Rona Moss-Morris
Credit: King's College London
The clinical impact of therapeutic interventions on mood may extend beyond mental health, according to the results of a recent systematic review and meta-analysis published in . Electronic biomedicine.1
The results showed that treatments that address mood outcomes also showed beneficial effects on common inflammation and inflammatory bowel disease (IBD)-specific biomarkers, and that The greater impact of psychological interventions to highlight their effects on disease outcomes has been elucidated in greater detail.1
“Mood interventions hold great promise in the management of IBD in improving mental health, inflammation, and disease outcomes. It provides a holistic approach and has the potential to reduce illness and healthcare costs,” said Rona Moss-Morris, head of psychology at King's College London, in a press release.2
Although psychological stress has been associated with increased inflammatory activity, the interrelationships between different types of stressors, emotional attention, and inflammation are poorly understood. Speculation about the potential neurobiological mechanisms underlying these interactions has led many to hypothesize a therapeutic role for mood interventions to reduce inflammation, particularly in conditions such as IBD. It has turned into.3
The researchers set out to address several research questions regarding the interaction between mood and inflammation, focusing specifically on whether interventions targeting mood outcomes affect inflammation levels in IBD. . Additionally, we investigated whether type of intervention, magnitude of effect on mood, and disease subtype moderated effects on inflammatory markers.1
The researchers began by conducting 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. I did. Eligible studies included adults with IBD and tested mood interventions as a primary or secondary income. , evaluated inflammatory outcomes before and after intervention.1
The initial search yielded 21,101 articles, and removal of duplicates resulted in 15,631 original references. In addition, he identified 15,489 studies as ineligible and 142 studies were eligible for full text screening. A total of 36 eligible studies were identified, of which 28 were included in the final analysis.1
These studies involved 1789 participants and consisted of 20 studies testing psychological treatments, 3 studies testing antidepressants, and 5 studies testing exercise interventions.1
Researchers evaluated intervention type, mood as a primary or secondary outcome, impact on mood outcome, and IBD subtype as a moderator of treatment effect. The primary a priori effect size outcome of interest was the standardized mean difference (SMD) between the psychosocial intervention group and the post-intervention control group.1
Analysis showed that the intervention to treat mood significantly reduced the levels of inflammatory biomarkers compared to the control (SMD, -0.349; 95% confidence interval) [CI], -0.48 to -0.22. z = −5.44; P <.001), corresponding to an 18% reduction in inflammatory biomarkers. Fecal calprotectin levels after interventions to treat mood were also significantly lower compared to controls (SMD, -0.186; 95% CI, -0.34 to -0.03; z = -2.38; 95% CI, -0.34 ~ -0.03; P = .018), corresponding to a decrease 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; 95% CI, -0.47 to -0.10; P = .002), reflecting a 2.44 mg/dL reduction with the intervention to treat mood. Unlike inflammatory biomarkers and fecal calprotectin, researchers found significant heterogeneity (I2 = 36.3%; I2 = 36.3%; P = .073) and evidence of publication bias (Egger = −1.815; P = .013), but we noted that the effect size did not change significantly during the leave-one-out analysis.1
The interventions included in the review significantly improved mood outcomes (SMD, -0.501; 95% CI, -0.73 to -0.27; z = -4.47; 95% CI, -0.73 to -0.27; P <.001). Further analysis revealed that interventions with effect ≥0.2 had a significantly greater post-intervention effect on inflammation (SMD, -0.376; 95% CI, -0.61 to -0.15; P = .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; P <.001).1
Of note, the effect size was larger for the psychotherapy intervention (SMD, -0.455; 95% CI, -0.61 to -0.30; 95% CI, -0.61 to -0.30; P <.001) when compared to exercise (SMD, -0.047; 95% CI, -0.25 to 0.15; P = .583) and antidepressants (SMD, -0.236; 95% CI, -0.56 to -0.09; P = .154).1
“Our research suggests that improved mood may influence physical disease through modulation of the immune system,” said Valeria Mondelli, clinical professor of psychoneuroimmunology at King's College London. he concluded.2 “This adds to a growing body of research demonstrating the role of inflammation in mental health, and suggests that interventions that work to improve mood may have a direct physical impact on levels of inflammation. However, further research is needed to understand the exact mechanisms of IBD. ”
References:
- Seaton N, Hudson J, Harding S Do other mood interventions improve inflammatory biomarkers in inflammatory bowel disease?: a systematic review and meta-analysis. electronic biomedicine. doi:10.1016/j.ebiom.2023.104910.
- King's College London. Mood interventions may reduce inflammation in Crohn's disease and colitis. Yurek Alert! January 24, 2024. Accessed January 24, 2024. https://www.eurekalert.org/news-releases/1032004
- Maydych V. Interactions between stress, inflammation, and emotional attention: Associations with depression. front neuroscience. doi:10.3389/fnins.2019.00384
