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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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