Department of Psychology, Sapienza University of Rome, Italy.
Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Italy.
J Psychosom Res. 2024 Feb;177:111592. doi: 10.1016/j.jpsychores.2024.111592. Epub 2024 Jan 10.
Inflammatory bowel disease (IBD) is often comorbid with mood disorders and depressive symptoms. The aetiology of depressive symptoms in IBD, however, remains largely unknown. Consistent with the inflammatory hypothesis of depression, the aim of this study was to explore the prospective associations between inflammatory biomarkers and depressive symptoms in a cohort of IBD patients with and without a previous clinical diagnosis of mood disorder.
IBD clinical activity was determined using the Harvey-Bradshaw Index for CD and the Partial Mayo score for UC; serum C-reactive protein (CRP) and faecal calprotectin (fCAL) were used as biomarkers of systemic and intestinal inflammation, respectively. Participants were administered the Hospital Anxiety and Depression Scale-depression (HADS-D) at baseline and 1-year follow-up.
Eighty-four participants (50 ± 16 years; 75% UC and 25% CD) were included in the main analyses. Longitudinal moderated regression models showed that baseline CRP significantly predicted follow-up HADS-D scores among individuals with a previous mood disorder diagnosis (β = 0.843, p < .001), but not among individuals without (β = -0.013, p = .896), after controlling for baseline HADS-D scores, body mass index, IBD phenotype, sex, and perceived stress. Likely due to lower power, results on FCAL (n = 31) were not statistically significant.
This study suggests that IBD patients with previous diagnosis of mood disorder may be at higher risk of inflammation-related depressive symptoms.
炎症性肠病（IBD）常伴有情绪障碍和抑郁症状。然而，IBD 中抑郁症状的病因在很大程度上仍不清楚。与抑郁的炎症假说一致，本研究旨在探索炎症生物标志物与 IBD 患者（包括有和无先前心境障碍临床诊断）中抑郁症状的前瞻性关联。
采用 CD 的 Harvey-Bradshaw 指数和 UC 的部分 Mayo 评分来确定 IBD 临床活动；使用血清 C 反应蛋白（CRP）和粪便钙卫蛋白（fCAL）分别作为全身和肠道炎症的生物标志物。在基线和 1 年随访时，参与者接受了医院焦虑和抑郁量表抑郁（HADS-D）评估。
84 名参与者（50±16 岁；75%UC 和 25%CD）被纳入主要分析。纵向调节回归模型显示，在控制基线 HADS-D 评分、体重指数、IBD 表型、性别和感知压力后，基线 CRP 显著预测了有先前心境障碍诊断的个体的随访 HADS-D 评分（β=0.843，p<0.001），但对无先前心境障碍诊断的个体无显著预测作用（β=-0.013，p=0.896）。可能由于效力较低，FCAL（n=31）的结果无统计学意义。
本研究表明，有先前心境障碍诊断的 IBD 患者可能面临更高的与炎症相关的抑郁症状风险。
