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Association between depressive symptoms and incidence of Crohn's disease and ulcerative colitis: results from the Nurses' Health Study.
Clin Gastroenterol Hepatol 2013; 11(1):57-62CG

Abstract

BACKGROUND & AIMS

Depression and psychosocial stress are believed to contribute to the pathogenesis of Crohn's disease (CD) and ulcerative colitis (UC). Although many mechanisms have been proposed to link these disorders, few prospective studies have examined the relationship between depressed mood and incidence of CD or UC.

METHODS

We analyzed data from 152,461 women (aged 29-72 years) enrolled since 1992-1993 in the Nurses' Health Study cohorts I and II. Self-reported depressive symptoms were assessed by using the Mental Health Index (MHI)-5, a validated 5-item subscale of the 36-item Short-Form health survey, which is designed to estimate psychological distress on the basis of scores that range from 0 to 100. Self-reported CD and UC were confirmed through blinded record review by 2 gastroenterologists. Cox proportional hazards models were used to associate recent (within 4 years) and baseline MHI-5 scores with risk for CD or UC, adjusting for other risk factors.

RESULTS

During 1,787,070 person-years of follow-up, we documented 170 cases of CD and 203 cases of UC. Compared with women with recent MHI-5 scores of 86-100, women with recent depressive symptoms (MHI-5 scores <52) had an increased risk of CD (multivariate-adjusted hazard ratio [HR], 2.39; 95% confidence interval [CI], 1.40-3.98; P trend = .001). Baseline depressive symptoms, assessed from the baseline MHI-5 score, were also associated with CD, although with a lower HR (1.62; 95% CI, 0.94-2.77). Recent (HR, 1.14; 95% CI, 0.68-1.92) and baseline depressive symptoms were not associated with increased risk of UC (HR, 1.07; 95% CI, 0.63-1.83).

CONCLUSIONS

On the basis of data from the Nurses' Health Study, depressive symptoms increase the risk for CD, but not UC, among women. Psychological factors might therefore contribute to development of CD. Further studies are needed to determine the mechanisms of this association.

Authors+Show Affiliations

Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA. aananthakrishnan@partners.org.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

22944733

Citation

Ananthakrishnan, Ashwin N., et al. "Association Between Depressive Symptoms and Incidence of Crohn's Disease and Ulcerative Colitis: Results From the Nurses' Health Study." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 11, no. 1, 2013, pp. 57-62.
Ananthakrishnan AN, Khalili H, Pan A, et al. Association between depressive symptoms and incidence of Crohn's disease and ulcerative colitis: results from the Nurses' Health Study. Clin Gastroenterol Hepatol. 2013;11(1):57-62.
Ananthakrishnan, A. N., Khalili, H., Pan, A., Higuchi, L. M., de Silva, P., Richter, J. M., ... Chan, A. T. (2013). Association between depressive symptoms and incidence of Crohn's disease and ulcerative colitis: results from the Nurses' Health Study. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 11(1), pp. 57-62. doi:10.1016/j.cgh.2012.08.032.
Ananthakrishnan AN, et al. Association Between Depressive Symptoms and Incidence of Crohn's Disease and Ulcerative Colitis: Results From the Nurses' Health Study. Clin Gastroenterol Hepatol. 2013;11(1):57-62. PubMed PMID: 22944733.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between depressive symptoms and incidence of Crohn's disease and ulcerative colitis: results from the Nurses' Health Study. AU - Ananthakrishnan,Ashwin N, AU - Khalili,Hamed, AU - Pan,An, AU - Higuchi,Leslie M, AU - de Silva,Punyanganie, AU - Richter,James M, AU - Fuchs,Charles S, AU - Chan,Andrew T, Y1 - 2012/08/31/ PY - 2012/08/08/received PY - 2012/08/20/accepted PY - 2012/9/5/entrez PY - 2012/9/5/pubmed PY - 2013/5/25/medline SP - 57 EP - 62 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 11 IS - 1 N2 - BACKGROUND & AIMS: Depression and psychosocial stress are believed to contribute to the pathogenesis of Crohn's disease (CD) and ulcerative colitis (UC). Although many mechanisms have been proposed to link these disorders, few prospective studies have examined the relationship between depressed mood and incidence of CD or UC. METHODS: We analyzed data from 152,461 women (aged 29-72 years) enrolled since 1992-1993 in the Nurses' Health Study cohorts I and II. Self-reported depressive symptoms were assessed by using the Mental Health Index (MHI)-5, a validated 5-item subscale of the 36-item Short-Form health survey, which is designed to estimate psychological distress on the basis of scores that range from 0 to 100. Self-reported CD and UC were confirmed through blinded record review by 2 gastroenterologists. Cox proportional hazards models were used to associate recent (within 4 years) and baseline MHI-5 scores with risk for CD or UC, adjusting for other risk factors. RESULTS: During 1,787,070 person-years of follow-up, we documented 170 cases of CD and 203 cases of UC. Compared with women with recent MHI-5 scores of 86-100, women with recent depressive symptoms (MHI-5 scores <52) had an increased risk of CD (multivariate-adjusted hazard ratio [HR], 2.39; 95% confidence interval [CI], 1.40-3.98; P trend = .001). Baseline depressive symptoms, assessed from the baseline MHI-5 score, were also associated with CD, although with a lower HR (1.62; 95% CI, 0.94-2.77). Recent (HR, 1.14; 95% CI, 0.68-1.92) and baseline depressive symptoms were not associated with increased risk of UC (HR, 1.07; 95% CI, 0.63-1.83). CONCLUSIONS: On the basis of data from the Nurses' Health Study, depressive symptoms increase the risk for CD, but not UC, among women. Psychological factors might therefore contribute to development of CD. Further studies are needed to determine the mechanisms of this association. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/22944733/Association_between_depressive_symptoms_and_incidence_of_Crohn's_disease_and_ulcerative_colitis:_results_from_the_Nurses'_Health_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(12)01029-4 DB - PRIME DP - Unbound Medicine ER -