Psychosis, Psychology, Stress and Counselling

Abstract

Helzer et al. (1984) have reported a 56% incidence of psychiatric disorders in patients with Crohn’s disease compared with a 30% incidence in a group of medically ill controls without Crohn’s disease. However, there was no evidence that the two disease syndromes have any consistent relationship to each other. Other studies have suggested an increased prevalence in depression in patients with Crohn’s disease (Gerbert 1980). Nevertheless, psychiatric illnesses are even more prevalent in patients with functional gastrointestinal disorders than they are in Crohn’s disease. Alpers and Clouse (1986) stress that the detection of psychiatric disease in a patient who also has inflammatory bowel disease will not resolve all the symptoms that cannot be attributed directly to the inflammatory bowel disease. However, it will clarify many difficulties. They felt that physicians treating patients with Crohn’s disease should learn to seek and recognise symptoms of psychiatric disorder and that it was well worthwhile to treat active psychiatric symptoms; especially affective and anxiety disorders (Alpers and Clouse 1986). There seems to be little firm evidence to suggest that psychiatric disease can have an adverse effect on the natural history of Crohn’s disease, but it is not surprising that, with the onset of recrudescence of symptoms in a chronic bowel disease, there is likely to be worsening of any inherent psychiatric illness.