Mental health intervention reduces IBD inflammatory biomarkers by 18%

Mental health intervention reduces IBD inflammatory biomarkers by 18%

Rhona Moss-Morris

Image source: King’s College London

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The clinical impact of mood therapy interventions may extend beyond mental health, according to the results of a recent systematic review and meta-analysis published in the journal Mental Health. Electronic Biomedicine.1

Results showed that treatments targeting mood outcomes also showed beneficial effects on general inflammation and inflammatory bowel disease (IBD)-specific biomarkers, further detailing the role of psychological interventions in enhancing effects on biomarkers and objective disease outcomes. Greater impact.1

“Emotional interventions for IBD management show great promise in improving mental health, inflammation, and disease outcomes. Integrated mental health supports and pharmacological treatments may provide a more comprehensive approach to IBD care, potentially reducing illness and health care costs,” Rona Moss-Morris, chair of the psychology department at King’s College London, said in a press release.2

Psychological stress has previously been linked to increased inflammatory activity, but the interrelationships between different types of stressors, emotional attention, and inflammation were unclear. Speculation about the underlying neurobiological mechanisms underlying these interactions has led many to speculate on the therapeutic role of mood interventions in reducing inflammation, particularly in conditions such as inflammatory bowel disease.3

The researchers set out to address several research questions about the interaction between mood and inflammation, specifically examining whether interventions targeting mood outcomes could affect inflammation levels in IBD. Additionally, they explored whether the type of intervention, the size of its effect on mood, and disease subtype moderated the effects on inflammatory markers.1

The researchers first conducted a systematic literature search for relevant randomized controlled trials from 1947 to October 2023 using MEDLINE, EMBASE, PsycINFO, Global Health, and Web of Science databases. Eligible studies involved adults with IBD, tested mood interventions as primary or secondary, and assessed inflammatory outcomes before and after the intervention.1

The initial search yielded 21,101 articles, and removal of duplicates yielded 15,631 original references. A further 15,489 studies were deemed ineligible, leaving 142 studies requiring full-text screening. A total of 36 eligible studies were identified, of which 28 were included in the final analysis.1

The studies, which included 1,789 participants, included 20 studies testing psychotherapy, 3 studies testing antidepressant medication, and 5 studies testing exercise interventions.1

Researchers assessed intervention type, mood as primary or secondary outcome, impact on mood outcomes, and IBD subtype as moderators of treatment efficacy. The main a priori effect size outcome of interest was the standardized mean difference (SMD) between the psychosocial intervention and control groups at post-intervention.1

After analysis, the intervention to treat mood significantly reduced levels of inflammatory biomarkers compared with the control group (SMD, -0.349; 95% confidence interval [CI]-0.48 to -0.22; z = -5.44; phosphorus <.001), equivalent to an 18% reduction in inflammatory biomarkers. Fecal calprotectin levels were also significantly reduced after the intervention to treat mood compared with the control group (SMD, -0.186; 95% CI, -0.34 to -0.03; z = -2.38; phosphorus = .018), equivalent to a reduction of 91 µg/g.1

A small but significant effect was also observed for C-reactive protein (SMD, -0.289; 95% CI, -0.47 to -0.10; z = -3.06; phosphorus = .002), reflecting a reduction of 2.44 mg/dL following the intervention to treat mood. Unlike inflammatory biomarkers and fecal calprotectin, the researchers called attention to significant heterogeneity (I = 36.3%; phosphorus = .073) and evidence of publication bias (Egger = -1.815; phosphorus = .013), but noted no significant change in effect size during the leave-one-out analysis.1

Interventions included in the review significantly improved mood outcomes (SMD, -0.501; 95% CI, -0.73 to -0.27; z = -4.47; phosphorus <.001). Further analysis showed that interventions with effect sizes ≥0.2 showed significantly greater post-intervention effects on inflammation (SMD, -0.376; 95% CI, -0.61 to -0.15; phosphorus = .003), and interventions that had at least a small effect on mood had a moderate effect on inflammation (SMD, 0.480; 95% CI, -0.67 to -0.29; phosphorus <.001).1

Notably, the effect size was larger for the psychotherapy intervention (SMD, -0.455; 95% CI, -0.61 to -0.30; phosphorus <.001) compared with exercise (SMD, -0.047; 95% CI, -0.25 to 0.15; phosphorus = .583) and antidepressants (SMD, -0.236; 95% CI, -0.56 to -0.09; phosphorus = .154).1

“Our study shows that improved mood can influence physical disease by modulating the immune system,” concludes Valeria Mondry, clinical professor of psychoneuroimmunology at King’s College London.2 “A growing body of research demonstrates the role of inflammation in mental health, adding to evidence that interventions that improve mood may also have a direct physical impact on inflammation levels. However, more research is needed to understand the exact mechanisms of IBD. “

refer to:

  1. Seaton N, Hudson J, Harding S, et al. Can mood interventions improve inflammatory biomarkers in inflammatory bowel disease? : Systematic review and meta-analysis. electronic biomedicine. doi:10.1016/j.ebiom.2023.104910.
  2. King’s College London. Mood interventions can reduce inflammation in Crohn’s disease and colitis. Ulric alert! January 24, 2024. Accessed: January 24, 2024. https://www.eurekalert.org/news-releases/1032004
  3. Maydych V. Interactions between stress, inflammation, and emotional attention: Relevance to depression. Frontiers of Neuroscience. doi:10.3389/fnins.2019.00384

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