Bidirectional association between inflammatory bowel disease and depression among patients and their unaffected siblings

Zhang, Bing; Wang, Ho‐Hui Eileen; Bai, Ya‐Mei; Tsai, Shih‐Jen; Su, Tung‐Ping; Chen, Tzeng‐Ji; Wang, Yen‐Po; Chen, Mu Hong

doi:10.1111/jgh.15855

Cited by 12 publications

(13 citation statements)

References 57 publications

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“…Three studies, including over 200 000 individuals and 7449 cases of incident IBD, investigated the association between depression and subsequent IBD. 32 , 39 , 40 History of depression was a risk factor for incident IBD (RR, 1.48; 95% CI, 1.33-1.64) ( Figure 3 , Table 2 ). No heterogeneity was noted (I 2 = 0.0%; P = .66).…”

Section: Resultsmentioning

confidence: 99%

“…The most commons reason for exclusion were that (1) the study was a systematic or narrative review and (2) depressive symptoms or depression were not assessed before diagnosis of IBD. Eight of 13 were prospective or retrospective cohort studies 10 , 18 , 31 , 33 , 37 , 38 , 40 and 5 were nested case-control studies. 19 , 32 , 35 , 36 , 39 Publication dates ranged from 2001 to 2022.…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies were conducted in Europe (United Kingdom [n = 5], Denmark [n = 2], Sweden), 10 , 19 , 31 , 34-37 , 39 3 in North America (Canada [n = 2], United States), 18 , 32 , 33 and 2 in Taiwan, Asia. 38 , 40 All studies considered incident IBD occurring after a diagnosis of depression with an average follow-up time ranging from 2.2 35 to 13 years. 18 Seven studies included 1 or more pertinent stratified analyses excluding patients diagnosed with IBD in proximity of previous depression ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“… 10 , 18 , 19 , 31 , 34 , 37 , 38 Other 5 studies were rated at moderate risk of bias ( Table 1 , Supplementary Table 1 ). 33 , 35 , 36 , 39 , 40 The article retrieved as a conference abstract was not assessed, 32 as critical appraisal of such studies is rather limited.…”

Section: Resultsmentioning

confidence: 99%

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

Piovani

Armuzzi

Bonovas

2023

Inflammatory Bowel Diseases

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Background Individuals with a history of depression/depressive symptoms are suspected to be at increased risk of incident inflammatory bowel diseases (IBDs). Methods We systematically searched MEDLINE/PubMed, Embase, and Scopus databases for longitudinal studies examining the association between depression/depressive symptoms and subsequent new-onset IBD (ie, Crohn’s disease and ulcerative colitis). We included studies in which the exposure was a confirmed diagnosis of depression/depressive symptoms measured through a validated scale. To limit concerns of diagnostic bias and reverse causality, and support temporality between exposure and outcomes, we synthesized estimates corresponding to the longest time lag reported. Two authors extracted study data independently and assessed each study’s risk of bias. Maximally adjusted relative risk (RR) estimates were synthesized using random- and fixed-effects models. Results Of 5307 records, 13 studies (8 cohort and 5 nested case-control studies; 9 million individuals) fulfilled the eligibility criteria. Depression was significantly associated with incident Crohn’s disease (RRrandom, 1.17; 95% confidence interval, 1.02-1.34; 7 studies, 17 676 cases) and ulcerative colitis (RRrandom, 1.21; 95% confidence interval, 1.10-1.33; 6 studies, 28 165 cases). The primary studies considered pertinent confounders. Several years, on average, separated exposure and outcomes. No evidence of important heterogeneity or publication bias was found. Summary estimates were at low risk of bias, and results were confirmed in multiple sensitivity analyses. No firm conclusions could be drawn regarding a dilution of the association over time. Conclusions Individuals with a history of depression may show small-to-moderate increased risk of IBD even when depression is diagnosed several years before new-onset IBD. Further epidemiological and mechanistic studies should clarify whether these associations are causal.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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

Piovani

Armuzzi

Bonovas

2023

Inflammatory Bowel Diseases

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“…These mechanisms may also play role in other brain disorders, including psychiatric manifestations. 89,90 This review summarizes current knowledge regarding the relationship between IBD and neurodegenerative diseases. Existing research to-date rely largely upon animal models or observational studies from population-based cohorts, of which conclusions drawn from the former may not be directly applicable to humans, and the latter may contain biases and confounders.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Bowel Disease and Neurodegenerative Diseases

et al. 2023

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A growing body of evidence has demonstrated an intricate association between inflammatory bowel disease (IBD) and neurodegenerative conditions, expanding beyond previous foci of comorbidities between IBD and mood disorders. These new discoveries stem from an improved understanding of the gut-microbiome-brain axis: specifically, the ability of the intestinal microbiota to modulate inflammation and regulate neuromodulatory compounds. Clinical retrospective studies incorporating large sample sizes and population-based cohorts have demonstrated and confirmed the relevance of IBD and chronic neurodegeneration in clinical medicine. In this review, we expound upon the current knowledge on the gut-microbiome-brain axis, highlighting several plausible mechanisms linking IBD with neurodegeneration. We also summarize the known associations between IBD with Parkinson disease, Alzheimer disease, vascular dementia and ischemic stroke, and multiple sclerosis in a clinical context. Finally, we discuss the implications of an improved understanding of the gut-microbiome-brain axis in preventing, diagnosing, and managing neurodegeneration among IBD and non-IBD patients.

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