Influences and Impact of Anxiety and Depression in the Setting of Inflammatory Bowel Disease

Navabi, Seyedehsan; Gorrepati, Venkata Subhash; Yadav, Sanjay Kumar; Chintanaboina, Jaykrishna; Maher, Sarah; Demuth, Peter; Stern, Benjamin; Stuart, August; Tinsley, Andrew; Clarke, Kofi; Williams, Emmanuelle; Coates, Matthew

doi:10.1093/ibd/izy143

Cited by 103 publications

(103 citation statements)

References 45 publications

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“…Despite conflicting data in prior studies, there is a growing body of evidence that inflammatory bowel disease is associated with depression-related symptoms [22][23][24][25]. Our study supports a potential mechanistic relationship between CD and depression by showing not only increased relative clinical activity, endoscopic scoring, and histologic grading in depressed CD patients but also respective correlations of clinical, endoscopic, and histologic data with the depressive symptom scale.…”

Section: Discussionsupporting

confidence: 73%

“…First, it is of crosssectional design which cannot establish a causal link between depression and CD, despite the observed correlation of depression scores with activity parameters of CD. Second, gender disparity between the 2 groups may have confounding effects, though it remains controversial whether female gender is an independent risk factor for depression in CD [25,48]. Further gender-matched studies are needed to confirm our data.…”

Section: Discussionmentioning

confidence: 72%

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Crohn’s Disease Patients with Depression Exhibit Alterations in Monocyte/Macrophage Phenotype and Increased Proinflammatory Cytokine Production

Tang

Zhao

Lei

et al. 2019

Dig Dis

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Background: Crohn's disease (CD) is strongly associated with depression, but the mechanisms underlying this relationship are not fully understood. Recently, neuroimmunological studies have demonstrated that proinflammatory monocytes/macrophages play a key role in the pathogenesis of depression. The present study investigates monocyte/macrophage phenotypes and plasma cytokine levels in CD. Methods: Eligible CD patients were divided into nondepressed and depressed groups according to Hospital Anxiety and Depression Scale for depression (HADS-D). The Harvey-Bradshaw index (HBI), the Simple Endoscopic Score for Crohn's disease (SES-CD), and the Global Histological Disease Activity Score (GHAS) were compared between the 2 groups. Immunohistochemistry was performed to quantify the expression of CD68, inducible nitic oxide synthase (iNOS), and CD163 in colon mucosa. Enzyme-linked Immunosorbent Assay was used to detect plasma levels of M1 macrophage-secreted cytokines (tumor necrosis factor [TNF]-α, interleukin 6 [IL-6], IL-1β) and M2 cytokines (transforming growth factor [TGF]-β1, IL-10, C-C motif chemokine ligand 22, [CCL22]). Flow cytometry was utilized to determine peripheral blood monocyte subsets. Results: Depressed CD patients (n = 91) presented higher HBI, SES-CD, GHAS than the nondepressed patients (n = 42). Intermediate (CD14++CD16+) and nonclassical monocytes (CD14+CD16++) percentages, integrated optical density (IOD) of iNOS+ cells representing M1 macrophages, and plasma levels of TNF-α, IL-6, IL-1β were increased while classical monocyte (CD14++CD16-) percentage, IOD of CD163+ cells representing M2 macrophages, and IL-10 plasma levels were decreased in depressed versus nondepressed CD patients. Plasma levels of TNF-α, IL-6, IL-1β correlated with HADS-D scores. Conclusion: Monocytes subpopulation disequilibrium toward intermediate and nonclassic phenotypes and macrophage polarization toward M1 phenotype with increased proinflammatory cytokine release are more likely to be found in CD patients with depressive symptoms.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 72%

Crohn’s Disease Patients with Depression Exhibit Alterations in Monocyte/Macrophage Phenotype and Increased Proinflammatory Cytokine Production

Tang

Zhao

Lei

et al. 2019

Dig Dis

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“…Several disease-specific and generic tools have been developed to assess PROs in IBD patients: some are devoted to quality of life like the Inflammatory Bowel Disease Questionnaire (IBDQ) and its short version (SIBDQ) [23][24][25], while others permit to assess fatigue (Functional Assessment Chronic Illness Therapy-Fatigue FACIT-F) [26], work productivity [27][28][29], as well as depression and anxiety [30][31][32][33][34]. More recently, an IBD Distress Scale has been constructed to evaluate IBD-specific distress [35].…”

Section: Introductionmentioning

confidence: 99%

Protocol of a multicentric prospective cohort study for the VALIDation of the IBD-disk instrument for assessing disability in inflammatory bowel diseases: the VALIDate study

Berre¹,

Bourreille²,

Flamant³

et al. 2020

BMC Gastroenterol

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Background: Inflammatory Bowel Diseases (IBD) affect psychological, family, social and professional dimensions of patients' life, leading to disability which is essential to quantify as part of Patient-Reported Outcomes (PROs) newly included in the targets to reach in IBD patients. Up to now, the IBD-Disability Index (IBD-DI) was the only validated tool to assess disability, but it is not appropriate for use in clinical practice. The IBD Disk was developed, a shortened and self-administered tool, adapted from the IBD-DI, in order to give immediate representation of patient-reported disability. However, the IBD Disk has not been validated yet in clinical practice. The aims of the VALIDate study are to validate this tool in a large population of IBD patients and to compare it to the already validated IBD-DI. Methods: The VALIDate study is an ongoing multicentric prospective cohort study launched in April 2018 in 3 French University Hospitals (Nantes, Rennes, Angers), with an objective to reach a sample of 400 patients over a period inclusion of 6 months. Each patient will fill in the two questionnaires IBD Disk and IBD-DI at baseline, then between 3 and 12 months later, during a follow-up visit. Clinical and socio-demographic data will also be collected. During these two consultations, gastroenterologists and patients will evaluate disease activity thanks to a semiquantitative 4-grade scale, named respectively PGA (Physician Global Assessment) and PtGA (Patient Global Assessment). This cohort will allow to evaluate the validity of the IBD Disk with respect to the IBD-DI in order to generalize its use for clinical practice. Other psychometric criteria of the IBD Disk will also be analysed as its reliability or its discriminant capacity. Close attention will nonetheless be needed to minimize the number of lost to follow-up patients between baseline and follow-up. Discussion: The VALIDate study is the study designed to validate the IBD Disk, a visual tool easily useable in daily practice to assess disability in IBD patients. The results of this trial should enable the diffusion of this tool.

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“…There is mutual in uence for UC and mental disorders [7]. On one hand, the occurrence of mental disorders is affected by UC-related factors, such as disease activity, complicated conditions (active in ammation, nutrition, and surgical problems), complex extra-intestinal manifestations, and reduced quality of life [3,8,9]. Depression could be improved by treatment designated for UC [10].…”

Section: Introductionmentioning

confidence: 99%

Crosstalk of multi-omics reveals specific characteristics in active ulcerative colitis patients with depression and anxiety

Yuan¹,

Chen²,

Duan³

et al. 2020

Preprint

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Background:Ulcerative colitis (UC) patients have a high incidence of mental disorders. The microbiota-gut-brain axis dysfunction is considered as one important pathogenesis of mental diseases. At present, little is known about how gut microbiota interact with the host in UC patients with depression and anxiety.Results: This prospective observational study enrolled 240 Chinese patients in two cohorts: the discovery cohort, including 69 active UC patients, 49 non-inflammatory bowel disease (IBD) depression and anxiety patients, and 62 healthy people, and the replication cohort of 60 active UC patients. About half of active UC patients showed symptoms of depression or anxiety. Through 16s rRNA sequencing, it was found that these UC patients accompanied with depression and anxiety had lower fecal microbial abundance with more Sellimonas , Eubacterium ventriosum group , Enterococcus , and Peptoclostridium , but less Prevotella_9 , Erysipelotrichaceae UCG_003 , Collinsella , and Dorea , compared with non-depressed/ anxious UC patients. Serum metabolome and proteome analysed using liquid chromatography/ mass spectrometry showed significantly increased glycochenodeoxycholate, stearoyllysophosphatidylcholine, and glyceryl stearates, while decreased 2'-deoxy-D-ribose and a set of immunoglobulin protein in the serum of UC patients with depression and anxiety. Through integration of multiple statistical analyses and multi-omics correlation analyses, we revealed a highly connected and comprehensive network, centring on Prevotella_9 and 1-stearoyl-sn-glycerol, composed of these bacteria, metabolites and proteins associated with UC-specific depression and anxiety.Conclusion: This study has identified a highly connected multi-omics network, composed of a set of gut microbiota, serum metabolites and proteins, specifically related to depression and anxiety in active UC. This network might influence host's mental state through mediating the effect of gut inflammation on synapse pruning in the central nervous system.

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Influences and Impact of Anxiety and Depression in the Setting of Inflammatory Bowel Disease

Cited by 103 publications

References 45 publications

Crohn’s Disease Patients with Depression Exhibit Alterations in Monocyte/Macrophage Phenotype and Increased Proinflammatory Cytokine Production

Crohn’s Disease Patients with Depression Exhibit Alterations in Monocyte/Macrophage Phenotype and Increased Proinflammatory Cytokine Production

Protocol of a multicentric prospective cohort study for the VALIDation of the IBD-disk instrument for assessing disability in inflammatory bowel diseases: the VALIDate study

Crosstalk of multi-omics reveals specific characteristics in active ulcerative colitis patients with depression and anxiety

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