Factors associated with depression in people with inflammatory bowel disease: the relationship between active disease and biases in neurocognitive processing
Wilkinson, B; Trick, L; Knight, A; et al.Valton, V; Goodhand, J; Kennedy, N; Heerasing, N; Ahmad, T; Bland, A; Elliott, R; Rosier, J; Dickens, C
Date: 2 July 2019
Journal
Neurogastroenterology and Motility
Publisher
Wiley
Publisher DOI
Abstract
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 ...
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: i) completed
questionnaires to record: age, sex, social support, socioeconomic status, anxiety and
depression (n=104) , ii) underwent assessments of biases in emotional recognition (n=112),
emotional memory and reinforcement learning iii) had recorded from clinical records: type of
IBD, duration of IBD, IBD activity and iv) 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.
Institute of Health Research
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