Comparison of depression and anxiety in inflammatory bowel patients treated with anti-TNF or immune modulators

Year 2023, Volume: 40 Issue: 1, 47 - 51, 18.03.2023

Esra Çataltepe , Nergis Ekmen , Mehmet Cindoruk

Abstract

The aim of this study was to investigate patients diagnosed with inflammatory bowel disease (IBD), the effects of drug groups used in the treatment of inflammatory bowel disease on depression and anxiety. This study was a single-center prospective study involving 94 patients with inflammatory bowel disease, 51 of whom had ulcerative colitis (UC) and 43 had Crohn's disease (CD). Harvey-Bradshaw activity scores for CD and Mayo Clinic activation scores for UC were calculated. Depression and anxiety data were collected with the Beck Depression Inventory and Beck Anxiety Inventory. The mean age for UC and CD were 40.25 ± 14 and 38.9 ± 13.8 years, respectively. There was a positive correlation between disease activation and depression and anxiety levels in both IBD subgroups (p<0.05). All patients included in the study were compared in terms of depression and anxiety levels before and after treatment, and a statistically significant improvement was found with the remission of both ulcerative colitis and Crohn's disease (p<0.001). There was a significant difference in depression and anxiety levels before and after treatment according to treatment options (p<0.001). There is a positive relationship between the disease activation score and the level of depression and anxiety in IBD. Immunosuppressive and immunomodulatory drugs used in the treatment of IBD may also improve the parameters of depression and anxiety in this disease.

Keywords

ulcerative colitis, crohn disease, depression, anxiety, disease activation

References

• Katon W, Ciechanowski P. Impact of major depression on chronic medical illness. Journal of psychosomatic research. 2002.
• Mikocka-Walus AA, Turnbull DA, Moulding NT, Wilson IG, Andrews JM, Holtmann GJ. Controversies surrounding the comorbidity of depression and anxiety in inflammatory bowel disease patients: a literature review. Inflammatory bowel diseases. 2007;13(2):225-34.
• Hisli N. Beck depresyon envanterinin universite ogrencileri icin gecerliligi, guvenilirligi.(A reliability and validity study of Beck Depression Inventory in a university student sample). J Psychol. 1989;7:3-13.
• Aydemir Ö, Köroğlu E. Psikiyatride kullanılan klinik ölçekler. Hekimler Yayın Birliği, Ankara. 2000;5.
• Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. Journal of consulting and clinical psychology. 1988;56(6):893.
• Kurina LM, Goldacre MJ, Yeates D, Gill LE. Depression and anxiety in people with inflammatory bowel disease. Journal of Epidemiology and Community Health. 2001;55(10):716-20. doi: 10.1136/jech.55.10.716.
• Walker EA, Gelfand MD, Gelfand AN, Creed F, Katon WJ. The relationship of current psychiatric disorder to functional disability and distress in patients with inflammatory bowel disease. General hospital psychiatry. 1996;18(4):220-9.
• Mittermaier C, Dejaco C, Waldhoer T, Oefferlbauer-Ernst A, Miehsler W, Beier M, et al. Impact of depressive mood on relapse in patients with inflammatory bowel disease: a prospective 18-month follow-up study. Psychosomatic medicine. 2004;66(1):79-84.
• Minderhoud IM, Samsom M, Oldenburg B. Crohn’s disease, fatigue, and infliximab: is there a role for cytokines in the pathogenesis of fatigue? World journal of gastroenterology: WJG. 2007;13(14):2089.
• Guloksuz S, Wichers M, Kenis G, Russel MG, Wauters A, Verkerk R, et al. Depressive symptoms in Crohn's disease: relationship with immune activation and tryptophan availability. PLoS One. 2013;8(3):e60435.
• Ertenli I, Ozer S, Kiraz S, Apras S, Akdogan A, Karadag O, et al. Infliximab, a TNF-alpha antagonist treatment in patients with ankylosing spondylitis: the impact on depression, anxiety and quality of life level. Rheumatology international. 2012;32(2):323-30.
• Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosomatic medicine. 2009;71(2):171-86.
• Raison CL, Rutherford RE, Woolwine BJ, Shuo C, Schettler P, Drake DF, et al. A randomized controlled trial of the tumor necrosis factor antagonist infliximab for treatment-resistant depression: the role of baseline inflammatory biomarkers. JAMA psychiatry. 2013;70(1):31-41.