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CLINICAL NEWS
Crohn Disease Risk in Women Elevated by
Depressive Symptoms
By Leo Robert | January 8, 2013
The presence of depressive symptoms in women increases the risk of Crohn disease, according to data
from the Nurses Health Study. Researchers in the Division of Gastroenterology, Massachusetts General
Hospital and Harvard Medical School, Boston, concluded that psychological factors might contribute to
the development of Crohn disease.
The were reported in the January 2013 issue of study results Clinical Gastroenterology and Hepatology.
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Ananthakrishnan and associates analyzed data from 152,461 women aged 29 to 72 years enrolled in the
Nurses Health Study I (a prospective cohort) and II. They used the Mental Health Index (MHI)-5, a
validated 5-item subscale of the 36-item Short-Form Health Survey, to assess self-reported depressive
symptoms, and they confirmed self-reported Crohn disease or ulcerative colitis through blinded record
review by 2 gastroenterologists. A diagnosis of Crohn disease or ulcerative colitis was assigned on the
basis of the typical clinical presentation for 4 weeks or longer and established typical findings on
endoscopic, histological, radiological, or surgical evaluation consistent with a diagnosis of Crohn
disease or ulcerative colitis.
Depressive symptoms were associated with a 2-fold increase in risk of Crohn disease. On the basis of
the recent MHI-5 administered within 4 years, a significant linear increase in the risk of Crohn disease
according to decreasing MHI-5 score was observed. The risk was increased in women with recent
depressive symptoms (MHI-5 scores lower than 52) compared with women with recent MHI-5 scores of
86 to 100. Baseline depressive symptoms also were associated with Crohn disease. Depressive
symptoms did not increase the risk of ulcerative colitis.
The authors noted that their findings lend support to a biopsychosocial model of inflammatory bowel
disease pathogenesis in which the risk of disease is influenced by psychosocial factors. They suggested
that preliminary animal and human studies show that managing depression through administration of
antidepressants or through improvement in coping mechanisms could reduce the risk of disease relapse.
References
1. Ananthakrishnan AN, Khalili H, Pan A, et al. Association between depressive symptoms and
incidence of Crohns disease and ulcerative colitis: results from the Nurses Health Study. Clin
2013;11:57-62. Gastroenterol Hepatol.
ConsultantLive.com. Vol. No. January 8, 2013
http://www.consultantlive.com/gastrointestinal-disorders/content/article/10162/2121584
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ConsultantLive.com. Vol. No. January 8, 2013
http://www.consultantlive.com/gastrointestinal-disorders/content/article/10162/2121584
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