Zhang B, et al. J Gastroenterol Hepatol.2022;doi:10.1111/jgh.15855.
The authors report no relevant financial disclosures.
Patients with inflammatory bowel disease were nine times more likely to develop depression, and their unaffected siblings twice as likely to develop depression, according to a study in the Journal of Gastroenterology and Hepatology.
In addition, researchers found that patients with depression were twice as likely to develop IBD, and their siblings without depression were also at heightened risk for developing IBD, compared with the general population.
“This research reveals a clinical overlap between both conditions and is the first study to investigate the two-way association between IBD and depression in siblings,” Bing Zhang, MD, assistant professor at the University of Southern California Keck School of Medicine and co-lead author of the study, said in a related press release.
Zhang and colleagues used demographic and claims data from the Taiwanese National Health Insurance Research Database to conduct parallel retrospective cohort analyses, which included patients with IBD or depression and their unaffected siblings. Researchers matched siblings to controls based on age, sex, enrollment time, monthly income and residence urbanization level and monitored all participants for up to 11 years for the development of depression or IBD.
For the first analysis, researchers enrolled 422 IBD patients, 537 unaffected siblings and 2,148 controls. After adjusting for confounders, researchers observed that IBD patients were nine times more likely to develop depression compared with controls (OR = 9.43; 95% CI, 6.43-13.81), and their siblings were almost twice as likely (OR = 1.82; 95% CI, 1.14-2.91).
For the second analysis, researchers enrolled 25,552 patients with depression, 26,147 unaffected siblings and 104,588 controls. During follow-up, 18 patients with depression developed IBD (OR =1.87; 95% CI, 1.07-3.26), as did 25 unaffected siblings (OR = 1.69; 95% CI, 1.05-2.69) and 58 controls.
“The finding that people with IBD are more prone to depression makes sense because
IBD causes constant gastrointestinal symptoms that can be very disruptive to a
patient’s life,” Zhang said in the release. “And the elevated depression risk among siblings of IBD patients may reflect caregiver fatigue if the siblings have a role in caring for the patient.”
However, according to the release, researchers were surprised by the heightened risk for IBD development in patients with depression, which Zhang said could be explained by the well-documented connection between the GI system and the central nervous system.
Various genetic, environmental and physiologic risk factors could also contribute to the pathology of IBD and depression, the researchers wrote.
“Increased awareness of such association and understanding of mutual influence may improve the diagnostic yield and management of IBD and psychiatric disorders among IBD patients leading to better clinical outcomes,” the authors concluded. “Further research on gut-brain axis is warranted to identify shared aspects of pathogenesis between the diseases, which may reveal novel therapeutic approaches leveraging the gut-brain axis.”