Study Links Depression to Increased IBD Activity, Faulty Emotional Recognition

Study Links Depression to Increased IBD Activity, Faulty Emotional Recognition
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Depression is linked to increased disease activity and fewer positive emotional recognition biases in people with inflammatory bowel disease (IBD), a study suggests.

The study, “Factors associated with depression in people with inflammatory bowel disease: The relationship between active disease and biases in neurocognitive processing,” was published in the journal Neurogastroenterology & Motility.

Depression is common in people with IBD, but it’s not clear what factors actually cause or make a person more likely to develop depression. Specifically, depression affects 14% to 27 % of people with IBD, a prevalence two to three times higher than that of the general population.

To address this question, researchers recruited 120 people with IBD (68 with Crohn’s disease, 49 with ulcerative colitis and three with unclassified IBD). The participants were assessed with a number of tests, such as the Emotional Recognition Task (ERT), which determines one’s ability to recognize basic emotions (happy, sad, angry, and fearful) from images of people’s eyes. Researchers also collected data on disease state, duration and type, as well as relevant demographic information.

In the cohort, 26 people (22%) had depression. They were more likely to be female and to have active disease. They also tended to have poor social support structures.

People in the cohort who had depression were also more likely to be taking corticosteroids, but whether a person was taking TNF-alpha inhibitors was not associated with depression.

Additionally, participants with depression tended to have fewer positive emotional recognition biases — they weren’t as good at correctly identifying other people’s emotions, for example, thinking a surprised face looks angry.

Interestingly, in statistical models, emotional recognition bias was found to mediate the effect of disease activity on depression — the likelihood of a participant being depressed was more accurately predicted when both emotional recognition bias and disease activity were accounted for, suggesting that these two factors are interconnected in how they mediate a person with IBD developing depression.

These results suggest that psychological interventions targeted at improving emotional recognition bias in people with IBD could be an effective way to prevent and treat depression in this population.

“Future prospective studies are required to confirm the effects of emotional processing biases in depression and allow stronger causal inferences to be drawn,” the researchers concluded.

In a press release, Chris Dickens, PhD, professor at the University of Exeter and co-author of the study, said: “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.”

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