Mood disorder therapy reduced inflammatory markers in patients with colitis
A systematic review and meta-analysis of 28 studies found that mood disorder therapy has a positive effect on overall inflammation and levels of the biomarkers of inflammatory bowel disease - fecal calprotectin and C-reactive protein. And, as the researchers note in a paper published in the journal eBioMedicine, the magnitude of the effect was greater with psychotherapeutic interventions compared to exercise or antidepressants.
Inflammatory bowel diseases include Crohn's disease and nonspecific ulcerative colitis, in which chronic autoimmune inflammation of the gastrointestinal organs is observed. These diseases are mostly treated with immunosuppression and in severe cases surgically. However, along with somatic symptoms, inflammatory bowel disease leads to a significantly increased risk of developing mental disorders, with rates of depression ranging from 25.3 to 38.9 percent and anxiety ranging from 32.1 to 57.6 percent.
A recent meta-analysis demonstrated that depression and anxiety predict poorer clinical outcomes, including increased frequency of exacerbations, hospitalization, emergency department visits, intensification of therapy, and surgery. In a subset of patients, the presence of a common psychiatric disorder worsened prognosis regardless of baseline disease activity.
Based on previous meta-analyses in which psychosocial interventions reduced inflammation and levels of pro-inflammatory cytokines in the blood, a group of scientists led by Natasha Seaton (Natasha Seaton) from King's College London conducted their systematic review and meta-analysis of randomized controlled trials that examined the effect of mood disorder therapy on the activity of inflammatory bowel disease. The analysis included 28 trials involving 1,789 participants.
The primary analysis showed that mood interventions (psychotherapy, antidepressants, exercise) significantly reduced levels of inflammatory biomarkers compared to controls - on average, levels were reduced by 18 percent (p < 0.001). A meta-analysis of 17 studies showed that fecal calprotectin levels were significantly lower with therapeutic interventions for mood disorders (p = 0.018). On average, its level fell by 91 micrograms per gram.
C-reactive protein levels were assessed in 16 studies and also decreased with mood disorder therapy (p = 0.002), by an average of 2.44 milligrams per deciliter. Notably, psychological therapies had a significant effect on inflammatory biomarkers (p < 0.001), while antidepressants (p = 0.154) and exercise (p = 0.583) were not significant.
Researchers believe that their study results may provide a basis for evidence-based use of psychotherapy for mood disorders in people with inflammatory bowel disease as an adjunctive treatment for the underlying disease. However, the biological and behavioral mechanisms of the observed effect remain to be elucidated.