{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:18:56Z","timestamp":1789449536235,"version":"build-2803163510"},"reference-count":82,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T00:00:00Z","timestamp":1680134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and aims: Inflammatory bowel diseases (IBD) are chronic disorders associated with a reduced quality of life, and patients often also suffer from psychiatric comorbidities. Overall, both mood and cognitive disorders are prevalent in chronic organic diseases, especially in the case of a strong immune component, such as rheumatoid arthritis, multiple sclerosis, and cancer. Divergent data regarding the true incidence and prevalence of mental disorders in patients with IBD are available. We aimed to review the current evidence on the topic and the burden of mental illness in IBD patients, the role of the brain\u2013gut axis in their co-existence, and its implication in an integrated clinical management. Methods: PubMed was searched to identify relevant studies investigating the gut\u2013brain interactions and the incidence and prevalence of psychiatric disorders, especially of depression, anxiety, and cognitive dysfunction in the IBD population. Results: Among IBD patients, there is a high prevalence of psychiatric comorbidities, especially of anxiety and depression. Approximately 20\u201330% of IBD patients are affected by mood disorders and\/or present with anxiety symptoms. Furthermore, it has been observed that the prevalence of mental illnesses increases in patients with active intestinal disease. Psychiatric comorbidities continue to be under-diagnosed in IBD patients and remain an unresolved issue in the management of these patients. Conclusions: Psychiatric illnesses co-occurring in IBD patients deserve acknowledgment from IBD specialists. These comorbidities highly impact the management of IBD patients and should be studied as an adjunctive therapeutic target.<\/jats:p>","DOI":"10.3390\/medicina59040682","type":"journal-article","created":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T03:17:35Z","timestamp":1680146255000},"page":"682","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Mental Illnesses in Inflammatory Bowel Diseases: mens sana in corpore sano"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5725-6986","authenticated-orcid":false,"given":"Bianca","family":"Bartocci","sequence":"first","affiliation":[{"name":"IBD Center, Humanitas Research Hospital-IRCCS, Via Manzoni 56, Rozzano, 20089 Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8543-4355","authenticated-orcid":false,"given":"Arianna","family":"Dal Buono","sequence":"additional","affiliation":[{"name":"IBD Center, Humanitas Research Hospital-IRCCS, Via Manzoni 56, Rozzano, 20089 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Gabbiadini","sequence":"additional","affiliation":[{"name":"IBD Center, Humanitas Research Hospital-IRCCS, Via Manzoni 56, Rozzano, 20089 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Busacca","sequence":"additional","affiliation":[{"name":"IBD Center, Humanitas Research Hospital-IRCCS, Via Manzoni 56, Rozzano, 20089 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Quadarella","sequence":"additional","affiliation":[{"name":"IBD Center, Humanitas Research Hospital-IRCCS, Via Manzoni 56, Rozzano, 20089 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Repici","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9290-735X","authenticated-orcid":false,"given":"Emanuela","family":"Mencaglia","sequence":"additional","affiliation":[{"name":"Medical Oncology and Haematology Unit, Humanitas Cancer Center, Humanitas Research Hospital IRCCS, Via Manzoni 56, Rozzano, 20089 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Gasparini","sequence":"additional","affiliation":[{"name":"Child Neuropsychiatry Unit, Niguarda Hospital, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1572-0118","authenticated-orcid":false,"given":"Alessandro","family":"Armuzzi","sequence":"additional","affiliation":[{"name":"IBD Center, Humanitas Research Hospital-IRCCS, Via Manzoni 56, Rozzano, 20089 Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1038\/s41572-020-0156-2","article-title":"Crohn\u2019s disease","volume":"6","author":"Roda","year":"2020","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1038\/s41572-020-0205-x","article-title":"Ulcerative colitis","volume":"6","author":"Kobayashi","year":"2020","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1038\/nrgastro.2017.136","article-title":"Environmental triggers in IBD: A review of progress and evidence","volume":"15","author":"Ananthakrishnan","year":"2018","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/j.dld.2021.03.002","article-title":"Quality of life in patients with moderate to severe ulcerative colitis and the impact of treatment: A narrative review","volume":"53","author":"Armuzzi","year":"2021","journal-title":"Dig. Liver Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/S2468-1253(21)00014-5","article-title":"Prevalence of symptoms of anxiety and depression in patients with inflammatory bowel disease: A systematic review and meta-analysis","volume":"6","author":"Barberio","year":"2021","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1038\/s41575-022-00634-6","article-title":"Depression and anxiety in inflammatory bowel disease: Epidemiology, mechanisms and treatment","volume":"19","author":"Bisgaard","year":"2022","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.crohns.2008.01.002","article-title":"Reconsidering the methodology of \u201cstress\u201d research in inflammatory bowel disease","volume":"2","author":"Keefer","year":"2008","journal-title":"J. Crohns Colitis"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.crohns.2007.06.005","article-title":"Impact of inflammatory bowel disease on quality of life: Results of the European Federationof Crohn\u2019s and ulcerative colitis associations (EFCCA) patient survey","volume":"1","author":"Ghosh","year":"2007","journal-title":"J. Crohns Colitis"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/bmb\/ldab010","article-title":"Psychological factors associated with inflammatory bowel disease","volume":"138","author":"Eugenicos","year":"2021","journal-title":"Br. Med. Bull."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ibd\/izz104","article-title":"The Cost of Inflammatory Bowel Disease: An Initiative From the Crohn\u2019s & Colitis Foundation","volume":"26","author":"Park","year":"2020","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/S0753-3322(01)80006-8","article-title":"Psychosocial aspects of inflammatory bowel disease","volume":"54","author":"Casati","year":"2000","journal-title":"Biomed. Pharmacother."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1111\/j.1572-0241.2001.03800.x","article-title":"Psychological distress, social support, and disease activity in patients with inflammatory bowel disease","volume":"96","author":"Sewitch","year":"2001","journal-title":"Am. J. Gastroenterol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1111\/j.1572-0241.2000.02012.x","article-title":"Stress and exacerbation in ulcerative colitis: A prospective study of patients enrolled in remission","volume":"95","author":"Levenstein","year":"2000","journal-title":"Am. J. Gastroenterol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1111\/apt.12195","article-title":"Psychiatric co-morbidity is associated with increased risk of surgery in Crohn\u2019s disease","volume":"37","author":"Ananthakrishnan","year":"2013","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Oligschlaeger, Y., Yadati, T., Houben, T., Condello Oliv\u00e1n, C.M., and Shiri-Sverdlov, R. (2019). Inflammatory Bowel Disease: A Stressed \u201cGut\/Feeling\u201d. Cells, 8.","DOI":"10.3390\/cells8070659"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1093\/ibd\/izy143","article-title":"Influences and Impact of Anxiety and Depression in the Setting of Inflammatory Bowel Disease","volume":"24","author":"Navabi","year":"2018","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"247","DOI":"10.2174\/156652408784533832","article-title":"The role of stress in the development and clinical course of inflammatory bowel disease: Epidemiological evidence","volume":"8","author":"Maunder","year":"2008","journal-title":"Curr. Mol. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1016\/S2468-1253(19)30089-5","article-title":"The influence of the brain-gut axis in inflammatory bowel disease and possible implications for treatment","volume":"4","author":"Gracie","year":"2019","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.neubiorev.2014.02.001","article-title":"Chemokines and chemokine receptors in mood disorders, schizophrenia, and cognitive impairment: A systematic review of biomarker studies","volume":"42","author":"Stuart","year":"2014","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1136\/gutjnl-2018-317182","article-title":"Depression increases the risk of inflammatory bowel disease, which may be mitigated by the use of antidepressants in the treatment of depression","volume":"68","author":"Frolkis","year":"2019","journal-title":"Gut"},{"key":"ref_21","first-page":"G391","article-title":"Corticotropin-releasing hormone mimics stress-induced colonic epithelial pathophysiology in the rat","volume":"277","author":"Santos","year":"1999","journal-title":"Am. J. Physiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1016\/j.neuroscience.2005.06.090","article-title":"Catecholamines mediate stress-induced increases in peripheral and central inflammatory cytokines","volume":"135","author":"Johnson","year":"2005","journal-title":"Neuroscience"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.1111\/j.1572-0241.2005.50071.x","article-title":"Heightened responses to stressors in patients with inflammatory bowel disease","volume":"100","author":"Farhadi","year":"2005","journal-title":"Am. J. Gastroenterol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"892","DOI":"10.2174\/1570159X14666160404124127","article-title":"Mechanisms by which Stress Affects the Experimental and Clinical Inflammatory Bowel Disease (IBD): Role of Brain-Gut Axis","volume":"14","author":"Brzozowski","year":"2016","journal-title":"Curr. Neuropharmacol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1080\/1744666X.2021.1933443","article-title":"Genetic susceptibility to inflammatory bowel disease: Should we be looking to the hypothalamus?","volume":"17","author":"Caldirola","year":"2021","journal-title":"Expert Rev. Clin. Immunol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"576973","DOI":"10.1016\/j.jneuroim.2019.576973","article-title":"Activation of microglia and macrophages in the circumventricular organs of the mouse brain during TLR2-induced fever and sickness responses","volume":"334","author":"Murayama","year":"2019","journal-title":"J. Neuroimmunol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1242\/jeb.073411","article-title":"Immune-neural connections: How the immune system\u2019s response to infectious agents influences behavior","volume":"216","author":"McCusker","year":"2013","journal-title":"J. Exp. Biol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Fornaro, R., Actis, G.C., Caviglia, G.P., Pitoni, D., and Ribaldone, D.G. (2022). Inflammatory Bowel Disease: Role of Vagus Nerve Stimulation. J. Clin. Med., 11.","DOI":"10.3390\/jcm11195690"},{"key":"ref_29","first-page":"2209","article-title":"Impaired parasympathetic function increases susceptibility to inflammatory bowel disease in a mouse model of depression","volume":"118","author":"Ghia","year":"2008","journal-title":"J. Clin. Investig."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1136\/gutjnl-2019-318427","article-title":"Leaky gut: Mechanisms, measurement and clinical implications in humans","volume":"68","author":"Camilleri","year":"2019","journal-title":"Gut"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.neuroscience.2017.10.023","article-title":"Anxiety- and Depressive-Like Behaviors are Associated with Altered Hippocampal Energy and Inflammatory Status in a Mouse Model of Crohn\u2019s Disease","volume":"366","author":"Amiri","year":"2017","journal-title":"Neuroscience"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1126\/science.abc6108","article-title":"Identification of a choroid plexus vascular barrier closing during intestinal inflammation","volume":"374","author":"Carloni","year":"2021","journal-title":"Science"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1186\/s12974-015-0281-0","article-title":"Chronic intestinal inflammation alters hippocampal neurogenesis","volume":"12","author":"Zonis","year":"2015","journal-title":"J. Neuroinflamm."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Vitali, R., Prioreschi, C., Lorenzo Rebenaque, L., Colantoni, E., Giovannini, D., Frusciante, S., Diretto, G., Marco-Jim\u00e9nez, F., Mancuso, M., and Casciati, A. (2022). Gut-Brain Axis: Insights from Hippocampal Neurogenesis and Brain Tumor Development in a Mouse Model of Experimental Colitis Induced by Dextran Sodium Sulfate. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms231911495"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1792","DOI":"10.1038\/s41380-021-01421-6","article-title":"Functional brain rewiring and altered cortical stability in ulcerative colitis","volume":"27","author":"Wang","year":"2022","journal-title":"Mol. Psychiatry"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"460","DOI":"10.3389\/fnhum.2016.00460","article-title":"Structural Imaging Changes and Behavioral Correlates in Patients with Crohn\u2019s Disease in Remission","volume":"10","author":"Nair","year":"2016","journal-title":"Front. Hum. Neurosci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1097\/MIB.0000000000000620","article-title":"Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases","volume":"22","author":"Knowles","year":"2016","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.jpsychores.2016.06.001","article-title":"Depression and anxiety in patients with Inflammatory Bowel Disease: A systematic review","volume":"87","author":"Neuendorf","year":"2016","journal-title":"J. Psychosom Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1111\/apt.12669","article-title":"The incidence and risk factors for developing depression after being diagnosed with inflammatory bowel disease: A cohort study","volume":"39","author":"Panara","year":"2014","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"6496727","DOI":"10.1155\/2017\/6496727","article-title":"Prevalence of Anxiety and Depression in Patients with Inflammatory Bowel Disease","volume":"2017","author":"Byrne","year":"2017","journal-title":"Can. J. Gastroenterol. Hepatol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Choi, K., Chun, J., Han, K., Park, S., Soh, H., Kim, J., Lee, J., Lee, H.J., Im, J.P., and Kim, J.S. (2019). Risk of Anxiety and Depression in Patients with Inflammatory Bowel Disease: A Nationwide, Population-Based Study. J. Clin. Med., 8.","DOI":"10.3390\/jcm8050654"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1017\/S2045796017000579","article-title":"Rising incidence of psychiatric disorders before diagnosis of immune-mediated inflammatory disease","volume":"28","author":"Marrie","year":"2019","journal-title":"Epidemiol. Psychiatr. Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.jpsychores.2017.07.015","article-title":"Increased incidence of psychiatric disorders in immune-mediated inflammatory disease","volume":"101","author":"Marrie","year":"2017","journal-title":"J. Psychosom. Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1824","DOI":"10.1093\/ecco-jcc\/jjab039","article-title":"Association Between Inflammatory Bowel Disease and Psychiatric Morbidity and Suicide: A Swedish Nationwide Population-Based Cohort Study With Sibling Comparisons","volume":"15","author":"Ludvigsson","year":"2021","journal-title":"J. Crohns Colitis"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"110983","DOI":"10.1016\/j.jpsychores.2022.110983","article-title":"Association of inflammatory bowel disease with suicidal ideation, suicide attempts, and suicide: A systematic review and meta-analysis","volume":"160","author":"Xiong","year":"2022","journal-title":"J. Psychosom. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1001\/jamapediatrics.2019.2662","article-title":"Association of Childhood-Onset Inflammatory Bowel Disease With Risk of Psychiatric Disorders and Suicide Attempt","volume":"173","author":"Butwicka","year":"2019","journal-title":"JAMA Pediatr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1111\/j.1572-0241.2008.01980.x","article-title":"The Manitoba IBD cohort study: A population-based study of the prevalence of lifetime and 12-month anxiety and mood disorders","volume":"103","author":"Walker","year":"2008","journal-title":"Am. J. Gastroenterol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1097\/PSY.0000000000001046","article-title":"The Prevalence and Incidence of Irritable Bowel Syndrome and Inflammatory Bowel Disease in Depression and Bipolar Disorder: A Systematic Review and Meta-Analysis","volume":"84","author":"Nikolova","year":"2022","journal-title":"Psychosom. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.jad.2019.01.014","article-title":"Inflammatory bowel disease and bipolar disorder: A population-based cross-sectional study","volume":"247","author":"Kao","year":"2019","journal-title":"J. Affect. Disord."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1093\/ibd\/izy235","article-title":"Increased Burden of Psychiatric Disorders in Inflammatory Bowel Disease","volume":"25","author":"Bernstein","year":"2019","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1038\/nrneurol.2014.181","article-title":"Classifying neurocognitive disorders: The DSM-5 approach","volume":"10","author":"Sachdev","year":"2014","journal-title":"Nat. Rev. Neurol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.psym.2020.10.002","article-title":"Cognitive Impairment in Adult Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis","volume":"62","author":"Hopkins","year":"2021","journal-title":"J. Acad. Consult. Liaison Psychiatry"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e406","DOI":"10.1212\/WNL.0000000000006854","article-title":"Comorbid anxiety, depression, and cognition in MS and other immune-mediated disorders","volume":"92","author":"Whitehouse","year":"2019","journal-title":"Neurology"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1097\/MIB.0000000000000594","article-title":"Cognitive Function of Patients with Crohn\u2019s Disease is Associated with Intestinal Disease Activity","volume":"22","author":"Golan","year":"2016","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"110610","DOI":"10.1016\/j.pnpbp.2022.110610","article-title":"Inflammatory bowel disease: A potential pathogenic factor of Alzheimer\u2019s disease","volume":"119","author":"Wang","year":"2022","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1136\/gutjnl-2020-320789","article-title":"Inflammatory bowel disease is associated with higher dementia risk: A nationwide longitudinal study","volume":"70","author":"Zhang","year":"2021","journal-title":"Gut"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"962681","DOI":"10.3389\/fnagi.2022.962681","article-title":"Inflammatory bowel disease and risk of dementia: An updated meta-analysis","volume":"4","author":"Liu","year":"2022","journal-title":"Front. Aging Neurosci."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e568","DOI":"10.1212\/WNL.0000000000201489","article-title":"Inflammatory Diseases, Inflammatory Biomarkers, and Alzheimer Disease: An Observational Analysis and Mendelian Randomization","volume":"100","author":"Huang","year":"2023","journal-title":"Neurology"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1111\/apt.16856","article-title":"Schizophrenia and risk of new-onset inflammatory bowel disease: A nationwide longitudinal study","volume":"55","author":"Sung","year":"2022","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1038\/s41537-022-00244-w","article-title":"Estimation of the bidirectional relationship between schizophrenia and inflammatory bowel disease using the mendelian randomization approach","volume":"8","author":"Qian","year":"2022","journal-title":"Schizophrenia"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1002\/npr2.12227","article-title":"Gut permeability and its clinical relevance in schizophrenia","volume":"42","author":"Ishida","year":"2022","journal-title":"Neuropsychopharmacol. Rep."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1177\/09727531221108849","article-title":"Altered Intestinal Permeability Biomarkers in Schizophrenia: A Possible Link with Subclinical Inflammation","volume":"29","author":"Gokulakrishnan","year":"2022","journal-title":"Ann. Neurosci."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"7056","DOI":"10.1007\/s12035-019-1578-2","article-title":"Upregulation of the Intestinal Paracellular Pathway with Breakdown of Tight and Adherens Junctions in Deficit Schizophrenia","volume":"56","author":"Maes","year":"2019","journal-title":"Mol. Neurobiol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1007\/s00406-020-01152-9","article-title":"Serum zonulin and claudin-5 levels in patients with schizophrenia","volume":"271","author":"Usta","year":"2021","journal-title":"Eur. Arch. Psychiatry Clin. Neurosci."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1038\/ajg.2009.685","article-title":"Factors associated with non-adherence to oral medication for inflammatory bowel disease: A systematic review","volume":"105","author":"Jackson","year":"2010","journal-title":"Am. J. Gastroenterol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1097\/00004836-200101000-00015","article-title":"Psychiatric predictors of noncompliance in inflammatory bowel disease: Psychiatry and compliance","volume":"32","author":"Nigro","year":"2001","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1016\/j.cgh.2020.07.013","article-title":"Anxiety and Depression Leads to Anti-Tumor Necrosis Factor Discontinuation in Inflammatory Bowel Disease","volume":"19","author":"Dolovich","year":"2021","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"3563","DOI":"10.1007\/s10620-017-4800-y","article-title":"Depressive Symptoms Predict Anti-tumor Necrosis Factor Therapy Noncompliance in Patients with Inflammatory Bowel Disease","volume":"62","author":"Calloway","year":"2017","journal-title":"Dig. Dis. Sci."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1111\/j.1365-2036.2009.03941.x","article-title":"Predictors of persistence with 5-aminosalicylic acid therapy for ulcerative colitis","volume":"29","author":"Kane","year":"2009","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1046\/j.1365-2036.2003.01648.x","article-title":"Studies of compliance with delayed-release mesalazine therapy in patients with inflammatory bowel disease","volume":"18","author":"Shale","year":"2003","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1111\/apt.12476","article-title":"Factors associated with thiopurine non-adherence in patients with inflammatory bowel disease","volume":"38","author":"Goodhand","year":"2013","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1097\/MIB.0000000000001194","article-title":"Inflammatory Bowel Disease Pharmacist Adherence Counseling Improves Medication Adherence in Crohn\u2019s Disease and Ulcerative Colitis","volume":"23","author":"Tiao","year":"2017","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Timmer, A., Preiss, J.C., Motschall, E., R\u00fccker, G., Jantschek, G., and Moser, G. (2011). Psychological interventions for treatment of inflammatory bowel disease. Cochrane Database Syst. Rev.","DOI":"10.1002\/14651858.CD006913.pub2"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1093\/ibd\/izz073","article-title":"Effect of Cognitive Behavioral Therapy on Clinical Disease Course in Adolescents and Young Adults With Inflammatory Bowel Disease and Subclinical Anxiety and\/or Depression: Results of a Randomized Trial","volume":"25","author":"Stapersma","year":"2019","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1097\/MEG.0b013e32834d09f1","article-title":"Evaluation of a group-based behavioral intervention to promote adherence in adolescents with inflammatory bowel disease","volume":"24","author":"Hommel","year":"2012","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/S2468-1253(16)30206-0","article-title":"Effect of psychological therapy on disease activity, psychological comorbidity, and quality of life in inflammatory bowel disease: A systematic review and meta-analysis","volume":"2","author":"Gracie","year":"2017","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.2174\/1389450115666140828104426","article-title":"Psychological perspectives of inflammatory bowel disease patients undergoing surgery: Rightful concerns and preconceptions","volume":"15","author":"Spinelli","year":"2014","journal-title":"Curr. Drug Targets"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1177\/1049732320972338","article-title":"Access to Psychological Support for Young People Following Stoma Surgery: Exploring Patients\u2019 and Clinicians\u2019 Perspectives","volume":"31","author":"Polidano","year":"2021","journal-title":"Qual. Health Res."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.cgh.2020.01.030","article-title":"Integrated Psychological Care Reduces Health Care Costs at a Hospital-Based Inflammatory Bowel Disease Service","volume":"19","author":"Lores","year":"2021","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1159\/000356316","article-title":"A randomized controlled trial of mindfulness-based stress reduction to prevent flare-up in patients with inactive ulcerative colitis","volume":"89","author":"Jedel","year":"2014","journal-title":"Digestion"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1097\/MIB.0000000000000629","article-title":"A Controlled Study of a Group Mindfulness Intervention for Individuals Living with Inflammatory Bowel Disease","volume":"22","author":"Neilson","year":"2016","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1002\/ibd.21575","article-title":"INSPIRE study: Does stress management improve the course of inflammatory bowel disease and disease-specific quality of life in distressed patients with ulcerative colitis or Crohn\u2019s disease? A randomized controlled trial","volume":"17","author":"Boye","year":"2011","journal-title":"Inflamm. Bowel Dis."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/4\/682\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:06:46Z","timestamp":1760123206000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/4\/682"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,30]]},"references-count":82,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["medicina59040682"],"URL":"https:\/\/doi.org\/10.3390\/medicina59040682","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,30]]}}}