Anonymous User
Login / Registration

a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2021; 75(1): 40–45. doi: 10.48095/ccgh202140.

Psychological aspects and possibilities of psychological intervention in patients with inflammatory bowel disease

Hana Bednaříková1,2, Natália Kaščáková1,3, Zuzana Zelinková1,2, Jozef Hašto1,3,4, Peter Tavel1

+ Affiliation


Psychological aspects of inflammatory bowel diseases (IBD) were given less attention in the social space of former Czechoslovak countries. The possibilities of psychological care for patients with IBD have to be re-evaluated due to the new worldwide trends in the management of IBD. In the complex management of IBD treatment arises a demand after psychologist as a helping member of the gastroenterological team in order to be available for patients, as well as to consult the cases with the specialists. In the following article we described psychological interventions (psychotherapeutic techniques), whose effectivity as a supplemental treatment in patients with IBD was examined. Recently, several studies on the effectivity of psychological interventions in patients with IBD have already been available. This trend is in accordance with a bio­psychosocial model of patients‘ care. Promising results were observed in psychotherapeutic techniques which use the work with body feelings, relieving the tension and relaxation training. The presence of psychologist and psychological guidance in difficult periods during chronic diseases such as IBD appears to be helpful. Patients with a psychiatric comorbidity tend to have worse course of disease. It is important to identify the patients who are in need of psychological care, mostly the ones with trauma anamnesis. Overcoming traumatic experience may provide positive impact on the disease course.


Crohn’s disease, psychologické intervencie, biopsychosociálny model starostlivosti o pacienta

To read this article in full, please register for free on this website.

Benefits for subscribers

Benefits for logged users


1. Prasko J, Jelenova D, Mihal V. Psychological aspects and psychotherapy of inflammatory bowel diseases and irritable bowel syndrome in children. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2010; 154 (4): 307–314. doi: 10.5507/bp.2010.046.
2. Mawdsley JE, Rampton DS. Psychological stress in IBD: new insights into pathogenic and therapeutic implications. Gut 2005; 54 (10): 1481–1491. doi: 10.1136/gut.2005.064261.
3. North CS, Alpers DH, Helzer JE et al. Do life events or depression exacerbate inflammatory bowel disease? A prospective study. Ann Intern Med 1991; 114 (5): 381–386. doi: 10.7326/0003-4819-114-5-381.
4. Bernstein MT, Targownik LE, Sexton KA et al. Assessing the relationship between sources of stress and symptom changes among persons with IBD over time: a prospective study. Can J Gastroenterol Hepatol 2016; 2016: 1681507. doi: 10.1155/2016/1681507.
5. Targownik LE, Sexton KA, Bernstein MT et al. The relationship among perceived stress, symptoms, and inflammation in persons with inflammatory bowel disease. Am J Gastroenterol 2015; 110 (7): 1001–1012. doi: 10.1038/ajg.2015.147.
6. Anathakrishnan AN, Bernstein CN, Iliopoulos D et al. Environmental triggers in IBD: a review of progress and evidence. Nat Rev Gastroenterol Hepatol 2018; 15 (1): 39–49. doi: 10.1038/nrgastro.2017.136.
7. Vidal A, Gómez-Gil E, Sans M et al. Life events and inflammatory bowel disease relapse: a prospective study of patients enrolled in remission. Am J Gastroenterol 2006; 101 (4): 775–781. doi: 10.1111/j.1572-0241.2006.00476.x.
8. Mikocka-Walus AA, Turnbull DA, Moulding NT et al. Controversies surrounding the comorbidity of depression and anxiety in inflammatory bowel disease patients: a literature review. Inflamm Bowel Dis 2007; 13 (2): 225–234. doi: 10.1002/ibd.20062.
9. McCombie AM, Mulder RT, Gearry RB. Psychotherapy for inflammatory bowel disease: a review and update. J Crohns Colitis 2013; 7 (12): 935–949. doi: 10.1016/j.crohns.2013.02.004.
10. Mikocka-Walus A, Ford AC, Drossman DA. Antidepressants in inflammatory bowel disease. Nat Rev Gastroenterol Hepatol 2020; 17 (3): 184–192. doi: 10.1038/s41575-019-0259-y.
11. Schmulson MJ, Drossman DA. What is new in Rome IV. J Neurogastroenterol Motil 2017; 23 (2): 151–163. doi: 10.5056/jnm16214.
12. Keefer L, Kane SV. Considering the bidirectional pathways between depression and IBD: reccomendations for comprehensive IBD care. Gastroenterol Hepatol (NY) 2017; 13 (3): 164–169.
13. Marrie RA, Walld R, Bolton JM et al. Rising incidence of psychiatric disorders before dia­gnosis of immune-mediated inflammatory disease. Epidemiol Psychiatr Sci 2019; 28 (3): 333–342. doi: 10.1017/S2045796017000579.
14. Irwin MR, Miller AH. Depressive disorders and immunity: 20 years of progress and discovery. Brain Behav Immun 2007; 21 (4): 374–383. doi: 10.1016/j.bbi.2007.01.010.
15. Ou G, Bressler JB, Galoport C et al. Rate of corticosteroid-induced mood changes in patients with inflammatory bowel disease: a prospective study. J Can Assoc Gastroenterol 2018; 1 (3): 99–106. doi: 10.1093/jcag/gwy023.
16. Drossman DA, Tack J, Ford AC et al. Neuromodulators for functional gastrointestinal disorders (disorders of gut-brain interaction): a Rome foundation working team report. Gastroenterology 2018; 154 (4): 1140–1171. doi: 10.1053/j.gastro.2017.11.279.
17. Choi K, Chun J, Han K et al. Risk of anxiety and depression in patients with inflammatory bowel disease: a nationwide, population-based study. J Clin Med 2019; 8 (5): 654. doi: 10.3390/jcm8050654.
18. Bednaříková H, Kaščáková N, Zelinková Z et al. Teória vzťahovej väzby a nešpecifické zápalové ochorenia čreva. Cs Psychologie 2019; 63 (2): 226–238.
19. Rudolf G, Henningsen P. Psychoterapeutická medicína a psychosomatika. Úvodná učebnica na psychodynamickom základe. Bratislava: Vydavateľstvo F 2018.
20. Drossman DA. Abuse, trauma, and GI illness: is there a link? Am J Gastroenterol 2011; 106 (1): 14–25. doi: 10.1038/ajg.2010.453.
21. Creed F, Guthrie E, Ratcliffe J et al. Reported sexual abuse predicts impaired functioning but a good response to psychological treatments in patients with severe irritable bowel syndrome. Psychosom Med 2005; 67 (3): 490–499. doi: 10.1097/
22. Simrén M, Axelsson J, Gillberg R et al. Quality of life in inflammatory bowel disease in remission: the impact of IBS-like symptoms and associated psychological factors. Am J Gastroenterol 2002; 97 (2): 389–396. doi: 10.1111/j.1572-0241.2002.05475.x.
23. Knowles SR, Mikocka-Walus AA. Psychological aspects of inflammatory bowel disease. London, New York: Routledge 2015.
24. Kascakova N, Furstova J, Polackova Solcova Iet al. The life stressor checklist (LSC-R): the occurrence of stressors in adult Czech population and the association with health. Cs Psychologie 2018; 63 (Suppl 1): 80–98.
25. Fiest KM, Bernstein CN, Walker JR et al. Systematic review of interventions for depression and anxiety in persons with inflammatory bowel disease. BMC Res Notes 2016; 9 (1): 404. doi: 10.1186/s13104-016-2204-2.
26. Klag T, Mazurak N, Fantasia L et al. High demand for psychotherapy in patients with inflammatory bowel disease. Inflamm Bowel Dis 2017; 23 (10): 1796–1802. doi 10.1097/MIB.00000 00000001216.
27. Bernstein CN. Addressing mental health in persons with IBD. J Can Assoc Gastroenterol 2018; 1 (3): 97–98. doi: 10.1093/jcag/gwy038.
28. Weaver E, Szigethy E. Managing pain and psychosocial care in IBD: a primer for the practising gastroenterologist. Curr Gastroenterol Rep 2020; 22 (4): 20. doi: 10.1007/s11894-020-0757-7.
29. Hofman A. EMDR – terapia psychotraumatických stresových syndrómov. Bratislava: Vydavateľstvo F 2007.
30. Ballou S, Keefer L. Psychological interventions for irritable bowel syndrome and inflammatory bowel diseases. Clin Transl Gastroenterol 2017; 8 (1): e 214. doi: 10.1038/ctg.2016.69.
31. Szigethy E. Hypnotherapy for inflammatory bowel disease across the lifespan. Am J Clin Hypn 2015; 58 (1): 81–99. doi: 10.1080/00029 157.2015.1040112.
32. Keefer L, Taft TH, Kiebles JL et al. Gut-directed hypnotherapy significantly augments clinical remission in quiescent ulcerative colitis. Aliment Pharmacol Ther 2013; 38 (7): 761–771. doi: 10.1111/apt.12449.
33. Hašto J. Autogénny tréning. 4. vyd. Bratislava: Vydavateľstvo F 2018.
34. Shinozaki M, Kanazawa M, Kano M et al. Effect of autogenic training on general improvement in patients with irritable bowel syndrome: a randomized controlled trial. Appl Psychophysiol Biofeedback 2010; 35 (3): 189–198. doi: 10.1007/s10484-009-9125-y.
35. Regueiro M, Greer JB, Szigethy E. Etiology and treatment of pain and psychosocial issues in patients with inflammatory bowel disease. Gastroenterol 2017; 152 (2): 430–439. doi: 10.1053/j.gastro.2016.10.036.
36. Hochgerner M, Pokorny V. Koncentratívna pohybová terapia (KPT) v teórii a praxi. Bratislava: Vydavateľstvo F 2003.
37. Kottje-Birnbacher L. Die Katathym-imaginative Psychotherapie. Ein erweiterter psychodynamischer Behandlungsansatz am Beispiel einer Kolitisbehandlung. Psychotherapeut 2002; 47 (4): 214–222. doi: 10.1007/s00278-002-0234-9.
38. Knowles SR, Monshat K, Castle DJ. The efficacy and methodological challenges of psychotherapy for adults with inflammatory bowel disease: a review. Inflamm Bowel Dis 2013; 19 (12): 2704–2715. doi: 10.1097/mib.0b013e318296ae5a.
39. Colonnello V, Agostini A. Disease course, stress, attachment, and mentalization in patients with inflammatory bowel disease. Med Hypotheses 2020; 140: 109665. doi: 10.1016/j.mehy.2020.109665.
40. Gerbarg PL, Jacob VE, Stevens L et al. The effect of breathing, movement, and meditation on psychological and physical symptoms and inflammatory bio­markers in inflammatory bowel disease: a randomized controlled trial. Inflamm Bowel Dis 2015; 21 (12): 2886–2896. doi: 10.1097/MIB.0000000000000568.
41. Song G, Fiocchi C, Achkar JP. Acupuncture in inflammatory bowel disease. Inflamm Bowel Dis 2019; 25 (7): 1129–1139. doi: 10.1093/ibd/izy371.
42. Schneider A, Streitberger K, Joos S. Acupuncture treatment in gastrointestinal diseases: a systematic review. World J Gastroenterol 2007; 13 (25): 3417–3424. doi: 10.3748/wjg.v13.i25.3417.
43. Keefer L, Palsson OS, Pandolfino JE. Best practise update: incorporating psychogastroenterology into management o digestive disorders. Gastroenterology 2018; 154 (4): 1249–1257. doi: 10.1053/j.gastro.2018.01.045.
44. Szigethy E, Murphy SM, Ehrlich OG et al. Mental health costs of inflammatory bowel disease. Inflamm Bowel Dis 2021; 27 (1): 40–48. doi: 10.1093/ibd/izaa030.
45. Zelinková Z, Podmanický D, Kadlečková B. Priame náklady na liečbu nešpecifických zápalových ochorení čreva. Gastroent Hepatol 2020; 74 (1): 35–38. doi: 10.14735/amgh202035.

Kreditovaný autodidaktický test