
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I would just reiterate that another reason to supplement probiotics (L. Rhamnosus especially, among others) is to correct such emotional complications. The gut bacteria are increasingly being investigated for their role in behavior as well as the mind/gut connection of the vagus nerve and neurotransmitters (GABA).

Probiogenomics is shedding light on gut microbiota and behavioral/emotional states. http://www.pnas.org/content/early/2011/08/26/1102999108 --this link is specifically about L. Rhamnosus.

A poignant excerpt explains: "Importantly, L. rhamnosus (JB-1) reduced stress-induced corticosterone and anxiety- and depression-related behavior."

Here's further elaboration, though this was only a rat study and it should be noted that L Rhamnosus studies have yet to be carried out on humans: http://blogs.discovermagazine.com/no...viour-in-mice/
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01-25-2013, 02:41 PM   #3
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After the team adjusted for potential confounders and the propensity score, presence of mood or anxiety co-morbidity was associated with a 28% increase in risk of surgery in Crohn's disease.

The researchers found that the psychiatric co-morbidity was associated with increased healthcare utilization.

Dr Ananthakrishnan's team concluded, "Depressive disorder or generalized anxiety is associated with a modestly increased risk of surgery in patients with Crohn's disease."

"Interventions addressing this may improve patient outcomes."
http://www.gastrohep.com/news/news.asp?id=109352
I'm confused
The way that is written is suggesting anxiety and depression leads to surgery. Is that not just a correlation? Meaning that the surgery could be causing the depression and anxiety?
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