New research from King’s College London has revealed that mood interventions can ease inflammatory bowel disease symptoms.
The research has shown that interventions that improve mood can reduce the levels of inflammation of people with inflammatory bowel disease by 18%.
The team found that mood interventions, including psychological therapy, antidepressants, and exercise, eased IBD symptoms by reducing inflammatory biomarker levels – preventing an effective and low-cost alternative treatment.
Supported by the National Institute for Health and Care (NIHR) and Medical Research Council (MRC), the research ‘Do interventions for mood improve inflammatory biomarkers in inflammatory bowel disease?: A systematic review and meta-analysis,’ is published in EBioMedicine.
What is IBD?
IBD is a chronic autoimmune condition affecting over 500,000 people in the UK that causes inflammation of the digestive tract. The condition includes Crohn’s disease and ulcerative colitis.
The inflammation results in abdominal pain, diarrhoea, fatigue, incontinence, and other deliberating symptoms. As well as the physical symptoms, IBD can majorly impact mental health and well-being.
Studying inflammatory biomarkers
Inflammatory biomarkers can be found in the body to indicate types and areas of inflammation. The team analysed existing studies on the levels of the biomarkers C-reactive protein and faecal calprotectin, which are specific indicators of IBD. They also looked at a combined measure of other inflammatory biomarkers.
The review is the first to investigate the relationship between interventions aiming to treat mood and levels of inflammatory biomarkers in IBD. The findings show that IBD symptoms can be improved with interventions for mood.
Natasha Seaton, first author of the study and PhD student at King’s IoPPN, said: “IBD is a distressing condition, and current medication that reduces inflammation is expensive and can have side effects.
“Our study showed that interventions that treat mental health reduce levels of inflammation in the body. This indicates that mood interventions could be a valuable tool in our approach to help those with IBD.”
Establishing the impacts of mood interventions
The researchers conducted a search of more than 15,000 articles, looking for all randomised controlled trials in adults with IBD that measured levels of inflammatory biomarkers and tested a mood intervention.
The team reviewed and analysed data from 28 randomised controlled trials involving over 1,700 participants to find out whether interventions targeting mood outcomes impact inflammation levels in IBD.
Researchers found that psychological therapies such as CBT and mindfulness-based stress reduction had the best outcomes for easing IBD symptoms. Interventions which had a larger positive effect on mood had a greater effect on reducing inflammatory biomarkers.
The findings show that the mechanism underlying the effect of psychological and social interventions on inflammation in IBD could be improved mood.
Individual analyses on IBD-specific inflammatory markers revealed a small reduction in C-reactive protein and faecal calprotectin following mood intervention, suggesting that treatments which improve mood have beneficial effects on generic inflammation as well as disease-specific biomarkers.
Professor Valeria Mondelli, co-lead of the Psychosis and Mood Disorders Theme at the NIHR Maudsley BRC and Clinical Professor of Psychoneuroimmunology at King’s IoPPN, said: “Our study suggests that improvements in mood can influence physical diseases through modulation of the immune system.
“We know stress-related feelings can increase inflammation, and the findings suggest that by improving mood, we can reduce this type of inflammation. This adds to the growing body of research demonstrating the role of inflammation in mental health and suggests that interventions working to improve mood could also have direct physical effects on levels of inflammation. However, more research is needed to understand the exact mechanisms in IBD.”
Problems with IBD medications
Many IBD medications are costly and have negative side effects. For example, the anti-inflammatory medication infliximab costs about £12,584 per year.
Interventions that improve mood cost around £480 to £800 in the UK and provide an alternative treatment method to ease symptoms of IBD.
Professor Rona Moss-Morris, Digital Therapies theme lead at NIHR Maudsley BRC, Professor of Psychology as Applied to Medicine at King’s IoPPN, and senior author of the study, said: “Interventions for mood show considerable promise for the management of IBD in improving mental health, inflammation, and disease outcomes. Integrated mental health support alongside pharmacological treatments may offer a more holistic approach to IBD care, potentially leading to reduced disease and healthcare costs.
“Currently, medications taken to reduce inflammation are often very costly compared to psychological therapies in the UK. Given this, including psychological interventions, such as cost-effective digital interventions, within IBD management might reduce the need for anti-inflammatory medication, resulting in an overall cost benefit.”
