Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, is a chronic, relapsing immune-mediated disease with a varying and sometimes severe disease course. IBD is often diagnosed in early adulthood and can lead to a substantial decline in quality of life. It has been suggested that patients with IBD are at increased risk of depression and anxiety, but it is still unclear to what extent these diseases co-occur and in what sequence they arise. This Review summarizes the literature on the degree of co-occurrence of IBD with depression and anxiety and the temporal relationship between these diseases. We also discuss the effect of psychological stress on the onset and course of IBD. In addition, we outline the possible mechanisms underlying the co-occurrence of IBD and depression and anxiety, which include changes in brain signalling and morphology, increases in peripheral and intracerebral pro-inflammatory cytokines, impairment of the nitric oxide pathway, changes in vagal nerve signalling, gut dysbiosis and genetics. Finally, we examine the possible effects of treatment of depression and anxiety on the risk and course of IBD, the influence of psychological interventions on IBD, and the effects of IBD treatment on psychiatric comorbidity.

炎症性肠病 (IBD) 包括克罗恩病和溃疡性结肠炎，是一种慢性、复发性免疫介导的疾病，病程多变，有时甚至很严重。IBD 通常在成年早期被诊断出来，并可能导致生活质量大幅下降。有人提出，IBD 患者患抑郁症和焦虑症的风险增加，但目前尚不清楚这些疾病在多大程度上同时发生以及它们以何种顺序出现。这篇综述总结了关于 IBD 与抑郁和焦虑的共同发生程度以及这些疾病之间的时间关系的文献。我们还讨论了心理压力对 IBD 发病和病程的影响。此外，我们概述了 IBD 与抑郁和焦虑同时发生的可能机制，其中包括大脑信号和形态的变化、外周和脑内促炎细胞因子的增加、一氧化氮通路的损害、迷走神经信号的变化、肠道菌群失调和遗传学。最后，我们研究了抑郁症和焦虑症治疗对 IBD 风险和病程的可能影响、心理干预对 IBD 的影响以及 IBD 治疗对精神疾病合并症的影响。