Summary: A link between disease activity in those with inflammatory bowel disease and less positive biases in emotional regulation could explain a higher risk of depression in those with IBD.
Depression is common in people with inflammatory bowel disease (IBD), but the actual causes of depression in this group are unknown. In a Neurogastroenterology & Motility study, depression was linked with more severe IBD symptoms, and a less positive cognitive bias in emotional recognition (a reduced ability to recognize basic emotions in others) was involved in this association.
The results raise the possibility that psychological interventions targeting emotional recognition biases could be used to treat or even prevent depression in high-risk individuals with IBD.
“These findings are preliminary but suggest that negative cognitive biases associated with IBD activity may lead to the development of depression in people with IBD. Our results could indicate novel ways to treat or even prevent depression in people with IBD, though our findings require replication in prospective studies, which will allow us to draw stronger inferences on the causal association of cognitive biases with depression,” said senior author Chris Dickens, PhD, of the University of Exeter, in the UK.
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Factors associated with depression in people with inflammatory bowel disease: The relationship between active disease and biases in neurocognitive processing
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: (a) completed questionnaires to record: age, sex, social support, socioeconomic status, anxiety and depression (n = 104), (b) underwent assessments of biases in emotional recognition (n = 112), emotional memory and reinforcement learning (c) had recorded from clinical records: type of IBD, duration of IBD, IBD activity and (d) 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.
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