Table 6.

German guideline guideline statements and recommendations on psychosocial issues in the management of ulcerative colitis[20]

1 Adverse life events, psychological stress and mental health disorders are not aetiologically linked to the onset of UC (EL2)

2 Subjective stress and affective disorders may have a negative impact on the course of UC

3 High disease activity is associated with high psychological symptom burden EL2)

4 Mental health disorders have a negative impact on the course of the disease and quality of life EL2)

5 Patients with persistent abdominal pain or diarrhea which cannot be explained by disease activity or complications of the disease should be assessed for irritable bowel syndrome (IBS) or depressive disorder. If IBS or depressive disorder is diagnosed, these disorders should be treated according to guideline recommendations (EL2)

6 Psychosocial co-morbidities and health- related quality of life (accounting for gender differences) should be taken into account in clinical practice at regular visits (EL2)

7 Care should involve cooperations with specialists in psychotherapy or psychosomatic medicine (EL2)

8 Physicians should inform patients about IBD self-help organisations (EL5)

9 In the case of a mental health disorder, psychotherapy is recommended (EL2)

10 Psychosocial support should be offered to children and adolescents (EL1)

UC: Ulcerative colitis; EL: Evidence level.