Reduction of depressive symptoms among patients with inflammatory bowel disease and rheumatic diseases treated with biological therapy: a cross sectional study

Juta Zinkevičiūtė1*, Gabrielius Tomas Zdanys1, Robertas Strumila2, Dalia Miltinienė3, Edgaras Dlugauskas 2,

1Faculty of Medicine, Vilnius University, M. K. Čiurlionio 21, 03101 Vilnius, Lithuania

2Clinic of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Geležinio Vilko 29A, LT- 01112, Vilnius, Lithuania

3 Clinic of Rheumatology, Orthopaedics Traumatology and Reconstructive Surgery, Centre of Rheumatology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariškių str. 2, LT – 08661, Vilnius, Lithuania


Introduction. Previous studies suggest that one of the possible reasons of depression is the autoimmune inflammation that causes increased interleukins and cytokines levels and thus affects the mood and behavior.

Aims. To compare the depression and anxiety symptoms among the patients with chronic systemic diseases (inflammatory bowel diseases and rheumatic diseases) receiving biological therapy and patients receiving different medical treatment.

Methods. Quantitative cross-sectional study design was used. Instruments: Ulcerative colitis activity index, Crohn’s disease activity index, the Hospital anxiety and depression scale (HADS) and the Visual Analogue Scale (VAS). Patients diagnosed with active inflammatory bowel disease or rheumatic disease and not using antidepressants were included into study. Participants were divided into an experimental group (receiving biological therapy treatments) and a control group (receiving treatments as usual). 

Results. 132 patients’ data were analyzed. The disease activity index was not significantly different between the experimental group and the control group (9,42 vs 11,45, p>0,05). The mean scores of the Hospital anxiety and depression scale were significantly different between the both groups (7,96 vs 13,68, p< .001), which indicates less depression symptoms in the experimental group. The mean anxiety and depression subscales scores were also significantly lower in the experimental group (anxiety subscale – 5,46 vs 9,39, p< 0.001; depression subscale – 2,44 vs 3,91, p=0,001).

Conclusions. Participants treated with biological therapy experienced fewer depression symptoms than participants showing similar disease activity but receiving treatment as usual.

Keywords: Tumor necrosis factor – α inhibitor, IL-6 inhibitor, autoimmune depression, inflammatory bowel disease, rheumatic disease.