Factors associated with depression in people with inflammatory bowel disease: The relationship between active disease and biases in neurocognitive processing.
cognitive functioning
depression
inflammation
inflammatory bowel disease
Journal
Neurogastroenterology and motility
ISSN: 1365-2982
Titre abrégé: Neurogastroenterol Motil
Pays: England
ID NLM: 9432572
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
05
11
2018
revised:
20
03
2019
accepted:
15
05
2019
pubmed:
4
7
2019
medline:
7
8
2020
entrez:
4
7
2019
Statut:
ppublish
Résumé
Depression is common among people with inflammatory bowel disease (IBD), though the causes remain unclear. We conducted a cross-sectional study to investigate the role of emotional processing biases in contributing to depression among people with IBD. One hundred and twenty outpatients with IBD were recruited and: (a) completed questionnaires to record: age, sex, social support, socioeconomic status, anxiety and depression (n = 104), (b) underwent assessments of biases in emotional recognition (n = 112), emotional memory and reinforcement learning (c) had recorded from clinical records: type of IBD, duration of IBD, IBD activity and (d) provided blood for high-sensitivity C-reactive protein levels (n = 99). Sixty-eight participants had Crohn's disease and 49 had ulcerative colitis. Of these, 35 had active disease and 26 had depression. Those with depression were more likely to be female, lack social support, have active disease, be taking corticosteroids but not TNF-alpha inhibitors and exhibit less positive emotional recognition bias. On multivariable regression analysis, depression was associated independently with lack of social support (unstandardized regression coefficient (B) = -1.40, P = 0.02) and increased disease activity (B = 1.29, P = 0.03). Causal steps analysis was consistent with less positive emotional recognition bias partially mediating the effects of disease activity on depression. This is the first study to demonstrate links between disease activity and less positive biases in emotional recognition that could explain higher rates of depression among people with active IBD. Future prospective studies are required to confirm the effects of emotional processing biases in depression and allow stronger causal inferences to be drawn.
Sections du résumé
BACKGROUND
Depression is common among people with inflammatory bowel disease (IBD), though the causes remain unclear. We conducted a cross-sectional study to investigate the role of emotional processing biases in contributing to depression among people with IBD.
MATERIALS AND METHODS
One hundred and twenty outpatients with IBD were recruited and: (a) completed questionnaires to record: age, sex, social support, socioeconomic status, anxiety and depression (n = 104), (b) underwent assessments of biases in emotional recognition (n = 112), emotional memory and reinforcement learning (c) had recorded from clinical records: type of IBD, duration of IBD, IBD activity and (d) provided blood for high-sensitivity C-reactive protein levels (n = 99).
KEY RESULTS
Sixty-eight participants had Crohn's disease and 49 had ulcerative colitis. Of these, 35 had active disease and 26 had depression. Those with depression were more likely to be female, lack social support, have active disease, be taking corticosteroids but not TNF-alpha inhibitors and exhibit less positive emotional recognition bias. On multivariable regression analysis, depression was associated independently with lack of social support (unstandardized regression coefficient (B) = -1.40, P = 0.02) and increased disease activity (B = 1.29, P = 0.03). Causal steps analysis was consistent with less positive emotional recognition bias partially mediating the effects of disease activity on depression.
CONCLUSIONS AND INFERENCES
This is the first study to demonstrate links between disease activity and less positive biases in emotional recognition that could explain higher rates of depression among people with active IBD. Future prospective studies are required to confirm the effects of emotional processing biases in depression and allow stronger causal inferences to be drawn.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13647Informations de copyright
© 2019 John Wiley & Sons Ltd.
Références
Fuller-Thomson E, Sulman J. Depression and inflammatory bowel disease: findings from two nationally representative Canadian surveys. Inflamm Bowel Dis. 2006;12(8):697-707.
Roman AL, Munoz F. Comorbidity in inflammatory bowel disease. World J Gastroenterol. 2011;17(22):2723-2733.
Walker JR, Ediger JP, Graff LA, et al. The Manitoba IBD cohort study: a population-based study of the prevalence of lifetime and 12-month anxiety and mood disorders. Am J Gastroenterol. 2008;103(8):1989-1997.
Walker EA, Gelfand MD, Gelfand AN, Creed F, Katon WJ. The relationship of current psychiatric disorder to functional disability and distress in patients with inflammatory bowel disease. Gen Hosp Psychiatry. 1996;18(4):220-229.
Vidal À, Gómez-Gil E, Sans M, et al. Health-related quality of life in inflammatory bowel disease patients: the role of psychopathology and personality. Inflamm Bowel Dis. 2008;14(7):977-983.
Hyphantis TN, Tomenson B, Bai M, Tsianos E, Mavreas V, Creed F. Psychological distress, somatization, and defense mechanisms associated with quality of life in inflammatory bowel disease patients. Dig Dis Sci. 2010;55(3):724-732.
Guthrie E, Jackson J, Shaffer J, Thompson D, Tomenson B, Creed F. Psychological disorder and severity of inflammatory bowel disease predict health-related quality of life in ulcerative colitis and Crohn’s disease. Am J Gastroenterol. 2002;97(8):1994-1999.
Zhang CK, Hewett J, Hemming J, et al. The influence of depression on quality of life in patients with inflammatory bowel disease. Inflamm Bowel Dis. 2013;19(8):1732-1739.
Farrokhyar F, Marshall JK, Easterbrook B, Irvine EJ. Functional gastrointestinal disorders and mood disorders in patients with inactive inflammatory bowel disease: prevalence and impact on health. Inflamm Bowel Dis. 2006;12(1):38-46.
de Boer AG, Sprangers MA, Bartelsman JF, de Haes HC. Predictors of health care utilization in patients with inflammatory bowel disease: a longitudinal study. Eur J Gastroenterol Hepatol. 1998;10(9):783-789.
Drossman DA, Leserman J, Mitchell CM, Li ZM, Zagami EA, Patrick DL. Health status and health care use in persons with inflammatory bowel disease. A national sample. Dig Dis Sci. 1991;36(12):1746-1755.
Mittermaier C, Dejaco C, Waldhoer T, et al. Impact of depressive mood on relapse in patients with inflammatory bowel disease: a prospective 18-month follow-up study. Psychosom Med. 2004;66(1):79-84.
Porcelli P, Leoci C, Guerra V, Taylor GJ, Bagby RM. A longitudinal study of alexithymia and psychological distress in inflammatory bowel disease. J Psychosom Res. 1996;41(6):569-573.
Persoons P, Vermeire S, Demyttenaere K, et al. The impact of major depressive disorder on the short- and long-term outcome of Crohn’s disease treatment with infliximab. Aliment Pharmacol Ther. 2005;22(2):101-110.
Mikocka-Walus A, Pittet V, Rossel J-B, et al. Symptoms of depression and anxiety are independently associated with clinical recurrence of inflammatory bowel disease. Clin Gastroenterol Hepatol. 2016;14(6):829-835.
North CS, Clouse RE, Spitznagel EL, Alpers DH. The relation of ulcerative colitis to psychiatric factors: a review of findings and methods. Am J Psychiatry. 1990;147(8):974-981.
Acosta-Ramirez D, Pagan-Ocasio V, Torres EA, Rodriguez M, Caro O. Profile of the inflammatory bowel disease patient with depressive disorders. P R Heal Sci J. 2001;20(3):215-220.
Freitas TH, Andreoulakis E, Alves GS, et al. Associations of sense of coherence with psychological distress and quality of life in inflammatory bowel disease. World J Gastroenterol. 2015;21(21):6713-6727.
Goodhand JR, Wahed M, Mawdsley JE, Farmer AD, Aziz Q, Rampton DS. Mood disorders in inflammatory bowel disease: relation to diagnosis, disease activity, perceived stress, and other factors. Inflamm Bowel Dis. 2012;18(12):2301-2309.
Nahon S, Lahmek P, Durance C, et al. Risk factors of anxiety and depression in inflammatory bowel disease. Inflamm Bowel Dis. 2012;18(11):2086-2091.
Panara AJ, Yarur AJ, Rieders B, et al. The incidence and risk factors for developing depression after being diagnosed with inflammatory bowel disease: a cohort study. Aliment Pharmacol Ther. 2014;39(8):802-810.
Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med. 2009;71(2):171-186.
Gimeno D, Kivimäki M, Brunner EJ, et al. Associations of C-reactive protein and interleukin-6 with cognitive symptoms of depression: 12-year follow-up of the Whitehall II study. Psychol Med. 2010;39(3):413-423.
Stewart JC, Rand KL, Muldoon MF, Kamarck TW. A prospective evaluation of the directionality of the depression-inflammation relationship. Brain Behav Immun. 2009;23(7):936-944.
Reichenberg A, Yirmiya R, Schuld A, et al. Cytokine-associated emotional and cognitive disturbances in humans. Arch Gen Psychiatry. 2001;58(5):445-452.
Wright CE, Strike PC, Brydon L, Steptoe A. Acute inflammation and negative mood: mediation by cytokine activation. Brain Behav Immun. 2005;19(4):345-350.
Guloksuz S, Wichers M, Kenis G, et al. Depressive symptoms in Crohn’s disease: relationship with immune activation and tryptophan availability. PLoS One. 2013;8(3):e60435.
Loftus EV, Feagan BG, Colombel J-F, et al. Effects of adalimumab maintenance therapy on health-related quality of life of patients with Crohn’s disease: patient-reported outcomes of the CHARM trial. Am J Gastroenterol. 2008;103:3132-3141.
Minderhoud IM, Samsom M, Oldenburg B. Crohn’s disease, fatigue, and infliximab: is there a role for cytokines in the pathogenesis of fatigue? World J Gastroenterol. 2007;13:2089-2093.
Bollen J, Trick L, Llewellyn D, et al. The effects of acute inflammation on cognitive functioning and emotional processing in humans: A systematic review of experimental studies. J Psychosom Res. 2017;94:47-55.
Clark L, Chamberlain SR, Sahakian BJ. Neurocognitive mechanisms in depression: implications for treatment. Annu Rev Neurosci. 2009;32(1):57-74.
Roiser JP, Elliott R, Sahakian BJ. Cognitive mechanisms of treatment in depression. Neuropsychopharmacology. 2012;37(1):117-136.
How G. Many subjects does it take to do a regression analysis? Multivariate Behav Res. 1991;26(3):499-510.
Kroenke K, Spitzer RL, Williams J. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-613.
Spitzer RL, Kroenke K, Williams J, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092-1097.
Berkman LF, Blumenthal J, Burg M, et al. Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. JAMA. 2003;289(23):3106-3116.
Mitchell PH, Powell L, Blumenthal J, et al. A short social support measure for patients recovering from myocardial infarction: the _ENRICHD_ Social Support Inventory. J Cardiopulm Rehabil. 2003;23(6):398-403.
Vaglio J, Conard M, Poston WS, et al. Testing the performance of the ENRICHD Social Support Instrument in cardiac patients. Health Qual Life Outcomes. 2004;2(1):24.
Brugha T, Bebbington P, Tennant C, Hurry J. The List of Threatening Experiences: a subset of 12 life event categories with considerable long-term contextual threat. Psychol Med. 1985;15(1):189-194.
W.H.O. EQ-5D. https://euroqol.org/eq-5d-instruments/eq-5d-5l-about/. Published 2018.
Han S-W, Gregory W, Nylander D, et al. The SIBDQ: further validation in ulcerative colitis patients. Am J Gastroenterol. 2000;95(1):145-151.
Irvine EJ, Zhou Q, Thompson AK. The Short Inflammatory Bowel Disease Questionnaire: a quality of life instrument for community physicians managing inflammatory bowel disease. CCRPT Investigators. Canadian Crohn’s Relapse Prevention Trial. Am J Gastroenterol. 1996;91(8):1571-1578.
Silverberg MS, Satsangi J, Ahmad T, et al. Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a working party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol. 2005;19(suppl a):5A-36A.
2015 D for C and LG. The English Indices of Deprivation 2015. London.
Bland AR, Roiser JP, Mehta MA, et al. EMOTICOM: a neuropsychological test battery to evaluate emotion, motivation, impulsivity, and social cognition. Front Behav Neurosci. 2016;10:25.
Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic and statistical considerations. J Pers Soc Psychol. 1986;51(6):1173-1182.
Preacher KJ, Hayes AF. SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behav Res Methods Instrum Comput. 2004;36(4):717-731.
Maxwell S, Cole D. Bias in cross-sectional analyses of longitudinal mediation. Psychol Methods. 2007;12:23-44.
Dickens C, Jackson J, Tomenson B, Hay E, Creed F. Association of depression and rheumatoid arthritis. Psychosomatics. 2003;44(3):209-215.
Abbott R, Whear R, Nikolaou V, et al. Tumour necrosis factor-α inhibitor therapy in chronic physical illness: A systematic review and meta-analysis of the effect on depression and anxiety. J Psychosom Res. 2015;79(3):175-184.
Müller N, Schwarz MJ, Dehning S, et al. The cyclooxygenase-2 inhibitor celecoxib has therapeutic effects in major depression: Results of a double-blind, randomized, placebo controlled, add-on pilot study to reboxetine. Mol Psychiatry. 2006;11(7):680-684.
Brown ES. Effects of glucocorticoids on mood, memory, and the hippocampus. Ann N Y Acad Sci. 2009;1179(1):41-55.
Agostini A, Filippini N, Cevolani D, et al. Brain functional changes in patients with ulcerative colitis. Inflamm Bowel Dis. 2011;17(8):1769-1777.