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Patients showing signs of depression at greater risk for Crohn’s disease
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The presence of depressive symptoms elevates the risk for developing Crohn’s disease, but not ulcerative colitis, according to recent results.
Researchers evaluated data on symptoms of depression in 152,461 women aged 29 to 72 years. All participants had been enrolled in the Nurses’ Health Study cohorts I (n=66,815) or II (n=85,646). Depression was assessed according to Mental Health Index (MHI)-5 scores obtained in 1992, 1996 and 2000 for cohort I and 1993, 1997 and 2001 for cohort II; scores below 52 indicated symptoms. Incidence of Crohn’s disease (CD) and ulcerative colitis (UC) within the cohort was assessed to determine potential associations between depressive symptoms and risk for either illness.
CD was diagnosed in 170 participants and UC occurred in 203. Depressive symptoms at baseline were observed in 16,986 women. Participants with recent scores indicating depressive symptoms were found to be at increased risk for CD via multivariate analysis (adjusted HR=2.36, 1.40-3.98) compared with women with MHI-5 scores between 86 and 100. The impact on risk was less powerful with increasing MHI-5 score: Patients with scores between 76 and 85 had an HR of 1.38 (0.90-2.13), while those with scores between 53 and 75 had an HR of 1.59 (1.02-2.48) (95% CI for all).
Symptoms of depression at baseline also were associated with risk for CD, but the link was not as strong (adjusted HR=1.62; 95% CI, 0.95-2.77). No association was observed between depressive symptoms and risk for UC, either according to baseline (HR=1.07, 0.63-1.83) or recent MHI-5 scores (HR=1.14, 0.68-1.92) (95% CI for both).
“Our results … provide support to a biopsychosocial model of IBD pathogenesis in which the risk of development of disease is influenced by psychosocial factors,” the researchers concluded. “Preliminary animal and human studies suggest that treating depression through administration of antidepressants or through improvement in coping mechanisms could reduce risk of disease relapse. Whether similar interventions can also influence risk of disease onset, particularly among individuals with genetic susceptibility for CD or UC, merits further study.”
Disclosure: Researcher James M. Richter serves as a consultant at Policy Analysis. Researcher Andrew T. Chan serves as a consultant for Bayer HealthCare, Millennium Pharmaceuticals and Pfizer.
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