Table 8.

European crohn’s colitis organization guideline statements and recommendations on psychosocial issues in Crohn’s disease[24]

1 Psychological disturbances seem to be a consequence of the illness rather than the cause or specific to Crohn’s disease (EL1). The degree of psychological distress correlates with the disease severity (EL2)

2 An association between psychological factors and the aetiology of Crohn’s disease is unproven (EL3), but there is a moderate influence on the course of the disease (EL1)

3 Depression and perceived chronic distress seem to represent further risk factors for relapse of the disease (EL1). It remains unclear whether acute life events trigger relapses (EL1). Most patients consider stress to have an influence on their illness (EL2)

4 Physicians should assess the patient’s psychosocial status and request additional psychological care and psychotherapy if indicated. Integrated psychosomatic care should be provided in IBD centres (EL2)

5 Patients should be informed of the existence of patient associations (EL5)

6 The psychosocial consequences and health related quality of life of patients should be taken into account in clinical practice at regular visits (EL1)

7 Psychotherapeutic interventions are indicated for psychological disorders, such as depression, anxiety, reduced quality of life with psychological distress, as well as maladaptive coping with the illness (EL1)

8 The choice of psychotherapeutic method depends on the psychological disturbance and should best be made by specialists (psychotherapist, specialist in psychosomatic medicine, psychiatrist). Psycho-pharmaceuticals should be prescribed for defined indications (EL5)

EL: Evidence level; IBD: Inflammatory bowel diseases.