Depression affected a quarter of people with inflammatory bowel disease (IBD) and was independently linked to an increase in disease activity, according to study results published in Neurogastroenterology and Motility.

Investigators conducted a cross-sectional study to determine how emotional processing biases would affect the development of depression in individuals with IBD.

Of the 120 outpatients with IBD who were asked to participate in the study, 68 patients had Crohn disease and 49 had ulcerative colitis; 35 of these patients had active disease and 26 had depression.

Depression was more frequently associated with being a woman, lacking social support, having active disease, taking corticosteroids (but not tumor necrosis factor α inhibitors), and expressing negative emotional recognition bias. Depression was also associated with a series of sociodemographic, IBD-related, and psychological factors, such as negative biases in emotional recognition; however, results from the multivariable analysis suggested that only lack of social support and greater disease activity were linked to depression. The use of causal step analysis revealed that the relationship between IBD activity and depression was partly mediated by emotional recognition bias, as the researchers had originally hypothesized.

The authors mentioned that “further research is required to investigate mechanisms underlying the development and maintenance of depression and, in particular, to test our hypotheses that that the association between disease activity/inflammation and depression might be mediated via emotional processing biases.”

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“Our findings raise the possibility that psychological interventions targeting emotional recognition biases among people with IBD, could be used to treat or even prevent depression in high risk individuals, such as those with active IBD, and thereby possibly improve medical as well as psychological outcomes,” concluded the investigators.

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Wilkinson B, Trick L, Knight A, et al. Factors associated with depression in people with inflammatory bowel disease: the relationship between active disease and biases in neurocognitive processing. Neurogastroenterol Motil. 2019;31(8):1-11.