Depression linked to increased IBD activity

Researchers found that depression was independently associated with greater inflammatory bowel disease, or IBD, activity, and that less positive cognitive bias in emotional recognition partially mediated the effects of disease activity on depression.

The role of inflammation in depression remains largely unclear, Chris Dickens, PhD, from the mental health research group at University of Exeter College of Medicine and Health, U.K., and colleagues wrote in Neurogastroenterology & Motility.

“We postulate here that the effects of inflammation may be mediated via negative cognitive biases, particularly biases in the processing of emotionally salient information (henceforth emotional processing),” they wrote. “Such negative cognitive biases are considered central to the development of depression, though their association with chronic inflammation in people with IBD has not been investigated previously.”

Outpatients with IBD completed questionnaires asking about age, sex, social support, socioeconomic status, anxiety and depression and underwent assessments of biases in emotional recognition, emotional memory and reinforcement learning. Researchers also examined patients’ clinical records for type, duration and activity of IBD as well as blood samples for highsensitivity Creactive protein levels.

Of 68 participants with Crohn's disease and 49 with ulcerative colitis, 35 had active disease and 26 had depression. Dickens and colleagues found that risk factors for depression included female sex, lack of social support, having active disease, taking corticosteroids (but not TNFalpha inhibitors) and showing less positive emotional recognition bias.

Multivariable regression analysis indicated that depression was independently linked to lack of social support (B = –1.4; P = .02) and greater disease activity (B = 1.29; P = .03). Based on causal steps analysis, the investigators also reported that less positive emotional recognition bias partially mediated the effects of disease activity on depression.

"These findings are preliminary but suggest that negative cognitive biases associated with IBD activity may lead to the development of depression in people with IBD,” Dickens said in a press release. “Our results could indicate novel ways to treat or even prevent depression in people with IBD, though our findings require replication in prospective studies, which will allow us to draw stronger inferences on the causal association of cognitive biases with depression.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.