Cognitive-affective symptoms of depression linked to exacerbated Crohn’s disease
Significant associations were observed between cognitive-affective depressive symptoms and risk for exacerbation of Crohn’s disease in a recent study published in The American Journal of Gastroenterology. Depressive symptoms also were associated with risk for hospitalization in these patients.
“Depression, defined in our study as negativity to the self and the future, is a risk factor for increased Crohn’s disease activity,” Lawrence S. Gaines, PhD, associate professor in the departments of psychiatry and medicine at Vanderbilt University, told Healio Gastroenterology. “These depression-related thought processes may lead to changes in self-care, such as not taking medication or smoking.”
Lawrence S. Gaines
Gaines and colleagues evaluated 2,144 adults with a self-reported diagnosis of Crohn’s disease who were volunteers in CCFA Partners, an internet-based cohort study sponsored by the Crohn’s and Colitis Foundation of America. Participants completed a survey to report data on their demographics, disease status and affective-cognitive depression at baseline, including the NIH PROMIS depression four-item short form questionnaire, and the Short Crohn’s Disease Activity Index (SCDAI), which they also completed at 12 months.
Adjusting for confounders, the researchers then performed linear and logistic regression analyses to assess whether Crohn’s disease status at 1 year was associated with the measure of depression at baseline.
They observed significant associations between depression t-scores and subsequent increases in SCDAI scores (unadjusted and adjusted analyses, P < .001). Moreover, the association was curved, with a shallower slope for lower levels of depression.
After adjusting for covariates, they found a 10-point increase in depression t-scores from 55 to 65 was associated with an 18.6-point increase in SCDAI (95% CI, 11.5-25.6), while a 10-point increase in depression t-scores from 45 to 55 was associated with a 6.9-point increase in SCDAI (95% CI, 2.4-11.4).
For SCDAI scores greater than 150, they found the odds ratios for 10-point increases in depression t-scores from 55 to 65 was 1.27 (95% CI; 1.01-1.6), and for increases from 65 to 75 the OR was 1.29 (95% CI, 0.97-1.72), both of which were larger than ORs for a change from 45 to 55.
Adjusted analyses also showed hospitalizations were significantly associated with depression t-scores (P = .03), with similar ORs for increases from 45 to 55, 55 to 65 and 65 to 75.
“People with Crohn’s disease should pay attention to their beliefs about themselves and the future before there are changes in inflammatory patterns,” Gaines said. “Mind–body interactions seem apparent in Crohn’s disease but further research is needed before we understand the Crohn’s–depression relationship.” – by Adam Leitenberger
Disclosure: The researchers report no relevant financial disclosures.