"It doesn\u27t do any harm, but patients feel better": a qualitative exploratory study on gastroenterologists\u27 perspectives on the role of antidepressants in inflammatory bowel disease

Background: Interest in psychological factors in patients with inflammatory bowel disease (IBD)has increased in recent years. It has even been proposed that treating psychological co-morbiditieswith antidepressants may control disease activity and improve quality of life. Despite this, there isno data on gastroenterologists\u27 attitudes to, and experiences with, antidepressant therapy inpatients with IBD.Methods: We conducted semi-structured interviews with 18 gastroenterologists associated withmetropolitan teaching hospitals. Qualitative content analysis was used to examine their responses.Results: Seventy-eight percent of gastroenterologists had treated IBD patients withantidepressants for pain, depression and/or anxiety, and insomnia. Antidepressants were reportedto be useful in improving psychosocial well-being, quality of life, and self-management of the diseaseby patients. However, in this group of gastroenterologists, there appears to be skepticism towardspsychological disorders themselves or antidepressant therapy having a central role in either thecausation of IBD or its clinical course. Nevertheless, these gastroenterologists were receptive tothe idea of conducting a trial of the role of antidepressants in IBD.Conclusion: While the majority of specialists have treated IBD patients with antidepressants,there is considerable skepticism with regard to efficacy of antidepressive therapy or the role ofpsychological factors in the outcome of IBD patients