Patients with the bowel disease ulcerative colitis are much more likely than those without the disorder to have a history of depression or anxiety.
Researchers showed the association is strongest when mental health problems are identified shortly before a diagnosis of ulcerative colitis.
The finding reopens a long-running medical debate about whether some people develop inflammatory bowel disease as a result of psychiatric disorders, or whether they already have the disease and the depression is a byproduct of it.
The researchers say it is possible that by suppressing the immune system, depression might put certain people more at risk of bowel disease.
Ulcerative colitis affects up to 100,000 people in the UK, most of them younger than 35 years of age. It occurs when the inside lining of the colon -- the large intestine -- or the rectum becomes inflamed and ulcerated. This causes pain, bloody diarrhea and tiredness.
Our results indicate that depression and anxiety, at least at the level of severity to require specialist psychiatric care, have only a small effect - if any - on the etiology of inflammatory bowel disease. The evidence for such an effect is stronger for ulcerative colitis than for Crohn's disease.
But the researchers add that sufferers of both disorders are significantly more at risk of becoming depressed or anxious in the months following their diagnosis.
Journal of Epidemiology and Community Health 2001;55:716-720
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