Jessica Salwen-Deremer, PhD, on Fatigue Among Patients With IBD

Hi, I am Jessie Salwen-Deremer. I'm a clinical psychologist and a diplomate of behavioral sleep medicine. I am assistant professor at the Geisel School of Medicine at Dartmouth and on staff at Dartmouth Hitchcock. I am here at Crohn's and Colitis Congress, having just finished giving a talk on fatigue and on behavioral risk factors that we can modify in folks with IBD.

Broadly, when we think about fatigue, we think about just how prevalent and how important it is. The vast majority of people with active disease will report some significant and interfering fatigue, and then even when disease is mild or inactive, still about 50%. So, it really is something that we should be assessing regularly in our patients with IBD. Some of the most important factors are that it is associated with a whole bunch of different modifiable behavioral risk factors. Things like sleep disturbance, anxiety, depression, stress, all of these are associated with increased fatigue and all of them can be targeted with cognitive behavioral therapy.

There's really good evidence for CBT for these different behavioral factors in a wide number of populations, and specific to IBD, we have some research emerging showing support for CBT in these areas. There's also some preliminary research supporting the use of CBT for decreasing the impact of fatigue on people's quality of life. So, if you have patients who are reporting significant fatigue and they're fairly well managed medically, it's a great opportunity to refer them to a psychologist, optimally, somebody who's integrated into your practice. But if not, hopefully you've developed a relationship with a local mental health person. And they may screen for things like insomnia, depression, stress, and the ways that people are coping with or not coping with their disease, and try to treat those with a variety of different techniques.