GI Psychiatry

Journal Article Annotations
2021, 1st Quarter

GI Psychiatry

Annotations by Ashwini Nadkarni, MD
March, 2021

  1. Prevalence of symptoms of anxiety and depression in patients with inflammatory bowel disease: a systematic review and meta-analysis.
  2. Association between inflammatory bowel disease and psychiatric morbidity and suicide: A Swedish nationwide population-based cohort study with sibling comparisons.
  3. The Brain-Gut Axis: Psychological Functioning and Inflammatory Bowel Diseases.

     

    Also of interest:


    PUBLICATION #1 — GI Psychiatry

    Prevalence of symptoms of anxiety and depression in patients with inflammatory bowel disease: a systematic review and meta-analysis.
    Brigida Barberio, Mohammad Zamani, Christopher J Black, Edoardo V Savarino, Alexander C Ford

    Annotation

    The finding:
    Pooled prevalence of anxiety symptoms in IBD patients was 32% and pooled prevalence of depression sx was 25%. Women with IBD—particularly women with Crohn’s disease— were more likely to experience anxiety than men with IBD. Patients with active disease had a higher probability of experiencing both anxiety and depressive symptoms than did patients with inactive disease.

    Strength and weaknesses:
    Although this meta-analysis was rigorous in its inclusion and exclusion criteria of relevant studies, the lack of DSM-5 nomenclature makes this report less useful in sharing new insights for psychiatrists (as opposed to gastroenterologists who often need more coaching to implement consistent screening).

    Relevance:
    This article provides an overview of the frequency and types of mood disorders observed in patients with IBD, a major autoimmune illness with a bidirectional relationship with psychiatric co-morbidity and likely a large source of referrals for C-L psychiatrists

    Type of study (EBM guide):
    Systematic review or meta-analysis


    PUBLICATION #2 — GI Psychiatry

    Association between inflammatory bowel disease and psychiatric morbidity and suicide: A Swedish nationwide population-based cohort study with sibling comparisons.
    Jonas F Ludvigsson, Ola Olén, Henrik Larsson, Jonas Halfvarson, Catarina Almqvist, Paul Lichtenstein, Agnieszka Butwicka

    Annotation

    The finding:
    There is an increased risk of psychiatric disorders and suicide attempts among patients with IBD and an increased risk of completed suicide seen in patients with Crohn’s disease and elderly onset of IBD (age 60 or greater).

    Strength and weaknesses:
    This study provides useful information to psychiatrists making risk assessments of patients with IBD. While it evaluates psychiatric co-morbidity and completed suicide, the study does not assess these together in patients with IBD. It does describe which psychiatric disorders pose increased risk among IBD patients for suicide (eg, bipolar disorder).

    Relevance:
    As a chronic medical illness with strong psychiatric co-morbidity, IBD poses a higher risk of suicide, but the data guiding us on this question remains uncertain. The study adds to the growing body of evidence of increased risk.

    Type of study (EBM guide):
    Cohort study


    PUBLICATION #3 — GI Psychiatry

    The Brain-Gut Axis: Psychological Functioning and Inflammatory Bowel Diseases.
    Spyros Peppas, Claudia Pansieri, Daniele Piovani, Silvio Danese, Laurent Peyrin-Biroulet, Andreas G Tsantes, Enrico Brunetta, Argirios E Tsantes, Stefanos Bonovas

    Annotation

    The finding:
    This article explains the complex relationship between the brain-gut-microbiome axis and the impact on resulting psychiatric conditions in IBD. The review is based on a MEDLINE and EMBASE literature search.

    Strength and weaknesses:
    This article provides the most up-to-date summary of the existing data of the bidirectional relationship between psychiatric disorders and IBD and also assesses data for treatment strategies. For many psychiatrists, no new information is presented that would aid in managing IBD patients with psychiatric disorders. However, an explanation of the relevance of diet and fecal microbiota transplantation may be interesting to psychiatrists interested in the most cutting-edge treatments for IBD. The question of whether such treatments and their impact on the intestinal microbiome proves relevant to psychiatric illnesses remains to be uncovered.

    Relevance:
    The brain-gut-microbiome is the pathophysiological basis for the relationship between IBD and psychiatric disorders; this article details the relationship and the impact on psychiatric disorders. The article also identifies relevant management strategies for psychiatric disorders

    Type of study (EBM guide):
    Systematic review or meta-analysis

     


    Also of interest – PUBLICATION #4 — GI Psychiatry

    Gut microbiota in psychiatric disorders: Better understanding or more complexity to be resolved?
    Błażej Misiak, Jerzy Samochowiec, Wojciech Marlicz, Igor Łoniewski
    Annotation (unstructured)

    This article provides a summary of the evidence for the role of the intestinal microbiome in the pathophysiology of neurodevelopmental disorders, mood disorders, and dementia. Its value is in providing a clear, well-written synthesis of the available data and describing the use of psychobiotics (eg, psychotropics which impact the gut microbiome and consequently treat psychiatric disorders) and probiotics in treating psychiatric disorders.

    Type of study (EBM guide):
    Systematic review or meta-analysis

     


    Also of interest – PUBLICATION #5 — GI Psychiatry

    Impact of Recreational Cannabis Legalization on Hospitalizations for Hyperemesis.
    Laura Nemer, Luis F Lara, Alice Hinton, Darwin L Conwell, Somashekar G Krishna, Gokulakrishnan Balasubramanian

    Annotation (unstructured)

    Cannabinoid hyperemesis syndrome may be a common reason for consult for C/L psychiatrists. This study examines the relationship between increased access to marijuana, and consequently, increased usage and incidents of hyperemesis resulting in hospitalization. This study examines the relationship between cannabis access, increased usage and resulting increase in hospitalizations. Unfortunately, the value of the study is limited in that it does not adequately address confounding factors.

    Type of study (EBM guide):
    Cohort study