Association of Depression With Incident Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis

Background Psychiatric disorders in patients with inflammatory bowel disease (IBD) represent a significant but uncertain facet of the disease, with unsolved questions regarding their overall magnitude, their impact on intestinal disease, and the whole burden of psychiatric manifestations. Aim This systematic review summarizes the evidence on the prevalence and impact of psychiatric disorders, including depression, anxiety, bipolar disorder (BD), and schizophrenia, among patients with IBD. Methods A systematic search across PubMed/MEDLINE, Embase, and Scopus databases from January 2010 to January 2023 was performed to identify relevant studies. The focus was on studies exploring the prevalence of specific psychiatric disorders in IBD patients compared to the general population and that reported specific outcome measures. A subsequent meta-analysis (MA) assessed the strength of the association between IBD and these psychiatric disorders, with data reliability ensured through rigorous extraction and quality assessment. Results Out of 3,209 articles, 193 met the inclusion criteria and only 26 provided complete data for comprehensive analysis. These studies showed a significantly higher overall prevalence of psychiatric comorbidities in IBD patients compared to the general population. The MA showed a significant association between IBD and depression (pooled OR 1.42, 95% CI = 1.33-1.52, P < .0001) and anxiety (pooled OR 1.3, 95% CI = 1.22-1.44, P < .0001). The association between IBD and BD was significant (pooled OR 1.64, 95% CI = 1.20-2.24, P < .0001) but showed considerable heterogeneity (I2 = 94.01%). Only 3 studies examined the association between schizophrenia and IBD, providing widely heterogeneous results, with an inconclusive OR, estimated at 0.93 (95% CI = 0.62-1.39, P = .73). Conclusions This MA highlights the high prevalence of psychiatric disorders, particularly depression and anxiety, in IBD patients, which exceeds rates in the general population. BD in IBD is proving to be an important but under-researched area. The sparse and contradictory data on schizophrenia requires further investigation. These findings highlight the need for better understanding, early detection, and tailored mental health interventions in the management of IBD to significantly improve patients’ quality of life.

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Upregulation of MMP9 and ORM2 leading to increased neutrophil infiltration as a potential common mechanism in the development of IBD and MDD

Sun,

Gao,

et al. 2024

Preprint

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Major depressive disorder (MDD) is an emotional distinguished by core clinical symptoms such as low mood, diminished interest, lack of pleasure, reduced activity, and mental inhibition. Inflammatory bowel disease (IBD) is characterized by chronic inflammation of the gastrointestinal tract with with an unknown etiology. Previous studies have indicated a positive association between MDD and IBD, although the specific underlying mechanism remains unclear. The objective of this research was to investigate shared differentially expressed genes (DEGs) common to MDD and IBD through bioinformatics analysis to elucidate the connection.The series matrix files of GSE3365 and GSE98793 were obtained from the NCBI GEO public database. The limma R package was utilized to identify DEGs common to MDD and IBD. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional annotation, protein–protein interaction analysis of the hub genes, weighted gene co-expression network analysis (WGCNA), correlation analysis of the hub genes with immune responses, and analysis of immune infiltrations were conducted. Gene set enrichment analysis was performed to elucidate the underlying pathogenesis. The intersection analysis identified 27 commonly upregulated genes and 13 downregulated genes. Subsequent GO and KEGG analyses revealed enrichment of infection-related signaling pathways among the DEGs. The integration of genes from the WGCNA module and differential genes resulted in the identification of eight commonly upregulated genes: PROS1, ORM2, SLP1, MMP9, CLEC5A, ARG1, OLR1, and EGF. Furthermore, immune infiltration analysis demonstrated an increase in neutrophil infiltration in both the MDD and IBD datasets. ORM2 and MMP9 were found to be correlated with neutrophil infiltration. These pivotal genes, associated with neutrophils and monocytes, play crucial roles in the pathophysiology of both conditions. Targeting ORM2 and MMP9 may hold promise as potential diagnostic and therapeutic strategies for managing the comorbidity of IBD and MDD.

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Association of Depression With Incident Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis

Cited by 4 publications

References 46 publications

Implementation of ‘IBD-Specific Cognitive Behavioural Therapy’ for Patients with Inflammatory Bowel Diseases with Poor Mental Quality of Life, Anxiety and Depression

Implementation of ‘IBD-Specific Cognitive Behavioural Therapy’ for Patients with Inflammatory Bowel Diseases with Poor Mental Quality of Life, Anxiety and Depression

The Burden of Psychiatric Manifestations in Inflammatory Bowel Diseases: A Systematic Review With Meta-analysis

Upregulation of MMP9 and ORM2 leading to increased neutrophil infiltration as a potential common mechanism in the development of IBD and MDD

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