Depression in Crohn’s Disease Patients Linked in Study to Disease Flares and Hospitalizations

Depression in Crohn’s Disease Patients Linked in Study to Disease Flares and Hospitalizations

Crohn’s disease patients who suffer from depression are at an increased risk for exacerbation of their symptoms and hospitalization, according to a study in The American Journal of Gastroenterology. The findings add to evidence of a link between the conditions, and may prod further research into the mechanisms underlying the connection.

The study,Association Between Affective-Cognitive Symptoms of Depression and Exacerbation of Crohn’s Disease, led by Lawrence S. Gaines, assessed 2,144 adults who were part of CCFA Partners — a patient-powered, internet-based research network funded by the Crohn’s and Colitis Foundation of America.

Researchers measured a row of characteristics at the study’s start and again after 12 months. Participants were assessed using a number of surveys, including a four-item short-form depression questionnaire, and a form measuring the severity of Crohn’s disease called the Short Crohn’s Disease Activity Index (SCDAI). Information about participant demographics was also collected.

In analyzing a correlation between depression and disease activity, they found that the more severe the depressive symptoms, the worse the Crohn’s disease manifestations became. Adjusting the analyses for an array of factors – such as age, gender, ethnicity, sleep quality, smoking, as well as those disease and medication-related — researchers made sure that the result could not be explained by another variable, as the link between depression and disease activity remained.

Interestingly, the association was not linear, so that while low levels of depression were linked to a modest increase in Crohn’s symptoms, each step on the scale for more severely depressed individuals was linked to a leap in Crohn’s symptom exacerbation. In addition, the team noted that depression was associated with hospitalizations.

“Depression, defined in our study as negativity to the self and the future, is a risk factor for increased Crohn’s disease activity,” said Dr. Gaines, associate professor in the departments of psychiatry and medicine at Vanderbilt University, in a press release. “These depression-related thought processes may lead to changes in self-care, such as not taking medication or smoking.”

While suggesting that depression may be linked to a lifestyle that increases the risk of exacerbations, other issues might also be at play. Treatment with corticosteroids is a risk factor for depression, and recent studies have suggested that the gut bacterial flora might influence depression risk.

“Mind-body interactions seem apparent in Crohn’s disease but further research is needed before we understand the Crohn’s–depression relationship,” concluded Dr. Gaines.

3 comments

  1. Victor Pasqualicchio says:

    I was diagnosed with Crohn’s Disease in 1987 after 4 years of testing and hospitalizations. I was only 20 when I was diagnosed and had the first of five surgeries, a resection of a intestine right where the small meets the large. it is now almost 30 years later and I can say that depression is IF not the number one factor present when I am not feeling well. I have had every procedure there is, every test , every type of treatment and nothing plays a bigger role than my depression. My biggest problem is that we live in a world where most doctor semi or wholly dismiss depression when I end up in the hospital. An example is when I have bad Crohn’s symptoms that send me to the ER and the Doctor does Blood work and a CT scan and all come s back to me it looks good! I always have to be my advocate for myself for I know this illness quite well and I know what it can do and has done to my body. I will not leave if I feel bad. One time recently, I was literally kicked out of the ER only to come back 12 hours later and landed in the ICU. I call this illness the sneaky illness but if anyone is reading this, especially if you are a doctor, LISTEN!

    • Carolyn Lee says:

      OH MY GOSH, You’re Spot On!!
      diagnosis 1986…most Dr. then asked me what Crohn’s Disease was. let’s pray all of them have educated themselves by now.

      We all know our bodies by now and how it reacts. Only if those who “practice medicine” would be willing to listen when we seek the help we need medically and mentally.

      I had developed Sepsis by means of Crohn’s Disease so active it nearly killed me. The physician said I came through the hospital to seek out drugs. Fired him on the spot laying in my hospital bed thinking I was dying of cancer.

      Why are some Drs. so mean and ignorant at times, this almost caused my death at the age of 29.

    • Junie b says:

      My beautiful 34 year old daughter has had numerous operations since 15 due to crohnes now has a second stoma was given a letter due to terrible diarrhoea last week E.R.nine hours later ct scan blood tests nothing all clear..she has a great attitude to life with a 13 year old son..no depression she is a walking miracle loosing her partner during all this I am so proud of her…

Leave a Comment

Your email address will not be published. Required fields are marked *