A eficácia do tratamento psicofarmacológico e psicoterapia nas Doenças Inflamatórias Intestinais

Abstract

Objectives: The aim of this revision article is to re-examine what we currently know about the efficacy of psychological therapies and psychotropic drugs in inflammatory bowel diseases(IBD), with particular emphasis on disease activity and psychological well-being. Methods: A literature review was performed using MEDLINE with the following keywords: "Psychotropic Drugs" , "Psychotherapy" and "Inflammatory Bowel Diseases". Results: Psychotherapy as an intervention for pain, fatigue, co-op mechanisms, medication adherence and reduction of healthcare utilization has shown early promise. For other variables such as anxiety, depression, quality of life, disease symptoms and disease course, results are mixed and differ from the type of psychotherapy applied. Moreover, the patients involved in psychotherapies report, in their own view, describe positive changes in their psychological state, their behavior and their ability to cope with their disease. The therapists had similar clinical feedback as well. Psychotropic drugs seem to decrease clinical IBD relapses, steroid treatment, endoscopies while improving both mental and somatic status of patients All in all, psychiatric interventions have tendency towards fewer surgical interventions, fewer relapses and reduction of psychological comorbidities was noted. Discussion/Conclusion: There isn't still a general consensus about the effectiveness of psychiatric interventions in IBD. It is currently not known the exact mechanisms of how or why psychopharmacologic and psychotherapies work and how to optimize them so that they render more robust outcomes. Nevertheless, these results indicate the possibility of an effect that needs experimental verification and given the high desire for and positive experiences of psychologic care and psychotropic drugs. Psychiatric interventions, supported by validated scientific evidence, will surely play an important role in the treatment of IBD.