Cognitive Behavioral Therapy Helps Depression And Inflammation In Inflammatory Bowel Disease

December 6, 2013 · Posted in Potential Treatments · Comment 

Teen girl with bellyacheCognitive behavioral therapy may improve both depression symptoms and inflammatory bowel disease. At a symposium on early-onset depression at the 2013 meeting of the American Academy of Child and Adolescent Psychiatry, Eva Szigethy of the University of Pittsburg discussed depression in inflammatory bowel disease (IBD), i.e. Crohn’s disease or ulcerative colitis. Depression and bipolar disorder are often associated with elevated inflammatory markers, such as IL-1b, IL-2, IL-6, INF gamma, TNF alpha, and CRP (C-reactive protein). This kind of inflammation can cause symptoms like decreased appetite, fatigue, anhedonia (loss of pleasure in activities one once enjoyed), and motor slowing.

In children with IBD randomized to cognitive behavioral therapy or just routine supportive care, the somatic symptoms of those receiving cognitive behavioral therapy improved, as did their IBD.

Other treatments may also target both depression and inflammation. Szigethy noted that there is some evidence that the TNF alpha–inhibiting anti-inflammatory drug infliximab has some antidepressant effects in those with high CRP and in patients with the autoimmune condition psoriasis. She indicated that the antidepressant bupropion decreases depression and inflammation in IBD and that bupropion has anti–TNF alpha effects (at least in animals).

Currently levels of inflammation are measured with blood drawn from a vein, but new techniques may be more child-friendly.  These include measuring inflammatory markers in hair (which reflects levels over the previous two weeks), saliva, or with a drop of blood from a pinprick (as used by researcher Ben Goldstein).