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Depressive and Anxiety Disorders in Patients with Inflammatory Bowel Diseases: Are There Any Gender Differences?

Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
Division of Gastroenterology and Endoscopy, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2023, 20(13), 6255;
Submission received: 29 April 2023 / Revised: 11 June 2023 / Accepted: 25 June 2023 / Published: 29 June 2023
(This article belongs to the Special Issue Well-Being and Mental Health among Women)


Gender differences were identified in the frequency and clinical presentations of inflammatory bowel disease (IBD) and depressive and anxiety disorders, which are more common in IBD patients than in the general population. The present manuscript provides a critical overview of gender differences in the frequency and clinical course of mood and anxiety disorders in IBD patients, with the aim of helping clinicians provide individualized management for patients. All of the included studies found that IBD patients reported a higher frequency of depressive and anxiety disorders than the general population. These findings should encourage healthcare providers to employ validated tools to monitor the mental health of their IBD patients, such as the Patient Health Questionnaire (PHQ-9). In addition, most studies confirm that women with IBD are more likely than men to develop affective disorders and show that up to 65% of women with IBD have depressive and anxiety disorders. Women with IBD require close mental health monitoring and ultimately a multidisciplinary approach involving mental health professionals. Drug treatment in women should be individualized and medications that may affect mental health (e.g., corticosteroids) should be thoroughly reconsidered. Further data are needed to ensure individualized treatment for IBD patients in a framework of precision medicine.

1. Introduction

Inflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are chronic inflammatory conditions characterized by intestinal and extra-intestinal symptoms (e.g., arthritis) associated with poor quality of life, especially during acute exacerbations [1,2]. The course of IBD can be complicated by comorbidities such as immune-mediated illnesses including dermatological, ocular, and articular disease, or conditions characterized by inflammatory dysregulation such as metabolic syndrome or mental disorders [3,4].
Mental conditions, with a predominance of depression and anxiety disorders, are common in patients with IBD. Recent articles have reported a higher risk of IBD in patients with schizophrenia [5] and bipolar disorder [6]. The prevalence of depressive disorders in IBD patients varies from 21% to 25%, while anxiety disorders are seen in 19.1% to 35% of patients with IBD [7]. Compared with the general population, IBD patients are twice as likely to have an affective disorder [8]. In addition, the link between IBD and mental disorders seems to be bidirectional: flares of gastrointestinal disease are associated with an increased risk of anxiety and depression, while conversely, patients with mood disorders seem to be at a higher risk of developing IBD [9,10,11,12].
Different mechanisms, including biological and psychosocial factors, have been suggested to explain the vulnerability of IBD patients to affective disorders [13]. IBD and affective disorders share inflammatory dysregulation [14,15]. Depressive disorders, in particular, are exacerbated by cell-mediated immunity alterations similarly to CD [16,17], which would explain the higher prevalence of mood disorders in CD than in UC [18]. In addition, the role of the gut−brain axis is increasingly recognized in the pathogenesis of both the conditions and an alteration of the microbiome is supposed to be associated with an increased risk of mental disorders [19]. On the other hand, the chronic course of IBD, the related stigma and social burden may favor the development of depressive and anxiety symptoms [20].
The gender differences in the prevalence and clinical presentations of both IBD and affective disorders are explained by the different regulation and action of sex hormones and neuropeptides in males and females [21,22,23]. In relation to IBD, females have a higher risk of CD in early adulthood and old age than males, while the opposite occurs for UC [24]. Regarding mental health, women are two to three times more likely to have major depression and anxiety disorders than men [25,26]. In addition, women with major depression are more vulnerable to metabolic abnormalities [25], while IBD symptoms worsen during the menstrual cycle, independently of disease activity [27]. In light of these data, clinicians should consider gender when managing patients with IBD and psychiatric comorbidities [28].
The aim of this article is to offer an overview of gender differences in the frequency and presentation of affective disorders in IBD patients in order to help clinicians provide more individualized treatment in the context of precision medicine.

2. Materials and Methods

A search was performed in PubMed (National Library of Medicine) to identify relevant papers. All original articles written in English from 1 January 2013 to 31 December 2022 that had abstracts and full texts were included. Two authors subsequently checked and extracted the following data from the included articles: authors and title, year of publication, characteristics of the study (country and sample size), and information relevant to this overview. The search was performed using the following keywords: “Inflammatory Bowel Disease”, “CD”, “UC”, “mental disorders”, “depression”, and “anxiety”.
Inclusion criteria were (1) original articles, (2) mean age of patients ≥ 18 years, (3) presence of information on anxiety and depression in IBD patients, and (4) the article focused on gender differences in affective disorders in patients with IBD.
Exclusion criteria were (1) reviews, meta-analyses, commentaries, letters, case reports, pooled analyses, comments, case studies, and study protocols; (2) mean age of patients < 18 years; (3) studies conducted on animals; (4) studies on psychiatric conditions other than anxiety or depressive disorders; (5) studies not examining the present topic; and (6) articles not written in English.

3. Results

3.1. Characteristics of the Included Studies

Most of the included studies had a retrospective design [29,30,31,32,33,34], three were cross-sectional [35,36,37], and three were prospective [38,39,40].
The sample sizes and the type of patient (e.g., inpatients or in clinical remission) varied greatly across studies. Tarar et al. [32] investigated the largest sample of IBD patients (nearly 1 million subjects).
The methods used to assess anxiety and depressive disorders differed across the studies; most used the HADS [35,37,38,39,40] or the ICD criteria [29,30,31,32,33,34], only Al-Aamri et al. assessed depression using PHQ-9 [36].

3.2. General Considerations

More than 1000 articles were identified by the initial search, of which 12 met all of the criteria and were included. These articles showed that the prevalence of depressive disorders in IBD patients (without stratification by gender or type of IBD) ranged from 13–14% [29] to 50% [35], while the prevalence of anxiety disorders ranged from 11% [30] to 42% [38]. With the exception of two studies [31,39], all included articles reported a significantly higher frequency of depressive or anxiety disorders in females versus males.
A summary of the results of the main findings of the included studies are reported in Table A1 (Appendix A).

3.3. Gender Distribution of Affective Disorder in IBD Patients

3.3.1. Depressive Disorders

The following methods were used to assess the presence of depressive disorders: diagnostic criteria from the International Classification of Diseases (ICD) or cut-off scores of rating scales such as the Patient Health Questionnaire (PHQ-9) [41] or the Hospital Anxiety and Depression Scale (HADS) [42].
A recent cross-sectional study [36] reported that 22.3% of their total sample had moderate to severe depression, corresponding to a PHQ-9 score ≥ 12. In addition, the frequency of clinically significant depressive symptoms in females was twice that in males. Similar results were reported by a European study by Sciberras et al. in IBD patients in clinical remission [38]. In contrast, a retrospective study conducted in the USA by Ali et al. found lower rates of depressive disorders in hospitalized patients (13.4% for UC and 14.9% for CD), but this was assessed using the ICD criteria for depressive disorders. The authors confirmed the higher risk of depression in women than in men [29]. Another American study by Tarar et al. reported similar rates of depressive disorders in patients hospitalized for IBD, using ICD criteria, and confirmed the higher vulnerability to depression in females than in males [32]. These results confirm the findings of two previous American studies of IBD patients without a previous psychiatric diagnosis [30,33]; the study by Ananthakrishnan et al. examined the risk of depressive disorders following bowel resection surgery. Finally, female gender and perianal surgery were identified as factors correlated with the presence of depressive disorders in an Italian study by Maconi et al. [40].
Four studies from Turkey, Canada, Switzerland, and Taiwan [31,35,37,39] did not find significant differences in the risk of developing depressive disorders between females and males.

3.3.2. Anxiety Disorders

A recent retrospective study from the USA reported a high prevalence (12.0%) of generalized anxiety disorder (GAD) in IBD inpatients, with females having a higher risk than males [34]. Similar results were found by a recent American study on anxiety disorders [32]. Sciberras et al. [38] reported even higher rates of anxiety disorders in European patients in clinical remission (41.8%), with women having approximately twice the risk as the men. Although they used the same HADS scale as Sciberras et al. for the detection of anxiety disorders, three other studies found lower frequencies of anxiety in IBD patients, but confirmed the higher rates in women compared with men [35,37,40]. In an American study, female patients who had undergone bowel resection surgery had a higher risk of anxiety disorders compared with men [30].
Regarding depressive disorders, the Canadian study by Narula et al. [39] failed to find any gender difference in the risk of developing anxiety disorders in IBD patients.

4. Discussion

The findings of the included studies confirm that depressive and anxiety disorders are more prevalent in IBD patients than in the general population [26], so these represent subjects who are vulnerable to suffer from psychiatric conditions. Of note, comparable to the situation in the general population [26], women with IBD seem to have an higher risk of having depressive or anxiety disorders than men. In this regard, a recent meta-analysis by Barberio et al. reported a pooled prevalence of 33.8% for anxiety symptoms in females and 22.8% in males, with an odds ratio (OR) of 1.7 [95% confidence interval (CI) 1.2–2.3]. Similarly, for depressive symptoms, the pooled prevalence was 21.2% in females and 16.2% in males, with an OR of 1.3 [95% CI 1.0–1.8] [21]. These observations were similar in patients with other inflammatory conditions such as atopic dermatitis, rheumatoid arthritis, cardiovascular diseases, and diabetes [43,44,45,46].
This means that, independently of the susceptibility to affective disorders conferred by IBD, gender-related factors increase vulnerability to mood and anxiety disorders in females compared with males [25].
The findings of the included studies in this review demonstrate a remarkably high rate of depressive disorders in women with IBD (about 65%) [29,32,33,36]. The study with the largest sample reported the greatest prevalence of depressive disorders in female inpatients (68%) [32]. Similar data were reported for anxiety disorders [32,34]. Taken as a whole, the different authors agree that patients with IBD have a higher probability to develop affective disorders compared with the general population and that female gender represents a risk factor. The differences in the findings of the studies (especially in relation to the frequency of depressive/anxiety disorders) may depend on several factors such as the severity of IBD (e.g., inpatients versus outpatients) [47], the type of IBD (CD versus UC), the method used to diagnose depressive and anxiety disorders, the type of drug treatment (e.g., corticosteroids) [48], and cultural/psychosocial aspects affecting access to mental health support and thus the possibility of an early diagnosis [49]. As also found by Neuendorf et al. [18], the studies included in this overview reported a higher frequency of affective disorders in patients with CD than with UC [29,30]. Regarding the methods used for assessment, the PHQ-9 is a questionnaire characterized by high sensitivity in identifying depressive symptoms and is frequently used in general medical populations (especially in primary care settings) due to its versatility and the quick completion time for patients [50]. On the other hand, HADS was originally designed to assess depressive and anxiety symptoms in hospitalized patients [42]. It is important to underline that both instruments are used to evaluate the severity of psychiatric symptoms and that cut-off scores are used to indicate the probability of a formal psychiatric diagnosis [51]. PHQ-9 was administered only in one study [36] that used a very strict cut-off score (≥12) for the detection of depressive disorders (a score ≥ 10 is generally advised to discriminate the absence or presence of depressive disorders). The study that included subjects with overlapping clinical characteristics (outpatients) and used HADS [38] reported similar frequencies of clinically significant depressive symptoms (22.3% versus 24.5%).
There are different hypotheses regarding the gender differences in the prevalence of affective disorders in IBD patients [52,53]. An area of growing interest is the gut–brain axis, which may be involved in the pathogenesis of anxiety and depressive disorders in IBD [54]. A recent systematic review highlighted how different levels of sex hormones (testosterone and oestradiol) can affect the diversity and composition of the microbiome, thus explaining the gender differences in the frequency of affective disorders in IBD patients [55]. Of note, recent findings highlight that women and men have a different microbiome composition, thus the eventual complementary administration of probiotics for the treatment of both IBD and affective disorders could be individualized according to the patient’s sex [56].
In addition, in the intestinal epithelium, especially in the colon, oestrogen receptor (ER) β plays an important role in the integrity of tight junctions and the barrier function [57]. Of note, some authors reported a significant reduction in ERβ expression in active IBD [57]. A study by Ma et al. [58] demonstrated that ERβ knockout mice developed both colitis and anxiety-like behaviors after the administration of dextran sodium sulfate (an agent that induces acute colitis). Anxiety and depressive disorders may also be exacerbated by impaired regulation of the hypothalamic–pituitary–adrenal (HPA) axis by gonadal hormones including oestrogens [59]. Oestradiol is protective against psychiatric disorders because it strengthens the response of the HPA axis to stressors [60], inhibits cell-mediated immunity associated with depressive disorders [61,62], and exerts antidepressant effects by blocking N-methyl-D-aspartate (NMDA) glutamatergic receptors in the central nervous system [63]. These factors explain the greater predisposition of women to affective disorders compared with men, in particular during specific phases of life such as the post-partum period [64] or menopause [65]. Similarly, women may experience exacerbation of IBD during menstruation [27]. There is a complex interaction between gonadal hormones, affective disorders, gut microbiota, and IBD [66], and it is no coincidence, for example, that CD is associated with depressive disorders, and is more frequent in women than in men in old age [24].
In addition to molecular mechanisms, a number of psychosocial and clinical factors may also explain gender differences in vulnerability to affective disorders among IBD patients. Different authors have reported that women with IBD generally have a worse perception of their quality of life compared with men [67]. This is explained by the fact that nearly half of women experience vulvovaginal discomfort and related sexual dysfunction during IBD flares [68,69], and these symptoms may be particularly severe during menopause [70]. Of note, sexual dysfunction was identified as a predictor of depressive symptoms in IBD patients [71]. In addition, women might experience more distress because many can actively avoid pregnancy for fear of the adverse effects on the fetus related to disease activity and treatments [72]. Finally, compared with male patients, female subjects report more concerns about their body image and function [73,74], which can trigger depressive disorders [75].
Gender stereotypes may also contribute to the gender differences seen in the frequency of affective disorders [76]. Women are more likely than men to utilize mental healthcare services [77,78] and clinicians might be more likely to investigate depressive and anxiety disorders in women than in men [79]. Finally, preliminary data indicate that female healthcare professionals have a more positive attitude towards patients with mental health conditions than male healthcare professionals [80].
Finally, it is interesting to highlight that also in pediatric patients affected by IBD, the prevalence of affective disorders is higher compared with the healthy population [81,82] although there are less data than for the adult population. A study by Glapa-Nowak et al. showed that females reported more anxiety symptoms and pain compared with males during disease flares [82]. This aspect, again, could be due to psychosocial aspects or to biological factors such as a different exposition of brain to male hormones during pregnancy according to the sex of the fetus [83].
In conclusion, women with IBD are more likely than men to have an affective disorder and may require specific management involving different healthcare professionals. Future research is needed to confirm these findings as the included studies had the following limitations: (1) they used different tools to assess depressive and anxiety disorders; (2) included patients had different severities of illness or different diagnoses (CD or UC); (3) the study designs differed; (4) there is not a clear distinction between sex and gender; and (5) the studies were conducted in countries with different healthcare systems and cultural attitudes that may influence the diagnosis of affective disorders [84].

5. Conclusions and Future Directions

The findings reported in the present manuscript support that gender can have implications for the management of IBD. Of note, women with IBD are more likely to develop affective disorders than men. This implies that female patients may need to be treated with different drugs and require specific monitoring and a targeted multidisciplinary approach. Individualized treatment for women is even more important as the presence of affective disorders is associated with a poorer prognosis in IBD [34] and quality of life [38]. Healthcare professionals should regularly assess the mental health of their patients, both during visits and remotely [85], in light of the availability of easily used tools and the detrimental effects of poor psychological wellbeing on the course of illness [86]. A biopsychosocial, multidisciplinary, and individualized approach should thus be promoted to improve prognosis [87]. This is particularly important for inflammatory diseases that share pathogenetic aspects with affective disorders and whose prognosis is strongly influenced by the presence of psychiatric disorders [88]. This is also demonstrated by preliminary data which indicate that the new biologic disease-modifying anti-inflammatory drugs not only influence the course of inflammatory diseases, but improve the psychological wellbeing of patients [89].

Author Contributions

Conceptualization, writing, review, and editing, E.F., A.C. and M.B., data acquisition, E.F.; review, editing, and supervision, M.V. All authors have read and agreed to the published version of the manuscript.


This study was partially funded by the Italian Ministry of Health—current research IRCCS.

Data Availability Statement

The datasets generated during and analyzed during the current study are not publicly available; however, they are available from the corresponding author upon reasonable request.


Flavio Caprioli contributed to the revision of the final version of the manuscript thanks to his experience in the field of IBD. Gay O’Casey is an English native speaker and revised the manuscript for language and style.

Conflicts of Interest

E.F. has no conflict of interest. A.C. served as an advisory board member and/or received lecture grants from Takeda, Janssen, Bromatech, Mayloy-Spindler, Alfasigma, Aurora, and Simbios. M.V. served as consultant to Abbvie, MSD, Takeda, Janssen-Cilag, and Celgene; he received lecturer fees from Abbvie, Ferring, Takeda, MSD, Janssen-Cilag, and Zambon. M.B. served as an advisory board member and/or received lecture grants from Lundbeck, Roche.

Appendix A

Table A1. Summary of the results on gender differences in affective disorders in patients with inflammatory bowel disease.
Table A1. Summary of the results on gender differences in affective disorders in patients with inflammatory bowel disease.
StudyCountrySample Size (UC/CD)Definition of Anxiety/Depressive DisordersPrevalence of Affective Disorders in the Total Sample and/or According to IBD DiagnosisMain Results
Al-Aamri et al., 2022 [36]Oman211 OutpatientsDepressive disorders: PHQ-9 ≥ 12Depressive disorders: 22.3%F have twice the risk of having clinically significant depressive symptoms than M
Ali et al., 2022 [29]USA130,799 UC
141,799 CD
(from 2016 to 2019 in the NIS database)
Depressive disorders:
Depressive disorders:
UC: 13.4%
CD: 14.9%
Depressive Disorders
F: 24% increased risk
(p < 0.001)
M: 12% reduced risk
(p < 0.001)
F: 30% increased risk
(p < 0.001)
M: 35% reduced risk
(p < 0.001)
Kaye et al., 2022 [34]USA28,173 InpatientsGAD:
Anxiety disorders (GAD): 12.0%In models adjusted for gender, GAD was associated with unfavourable outcomes including sepsis, acute hepatic and respiratory failure, inpatient mortality, intestinal abscess and perforation
Sciberras et al., 2022 [38]Greece, Italy, Malta, Portugal and Israel585 Patients in clinical remissionClinically significant anxiety and depressive symptoms: HADS ≥ 8Anxiety disorders:
Depressive disorders:
A formal diagnosis of
anxiety or depression was more frequent in CD (27.5%, p < 0.05) than in UC
F compared with M:
HADS-A ≥ 8, OR 1.89 (95% CI 1.17–3.08)
HADS-D ≥ 8, OR 2.18 (95% CI 1.07–4.43)
HADS-A or HADS-D ≥ 8, OR 1.7 (95% CI 1.1–2.8)
Unemployed patients were more likely to have a HADS-A or a HADS-D score ≥ 8
(p < 0.01)
Patients with depressive or anxiety symptoms were more
likely to be sedentary (p < 0.05)
Tarar et al., 2022 [32]USA963,619 Inpatients
(from 2016 to 2018 in the NIS database)
Anxiety and depressive disorders:
Anxiety disorders: 20.9%
Depressive disorders:
Anxiety disorders were significantly more prevalent in patients with CD (AOR 1.56, 95% CI 1.53–1.58) compared with UC (AOR 1.23, 95% CI 1.20–1.26)
Female gender was significantly associated with a higher risk of having depression and anxiety (AOR 1.50, 95% CI 1.49–1.51; AOR 1.46, 95% CI 1.45–1.47, respectively; p < 0.001)
Zhang et al., 2022 [31]Taiwan422 IBD patients (175 with UC and 247 with CD), 537 unaffected siblings, and 2148 controlsDepressive disorders:
Depressive disorders
(during 11 year follow-up period):
Gender did not affect the risk of depressive disorders in IBD patients (HR 0.86, 95% CI 0.62–1.19)
M with depressive disorders were at higher risk of IBD (HR 1.76; 95% CI 1.16–2.68), but not F
Female unaffected siblings (but not male ones) demonstrated increased risk for depression (HR 1.87, 95% CI 1.02–3.40)
Ateş Bulut et al., 2019 [35]Turkey122 IBD patients (64 with UC and 58 with CD) and 42 healthy controlsDepressive disorders: HADS-D > 7
Anxiety disorders: HADS-A > 10
Depressive disorders:
UC: 52%
CD: 47%
Anxiety disorders:
UC: 19%
CD: 38%
The mean depression scores were similar between F and M (p > 0.05)
Anxiety scores were higher in F than in M (p < 0.05)
Narula et al., 2019 [39]Canada414 IBD patients (187 with UC and 227 with CD)Anxiety or depressive disorders:
HADS anxiety or depression sub-score ≥ 11
Anxiety or depressive disorders:
No significant differences in the frequency of affective disorders between genders (p = 0.17)
Pittet et al., 2017 [37]Switzerland1102 IBD patients (596 with CD, 475 with UC, and 31 with IBDU)Anxiety disorders: HADS-A
Depressive disorders: HADS-D
Anxiety disorders:
Depressive disorders:
F reported more anxiety disorders than M (34.2% vs. 21.8%, p < 0.001)
Severe anxiety was significantly associated with concerns about stigmatization, constraints, impact of symptoms on body and mind, loss of body control (p < 0.05)
Maconi et al., 2014 [40]Italy195 CD patientsDepressive or anxiety disorders:
HADS anxiety or depression sub-score ≥ 8
Depressive or anxiety disorders:
Anxiety and/or depressive disorders were correlated with female gender (p = 0.017), perianal disease (p = 0.003), and perianal surgery (p = 0.042)
Panara et al., 2014 [33]USA393 IBD patients (121 with UC and 272 with CD)Depressive disorders: ICD-9 CMDepressive disorders: 20.1%Female gender was identified as an independent factor associated with the development of depression (HR 1.3, 95% CI 1.1–1.7)
Depression was more frequently treated with pharmacotherapy in F than in M (p < 0.01)
Ananthakrishnan et al., 2013 [30]USA707 CD and 530 UC patients who underwent bowel resection surgeryDepressive disorders: ICD-9 CM
Anxiety disorders: ICD-9 CM
(5 years after surgery)
Depressive disorders:
CD: 16%
UC: 11%
Anxiety disorders:
CD: 14%
UC: 11%
Female gender was associated with an increased risk of depression (AOR 1.77, 95% CI 1.16–2.71) and anxiety (AOR 2.07, 95% CI 1.35–3.19)
AOR: adjusted odds ratio; CD: Crohn’s disease; CI: confidence interval; F: females; GAD: generalized anxiety disorder; HADS-A/D: Hospital Anxiety and Depression Scale-Anxiety/Depression; HR: hazard ratio; IBD: inflammatory bowel disease; IBDU: inflammatory bowel disease undetermined; ICD-9 CM: International Classification of Diseases, 9th Revision, Clinical Modification; ICD-10 CM: International Classification of Diseases, 10th Revision, Clinical Modification; M: males; NIS: National Inpatient Sample; OR: odds ratio; PHQ-9: Patient Health Questionnaire-9; UC: ulcerative colitis.


  1. Bryant, R.V.; Van Langenberg, D.R.; Holtmann, G.J.; Andrews, J.M. Functional Gastrointestinal Disorders in Inflammatory Bowel Disease: Impact on Quality of Life and Psychological Status: Functional Gastrointestinal Disorders in IBD. J. Gastroenterol. Hepatol. 2011, 26, 916–923. [Google Scholar] [CrossRef] [PubMed]
  2. Van Gennep, S.; De Boer, N.K.H.; Gielen, M.E.; Rietdijk, S.T.; Gecse, K.B.; Ponsioen, C.Y.; Duijvestein, M.; D’Haens, G.R.; Löwenberg, M.; De Boer, A.G.E.M. Impaired Quality of Working Life in Inflammatory Bowel Disease Patients. Dig. Dis. Sci. 2021, 66, 2916–2924. [Google Scholar] [CrossRef] [PubMed]
  3. Argollo, M.; Gilardi, D.; Peyrin-Biroulet, C.; Chabot, J.-F.; Peyrin-Biroulet, L.; Danese, S. Comorbidities in Inflammatory Bowel Disease: A Call for Action. Lancet Gastroenterol. Hepatol. 2019, 4, 643–654. [Google Scholar] [CrossRef] [PubMed]
  4. Cambria, C.; Ingegnoli, F.; Borzi, E.; Cantone, L.; Coletto, L.A.; Rizzuto, A.S.; De Lucia, O.; Briguglio, S.; Ruscica, M.; Caporali, R.; et al. Synovial Fluid-Derived Extracellular Vesicles of Patients with Arthritides Contribute to Hippocampal Synaptic Dysfunctions and Increase with Mood Disorders Severity in Humans. Cells 2022, 11, 2276. [Google Scholar] [CrossRef]
  5. Sung, K.; Zhang, B.; Wang, H.E.; Bai, Y.; Tsai, S.; Su, T.; Chen, T.; Hou, M.; Lu, C.; Wang, Y.; et al. Schizophrenia and Risk of New-onset Inflammatory Bowel Disease: A Nationwide Longitudinal Study. Aliment. Pharmacol. Ther. 2022, 55, 1192–1201. [Google Scholar] [CrossRef] [PubMed]
  6. Kao, L.-T.; Lin, H.-C.; Lee, H.-C. Inflammatory Bowel Disease and Bipolar Disorder: A Population-Based Cross-Sectional Study. J. Affect. Disord. 2019, 247, 120–124. [Google Scholar] [CrossRef]
  7. Bisgaard, T.H.; Allin, K.H.; Keefer, L.; Ananthakrishnan, A.N.; Jess, T. Depression and Anxiety in Inflammatory Bowel Disease: Epidemiology, Mechanisms and Treatment. Nat. Rev. Gastroenterol. Hepatol. 2022, 19, 717–726. [Google Scholar] [CrossRef]
  8. Fuller-Thomson, E.; Lateef, R.; Sulman, J. Robust Association Between Inflammatory Bowel Disease and Generalized Anxiety Disorder: Findings from a Nationally Representative Canadian Study. Inflamm. Bowel Dis. 2015, 21, 2341–2348. [Google Scholar] [CrossRef]
  9. Gracie, D.J.; Guthrie, E.A.; Hamlin, P.J.; Ford, A.C. Bi-Directionality of Brain–Gut Interactions in Patients With Inflammatory Bowel Disease. Gastroenterology 2018, 154, 1635–1646.e3. [Google Scholar] [CrossRef] [Green Version]
  10. Kochar, B.; Barnes, E.L.; Long, M.D.; Cushing, K.C.; Galanko, J.; Martin, C.F.; Raffals, L.E.; Sandler, R.S. Depression Is Associated With More Aggressive Inflammatory Bowel Disease. Am. J. Gastroenterol. 2018, 113, 80–85. [Google Scholar] [CrossRef]
  11. Marrie, R.A.; Graff, L.A.; Fisk, J.D.; Patten, S.B.; Bernstein, C.N. The Relationship Between Symptoms of Depression and Anxiety and Disease Activity in IBD Over Time. Inflamm. Bowel Dis. 2021, 27, 1285–1293. [Google Scholar] [CrossRef]
  12. Fairbrass, K.M.; Lovatt, J.; Barberio, B.; Yuan, Y.; Gracie, D.J.; Ford, A.C. Bidirectional Brain–Gut Axis Effects Influence Mood and Prognosis in IBD: A Systematic Review and Meta-Analysis. Gut 2022, 71, 1773–1780. [Google Scholar] [CrossRef] [PubMed]
  13. Bernstein, C.N. Psychological Stress and Depression: Risk Factors for IBD? Dig. Dis. 2016, 34, 58–63. [Google Scholar] [CrossRef] [PubMed]
  14. Dragoni, G.; Innocenti, T.; Galli, A. Biomarkers of Inflammation in Inflammatory Bowel Disease: How Long before Abandoning Single-Marker Approaches? Dig. Dis. 2021, 39, 190–203. [Google Scholar] [CrossRef]
  15. Caldiroli, A.; Capuzzi, E.; Barkin, J.L.; Grassi, S.; Esposito, C.M.; Auxilia, A.M.; Russo, S.; Tagliabue, I.; Carnevali, G.S.; Mucci, F.; et al. Is There an Association between Inflammatory/Anti-Oxidant Markers and the Presence of Psychotic Symptoms or Severity of Illness in Mood and Psychotic Disorders? A Multi-Centric Study on a Drug-Free Sample. Brain Behav. Immun. Health 2022, 22, 100453. [Google Scholar] [CrossRef]
  16. Maes, M. Depression Is an Inflammatory Disease, but Cell-Mediated Immune Activation Is the Key Component of Depression. Prog. Neuropsychopharmacol. Biol. Psychiatry 2011, 35, 664–675. [Google Scholar] [CrossRef] [PubMed]
  17. Monteleone, G.; Fina, D.; Caruso, R.; Pallone, F. New Mediators of Immunity and Inflammation in Inflammatory Bowel Disease. Curr. Opin. Gastroenterol. 2006, 22, 361–364. [Google Scholar] [CrossRef]
  18. Neuendorf, R.; Harding, A.; Stello, N.; Hanes, D.; Wahbeh, H. Depression and Anxiety in Patients with Inflammatory Bowel Disease: A Systematic Review. J. Psychosom. Res. 2016, 87, 70–80. [Google Scholar] [CrossRef]
  19. Socała, K.; Doboszewska, U.; Szopa, A.; Serefko, A.; Włodarczyk, M.; Zielińska, A.; Poleszak, E.; Fichna, J.; Wlaź, P. The Role of Microbiota-Gut-Brain Axis in Neuropsychiatric and Neurological Disorders. Pharmacol. Res. 2021, 172, 105840. [Google Scholar] [CrossRef]
  20. Guo, L.; Rohde, J.; Farraye, F.A. Stigma and Disclosure in Patients With Inflammatory Bowel Disease. Inflamm. Bowel Dis. 2020, 26, 1010–1016. [Google Scholar] [CrossRef]
  21. Barberio, B.; Zamani, M.; Black, C.J.; Savarino, E.V.; Ford, A.C. Prevalence of Symptoms of Anxiety and Depression in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis. Lancet Gastroenterol. Hepatol. 2021, 6, 359–370. [Google Scholar] [CrossRef]
  22. Tabano, S.; Tassi, L.; Cannone, M.G.; Brescia, G.; Gaudioso, G.; Ferrara, M.; Colapietro, P.; Fontana, L.; Miozzo, M.R.; Croci, G.A.; et al. Mental Health and the Effects on Methylation of Stress-Related Genes in Front-Line versus Other Health Care Professionals during the Second Wave of COVID-19 Pandemic: An Italian Pilot Study. Eur. Arch. Psychiatry Clin. Neurosci. 2023, 273, 347–356. [Google Scholar] [CrossRef]
  23. Xu, L.; Huang, G.; Cong, Y.; Yu, Y.; Li, Y. Sex-Related Differences in Inflammatory Bowel Diseases: The Potential Role of Sex Hormones. Inflamm. Bowel. Dis. 2022, 28, 1766–1775. [Google Scholar] [CrossRef]
  24. Shah, S.C.; Khalili, H.; Gower-Rousseau, C.; Olen, O.; Benchimol, E.I.; Lynge, E.; Nielsen, K.R.; Brassard, P.; Vutcovici, M.; Bitton, A.; et al. Sex-Based Differences in Incidence of Inflammatory Bowel Diseases—Pooled Analysis of Population-Based Studies From Western Countries. Gastroenterology 2018, 155, 1079–1089.e3. [Google Scholar] [CrossRef]
  25. Ceresa, A.; Esposito, C.M.; Surace, T.; Legnani, F.; Cirella, L.; Cetti, D.; Di Paolo, M.; Nosari, G.; Zanelli Quarantini, F.; Serati, M.; et al. Gender Differences in Clinical and Biochemical Parameters of Patients Consecutively Hospitalized for Unipolar Depression. Psychiatry Res. 2022, 310, 114476. [Google Scholar] [CrossRef] [PubMed]
  26. Wittchen, H.U.; Jacobi, F.; Rehm, J.; Gustavsson, A.; Svensson, M.; Jönsson, B.; Olesen, J.; Allgulander, C.; Alonso, J.; Faravelli, C.; et al. The Size and Burden of Mental Disorders and Other Disorders of the Brain in Europe 2010. Eur. Neuropsychopharmacol. 2011, 21, 655–679. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  27. Truta, B. The Impact of Inflammatory Bowel Disease on Women’s Lives. Curr. Opin. Gastroenterol. 2021, 37, 306–312. [Google Scholar] [CrossRef] [PubMed]
  28. Lungaro, L.; Costanzini, A.; Manza, F.; Barbalinardo, M.; Gentili, D.; Guarino, M.; Caputo, F.; Zoli, G.; De Giorgio, R.; Caio, G. Impact of Female Gender in Inflammatory Bowel Diseases: A Narrative Review. JPM 2023, 13, 165. [Google Scholar] [CrossRef] [PubMed]
  29. Ali, H.; Pamarthy, R.; Bolick, N.L.; Lambert, K.; Naseer, M. Relation between Inflammatory Bowel Disease, Depression, and Inpatient Outcomes in the United States. Proc. (Bayl. Univ. Med. Cent.) 2022, 35, 278–283. [Google Scholar] [CrossRef]
  30. Ananthakrishnan, A.N.; Gainer, V.S.; Cai, T.; Perez, R.G.; Cheng, S.-C.; Savova, G.; Chen, P.; Szolovits, P.; Xia, Z.; De Jager, P.L.; et al. Similar Risk of Depression and Anxiety Following Surgery or Hospitalization for Crohn’s Disease and Ulcerative Colitis. Am. J. Gastroenterol. 2013, 108, 594–601. [Google Scholar] [CrossRef] [Green Version]
  31. Zhang, B.; Wang, H.E.; Bai, Y.; Tsai, S.; Su, T.; Chen, T.; Wang, Y.; Chen, M. Bidirectional Association between Inflammatory Bowel Disease and Depression among Patients and Their Unaffected Siblings. J. Gastroenterol. Hepatol. 2022, 37, 1307–1315. [Google Scholar] [CrossRef] [PubMed]
  32. Tarar, Z.I.; Zafar, M.U.; Farooq, U.; Ghous, G.; Aslam, A.; Inayat, F.; Ghouri, Y.A. Burden of Depression and Anxiety among Patients with Inflammatory Bowel Disease: Results of a Nationwide Analysis. Int. J. Colorectal. Dis. 2022, 37, 313–321. [Google Scholar] [CrossRef] [PubMed]
  33. Panara, A.J.; Yarur, A.J.; Rieders, B.; Proksell, S.; Deshpande, A.R.; Abreu, M.T.; Sussman, D.A. The Incidence and Risk Factors for Developing Depression after Being Diagnosed with Inflammatory Bowel Disease: A Cohort Study. Aliment. Pharmacol. Ther. 2014, 39, 802–810. [Google Scholar] [CrossRef] [PubMed]
  34. Kaye, A.J.; Patel, S.J.; Meyers, S.R.; Ahlawat, S. Outcomes of Inflammatory Bowel Disease in Hospitalized Patients With Generalized Anxiety Disorder. Cureus 2022, 14, e27656. [Google Scholar] [CrossRef]
  35. Department of Geriatric Medicine, Dokuz Eylul University School of Medicine, Izmir, Turkey; Ates Bulut, E.; Toruner, M. Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey The Influence of Disease Type and Activity to Sexual Life and Health Quality in Inflammatory Bowel Disease. Turk. J. Gastroenterol. 2018, 30, 33–39. [Google Scholar] [CrossRef]
  36. Al-Aamri, H.; Al-Huseini, S.; Chan, M.F.; Al Saadi, A.; Al-Sibani, N.; Al-Dughaishi, Z.; Al-Alawi, M. Clinical Predictors of Depression among Patients with Inflammatory Bowel Diseases: A Cross-Sectional Analytical Study from Oman. Oman Med. J. 2022, 37, e352. [Google Scholar] [CrossRef]
  37. Pittet, V.; Vaucher, C.; Froehlich, F.; Burnand, B.; Michetti, P.; Maillard, M.H.; On behalf of the Swiss IBD Cohort Study Group. Patient Self-Reported Concerns in Inflammatory Bowel Diseases: A Gender-Specific Subjective Quality-of-Life Indicator. PLoS ONE 2017, 12, e0171864. [Google Scholar] [CrossRef] [Green Version]
  38. Sciberras, M.; Karmiris, K.; Nascimento, C.; Tabone, T.; Nikolaou, P.; Theodoropoulou, A.; Mula, A.; Goren, I.; Yanai, H.; Amir, H.; et al. Mental Health, Work Presenteeism, and Exercise in Inflammatory Bowel Disease. J. Crohn’s Colitis 2022, 16, 1197–1201. [Google Scholar] [CrossRef]
  39. Narula, N.; Pinto-Sanchez, M.I.; Calo, N.C.; Ford, A.C.; Bercik, P.; Reinisch, W.; Moayyedi, P. Anxiety But Not Depression Predicts Poor Outcomes in Inflammatory Bowel Disease. Inflamm. Bowel Dis. 2019, 25, 1255–1261. [Google Scholar] [CrossRef]
  40. Maconi, G.; Gridavilla, D.; Viganò, C.; Sciurti, R.; Asthana, A.K.; Furfaro, F.; Re, F.; Ardizzone, S.; Ba, G. Perianal Disease Is Associated with Psychiatric Co-Morbidity in Crohn’s Disease in Remission. Int. J. Colorectal. Dis. 2014, 29, 1285–1290. [Google Scholar] [CrossRef]
  41. Costantini, L.; Pasquarella, C.; Odone, A.; Colucci, M.E.; Costanza, A.; Serafini, G.; Aguglia, A.; Belvederi Murri, M.; Brakoulias, V.; Amore, M.; et al. Screening for Depression in Primary Care with Patient Health Questionnaire-9 (PHQ-9): A Systematic Review. J. Affect. Disord. 2021, 279, 473–483. [Google Scholar] [CrossRef]
  42. Zigmond, A.S.; Snaith, R.P. The Hospital Anxiety and Depression Scale. Acta Psychiatr. Scand. 1983, 67, 361–370. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  43. Ferrucci, S.M.; Tavecchio, S.; Angileri, L.; Surace, T.; Berti, E.; Buoli, M. Factors Associated with Affective Symptoms and Quality of Life in Patients with Atopic Dermatitis. Acta Derm. Venereol. 2021, 101, adv00590. [Google Scholar] [CrossRef] [PubMed]
  44. Deischinger, C.; Dervic, E.; Leutner, M.; Kosi-Trebotic, L.; Klimek, P.; Kautzky, A.; Kautzky-Willer, A. Diabetes Mellitus Is Associated with a Higher Risk for Major Depressive Disorder in Women than in Men. BMJ Open Diab. Res. Care 2020, 8, e001430. [Google Scholar] [CrossRef] [PubMed]
  45. Ingegnoli, F.; Buoli, M.; Posio, C.; Di Taranto, R.; Lo Muscio, A.; Cumbo, E.; Ostuzzi, S.; Caporali, R. COVID-19 Related Poor Mental Health and Sleep Disorders in Rheumatic Patients: A Citizen Science Project. BMC Psychiatry 2021, 21, 385. [Google Scholar] [CrossRef] [PubMed]
  46. Serpytis, P.; Navickas, P.; Lukaviciute, L.; Navickas, A.; Aranauskas, R.; Serpytis, R.; Deksnyte, A.; Glaveckaite, S.; Petrulioniene, Z.; Samalavicius, R. Gender-Based Differences in Anxiety and Depression Following Acute Myocardial Infarction. Arq. Bras. Cardiol. 2018, 111, 676–683. [Google Scholar] [CrossRef]
  47. Swaminathan, A.; Fan, D.; Borichevsky, G.M.; Mules, T.C.; Hirschfeld, E.; Frampton, C.M.; Day, A.S.; Siegel, C.A.; Gearry, R.B. The Disease Severity Index for Inflammatory Bowel Disease Is Associated with Psychological Symptoms and Quality of Life, and Predicts a More Complicated Disease Course. Aliment Pharmacol. Ther. 2022, 56, 664–674. [Google Scholar] [CrossRef]
  48. Birnie, M.T.; Claydon, M.D.B.; Troy, O.; Flynn, B.P.; Yoshimura, M.; Kershaw, Y.M.; Zhao, Z.; Demski-Allen, R.C.R.; Barker, G.R.I.; Warburton, E.C.; et al. Circadian Regulation of Hippocampal Function Is Disrupted with Corticosteroid Treatment. Proc. Natl. Acad. Sci. USA 2023, 120, e2211996120. [Google Scholar] [CrossRef]
  49. Shao, Z.; Richie, W.D.; Bailey, R.K. Racial and Ethnic Disparity in Major Depressive Disorder. J. Racial Ethn. Health Disparities 2016, 3, 692–705. [Google Scholar] [CrossRef]
  50. Zeng, S.; Liu, C.; Zhang, J.; An, P.; Liu, Z.; Jiang, C.; Shi, J.; Wu, K.; Dong, W. Risk Factors for Poor Sleep Quality in Patients with Inflammatory Bowel Disease in China: A Multicenter Study. Front. Psychiatry 2023, 14, 1130396. [Google Scholar] [CrossRef]
  51. Gan, Y.; Kakiashvili, T.; Koczkodaj, W.W.; Li, F. A Note on Relevance of Diagnostic Classification and Rating Scales Used in Psychiatry. Comput. Methods Programs Biomed. 2013, 112, 16–21. [Google Scholar] [CrossRef]
  52. Goodman, W.A.; Erkkila, I.P.; Pizarro, T.T. Sex Matters: Impact on Pathogenesis, Presentation and Treatment of Inflammatory Bowel Disease. Nat. Rev. Gastroenterol. Hepatol. 2020, 17, 740–754. [Google Scholar] [CrossRef] [PubMed]
  53. Rustgi, S.D.; Kayal, M.; Shah, S.C. Sex-Based Differences in Inflammatory Bowel Diseases: A Review. Therap. Adv. Gastroenterol. 2020, 13, 175628482091504. [Google Scholar] [CrossRef] [PubMed]
  54. Yuan, X.; Chen, B.; Duan, Z.; Xia, Z.; Ding, Y.; Chen, T.; Liu, H.; Wang, B.; Yang, B.; Wang, X.; et al. Depression and Anxiety in Patients with Active Ulcerative Colitis: Crosstalk of Gut Microbiota, Metabolomics and Proteomics. Gut Microbes 2021, 13, 1987779. [Google Scholar] [CrossRef]
  55. d’Afflitto, M.; Upadhyaya, A.; Green, A.; Peiris, M. Association Between Sex Hormone Levels and Gut Microbiota Composition and Diversity—A Systematic Review. J. Clin. Gastroenterol. 2022, 56, 384–392. [Google Scholar] [CrossRef]
  56. Holingue, C.; Budavari, A.C.; Rodriguez, K.M.; Zisman, C.R.; Windheim, G.; Fallin, M.D. Sex Differences in the Gut-Brain Axis: Implications for Mental Health. Curr. Psychiatry Rep. 2020, 22, 83. [Google Scholar] [CrossRef]
  57. Chen, C.; Gong, X.; Yang, X.; Shang, X.; Du, Q.; Liao, Q.; Xie, R.; Chen, Y.; Xu, J. The Roles of Estrogen and Estrogen Receptors in Gastrointestinal Disease (Review). Oncol. Lett. 2019, 18, 5673–5680. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  58. Ma, Y.; Liu, T.; Li, X.; Kong, A.; Xiao, R.; Xie, R.; Gao, J.; Wang, Z.; Cai, Y.; Zou, J.; et al. Estrogen Receptor β Deficiency Impairs Gut Microbiota: A Possible Mechanism of IBD-Induced Anxiety-like Behavior. Microbiome 2022, 10, 160. [Google Scholar] [CrossRef]
  59. Oyola, M.G.; Handa, R.J. Hypothalamic–Pituitary–Adrenal and Hypothalamic–Pituitary–Gonadal Axes: Sex Differences in Regulation of Stress Responsivity. Stress 2017, 20, 476–494. [Google Scholar] [CrossRef]
  60. Verma, R.; Balhara, Y.S.; Gupta, C. Gender Differences in Stress Response: Role of Developmental and Biological Determinants. Ind. Psychiatry J. 2011, 20, 4. [Google Scholar] [CrossRef] [PubMed]
  61. Altamura, A.C.; Buoli, M.; Pozzoli, S. Role of Immunological Factors in the Pathophysiology and Diagnosis of Bipolar Disorder: Comparison with Schizophrenia: A Comprehensive Review. Psychiatry Clin. Neurosci. 2014, 68, 21–36. [Google Scholar] [CrossRef]
  62. Bijlsma, J.W.J.; Cutolo, M.; Masi, A.T.; Chikanza, I.C. The Neuroendocrine Immune Basis of Rheumatic Diseases. Immunol. Today 1999, 20, 298–301. [Google Scholar] [CrossRef]
  63. Benarroch, E.E. Neurosteroids: Endogenous Modulators of Neuronal Excitability and Plasticity. Neurology 2007, 68, 945–947. [Google Scholar] [CrossRef]
  64. Serati, M.; Redaelli, M.; Buoli, M.; Altamura, A.C. Perinatal Major Depression Biomarkers: A Systematic Review. J. Affect. Disord. 2016, 193, 391–404. [Google Scholar] [CrossRef] [PubMed]
  65. Vivian-Taylor, J.; Hickey, M. Menopause and Depression: Is There a Link? Maturitas 2014, 79, 142–146. [Google Scholar] [CrossRef] [PubMed]
  66. Kim, S.; Lee, J.-Y.; Shin, S.G.; Kim, J.K.; Silwal, P.; Kim, Y.J.; Shin, N.-R.; Kim, P.S.; Won, M.; Lee, S.-H.; et al. ESRRA (Estrogen Related Receptor Alpha) Is a Critical Regulator of Intestinal Homeostasis through Activation of Autophagic Flux via Gut Microbiota. Autophagy 2021, 17, 2856–2875. [Google Scholar] [CrossRef]
  67. Van Der Have, M.; Van Der Aalst, K.S.; Kaptein, A.A.; Leenders, M.; Siersema, P.D.; Oldenburg, B.; Fidder, H.H. Determinants of Health-Related Quality of Life in Crohn’s Disease: A Systematic Review and Meta-Analysis. J. Crohn’s Colitis 2014, 8, 93–106. [Google Scholar] [CrossRef] [Green Version]
  68. Ona, S.; James, K.; Ananthakrishnan, A.N.; Long, M.D.; Martin, C.; Chen, W.; Mitchell, C.M. Association Between Vulvovaginal Discomfort and Activity of Inflammatory Bowel Diseases. Clin. Gastroenterol. Hepatol. 2020, 18, 604–611.e1. [Google Scholar] [CrossRef] [PubMed]
  69. Zhang, J.; Nie, J.; Zou, M.; Zeng, Q.; Feng, Y.; Luo, Z.; Gan, H. Prevalence and Associated Factors of Sexual Dysfunction in Patients With Inflammatory Bowel Disease. Front. Endocrinol. 2022, 13, 881485. [Google Scholar] [CrossRef]
  70. Armuzzi, A.; Bortoli, A.; Castiglione, F.; Contaldo, A.; Daperno, M.; D’Incà, R.; Labarile, N.; Mazzuoli, S.; Onali, S.; Milla, M.; et al. Female Reproductive Health and Inflammatory Bowel Disease: A Practice-Based Review. Dig. Liv. Dis. 2022, 54, 19–29. [Google Scholar] [CrossRef]
  71. Bel, L.G.J.; Vollebregt, A.M.; Van Der Meulen-de Jong, A.E.; Fidder, H.H.; Ten Hove, W.R.; Vliet-Vlieland, C.W.; Ter Kuile, M.M.; De Groot, H.E.; Both, S. Sexual Dysfunctions in Men and Women with Inflammatory Bowel Disease: The Influence of IBD-Related Clinical Factors and Depression on Sexual Function. J. Sex. Med. 2015, 12, 1557–1567. [Google Scholar] [CrossRef] [PubMed]
  72. Ronchetti, C.; Cirillo, F.; Di Segni, N.; Cristodoro, M.; Busnelli, A.; Levi-Setti, P.E. Inflammatory Bowel Disease and Reproductive Health: From Fertility to Pregnancy—A Narrative Review. Nutrients 2022, 14, 1591. [Google Scholar] [CrossRef] [PubMed]
  73. Beese, S.E.; Harris, I.M.; Dretzke, J.; Moore, D. Body Image Dissatisfaction in Patients with Inflammatory Bowel Disease: A Systematic Review. BMJ Open Gastroenterol. 2019, 6, e000255. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  74. Muller, K.R.; Prosser, R.; Bampton, P.; Mountifield, R.; Andrews, J.M. Female Gender and Surgery Impair Relationships, Body Image, and Sexuality in Inflammatory Bowel Disease. Inflamm. Bowel Dis. 2010, 16, 657–663. [Google Scholar] [CrossRef]
  75. Silva, D.; Ferriani, L.; Viana, M.C. Depression, Anthropometric Parameters, and Body Image in Adults: A Systematic Review. Rev. Assoc. Med. Bras. 2019, 65, 731–738. [Google Scholar] [CrossRef]
  76. Boysen, G.; Ebersole, A.; Casner, R.; Coston, N. Gendered Mental Disorders: Masculine and Feminine Stereotypes About Mental Disorders and Their Relation to Stigma. J. Soc. Psychol. 2014, 154, 546–565. [Google Scholar] [CrossRef]
  77. Buoli, M.; Cesana, B.M.; Dell’Osso, B.; Fagiolini, A.; De Bartolomeis, A.; Bondi, E.; Maina, G.; Bellomo, A.; Altamura, A.C. Gender-Related Differences in Patients with Bipolar Disorder: A Nationwide Study. CNS Spectr. 2019, 24, 589–596. [Google Scholar] [CrossRef]
  78. Kovess-Masfety, V.; Boyd, A.; Van De Velde, S.; De Graaf, R.; Vilagut, G.; Haro, J.M.; Florescu, S.; O’Neill, S.; Weinberg, L.; Alonso, J.; et al. Are There Gender Differences in Service Use for Mental Disorders across Countries in the European Union? Results from the EU-World Mental Health Survey. J. Epidemiol. Community Health 2014, 68, 649–656. [Google Scholar] [CrossRef]
  79. Stoppe, G.; Sandholzer, H.; Huppertz, C.; Duwe, H.; Staedt, J. Gender Differences in the Recognition of Depression in Old Age. Maturitas 1999, 32, 205–212. [Google Scholar] [CrossRef]
  80. Stuber, J.P.; Rocha, A.; Christian, A.; Link, B.G. Conceptions of Mental Illness: Attitudes of Mental Health Professionals and the General Public. Psychiatr. Serv. 2014, 65, 490–497. [Google Scholar] [CrossRef] [Green Version]
  81. Arp, L.; Jansson, S.; Wewer, V.; Burisch, J. Psychiatric Disorders in Adult and Paediatric Patients With Inflammatory Bowel Diseases—A Systematic Review and Meta-Analysis. J. Crohn’s Colitis 2022, 16, 1933–1945. [Google Scholar] [CrossRef]
  82. Glapa-Nowak, A.; Bukowska-Posadzy, A.; Szczepanik, M.; Kwiecień, J.; Szaflarska-Popławska, A.; Iwańczak, B.; Flak-Wancerz, A.; Dembiński, Ł.; Osiecki, M.; Kierkuś, J.; et al. Subjective Psychophysical Experiences in the Course of Inflammatory Bowel Disease—A Comparative Analysis Based on the Polish Pediatric Crohn’s and Colitis Cohort (POCOCO). IJERPH 2021, 18, 784. [Google Scholar] [CrossRef]
  83. Grassi, S.; Morelli, V.; Arosio, M.; Buoli, M. Gender Identity Fluctuation in a Genetic Female with Late-Onset, Non-Classical Congenital Adrenal Hyperplasia. Arch. Sex. Behav. 2019, 48, 1265–1268. [Google Scholar] [CrossRef] [PubMed]
  84. Kleinman, A. Culture and Depression. N. Engl. J. Med. 2004, 351, 951–953. [Google Scholar] [CrossRef] [PubMed]
  85. Costantino, A.; Noviello, D.; Mazza, S.; Berté, R.; Caprioli, F.; Vecchi, M. Trust in Telemedicine from IBD Outpatients during the COVID-19 Pandemic. Dig. Liver Dis. 2021, 53, 291–294. [Google Scholar] [CrossRef]
  86. Williams, D.J. No Health without ‘Mental Health’. J. Public Health 2018, 40, 444. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  87. Wade, D.T.; Halligan, P.W. The Biopsychosocial Model of Illness: A Model Whose Time Has Come. Clin. Rehabil. 2017, 31, 995–1004. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  88. Beurel, E.; Toups, M.; Nemeroff, C.B. The Bidirectional Relationship of Depression and Inflammation: Double Trouble. Neuron 2020, 107, 234–256. [Google Scholar] [CrossRef]
  89. Vasiliu, O. Investigational Drugs for the Treatment of Depression (Part 1): Monoaminergic, Orexinergic, GABA-Ergic, and Anti-Inflammatory Agents. Front. Pharmacol. 2022, 13, 884143. [Google Scholar] [CrossRef]
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Fracas, E.; Costantino, A.; Vecchi, M.; Buoli, M. Depressive and Anxiety Disorders in Patients with Inflammatory Bowel Diseases: Are There Any Gender Differences? Int. J. Environ. Res. Public Health 2023, 20, 6255.

AMA Style

Fracas E, Costantino A, Vecchi M, Buoli M. Depressive and Anxiety Disorders in Patients with Inflammatory Bowel Diseases: Are There Any Gender Differences? International Journal of Environmental Research and Public Health. 2023; 20(13):6255.

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Fracas, Elia, Andrea Costantino, Maurizio Vecchi, and Massimiliano Buoli. 2023. "Depressive and Anxiety Disorders in Patients with Inflammatory Bowel Diseases: Are There Any Gender Differences?" International Journal of Environmental Research and Public Health 20, no. 13: 6255.

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