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The impact of major depressive disorder on the short‐ and long‐term outcome of Crohn's disease treatment with infliximab
Open accessAbstract
Summary: Background: Major depressive disorder is the most common psychiatric diagnosis in Crohn's disease. In other chronic diseases, evidence suggests that depression influences the course of the disease. Strong evidence of such a mediating role of major depressive disorder in Crohn's disease has never been found. Aim: To assess the relationship between major depressive disorder and outcome of treatment of luminal Crohn's disease with infliximab. Methods: In this prospective study, 100 consecutive unselected patients underwent assessment of psychosocial, demographical disease‐related biological and clinical parameters at baseline and at 4 weeks after infliximab. Major depressive disorder was diagnosed using the Patient Health Questionnaire. Subsequently, the patients were followed up clinically until the next flare or during 9 months. Results: The Crohn's disease responded in 75% of the patients, and remission was achieved in 60%. The presence of major depressive disorder at baseline predicted a lower remission rate (OR = 0.166, 95% CI = 0.049–0.567, P = 0.004). At follow‐up, 88% of the patients needed retreatment. At univariate regression analysis, major depressive disorder significantly decreased time to retreatment (P = 0.001). Multivariate Cox regression confirmed major depressive disorder as an independent determinant of active disease both at baseline and at re‐evaluation (hazard ratio = 2.271, 95% CI: 1.36–3.79, P = 0.002). Conclusion: Major depressive disorder is a risk factor for failure to achieve remission with infliximab and for earlier retreatment in patients with active luminal Crohn's disease. Assessment and management of major depressive disorder should be part of the clinical approach to patients with Crohn's disease.
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“whereas only 43% of patients in the placebo group experienced clinically significant improvements in fatigue at Week 12, 58% of those in the etanercept group experienced such improvements”
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ResultMood swings in patients with Crohn's disease: incidence and associated factors
de Lima, F. D. V., Ribeiro, T. C. D. R., Chebli, L. A., Pace, F. H. D. L., Chaves, L. D. D. M., Ribeiro, M. S., & Chebli, J. M. F. (2012) · Revista da Associação Médica Brasileira (English Edition) · doi:10.1016/s2255-4823(12)70233-3 · Cited by 9
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BackgroundOscilação do humor em pacientes com doença de Crohn: incidência e fatores associados
de Lima, F. D. V., Ribeiro, T. C. D. R., Chebli, L. A., Pace, F. H. D. L., Chaves, L. D. D. M., Ribeiro, M. S., & Chebli, J. M. F. (2012) · Revista da Associação Médica Brasileira · doi:10.1590/s0104-42302012000400021 · Cited by 12
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“On the other hand, being affected by major depressive disorder is a negative predictor of clinical remission after IFX treatment [141].”
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“[10–13] Addressing the psychiatric comorbidities in IBD is critical as it leads to improved QoL and a favourable overall treatment outcome.”
Li, Y. O., Bernstein, C. N., Xu, W., & Hu, P. (2022) · Journal of Translational Medicine · doi:10.1186/s12967-022-03242-9 · Cited by 7
Hoogkamer, A. B., Brooks, A. J., Rowse, G., & Lobo, A. (2020) · Frontline Gastroenterology · doi:10.1136/flgastro-2019-101353 · Cited by 11
“42 Targeting these at-risk patients, before they develop psychological morbidity, would help clinicians deliver the most effective care as well as avoiding complications encountered from lack of adherence to medication.”
Does Reverse Causality Underlie the Temporal Relationship Between Depression and Crohn’s Disease?
Gaines, L. S., Slaughter, J. C., Schwartz, D. A., Beaulieu, D. B., Horst, S., Dalal, R. L., Scoville, E., Sandler, R. S., & Kappelman, M. D. (2019) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izz123 · Cited by 11
Wall, C. L., McCombie, A., Gearry, R. B., & Day, A. S. (2019) · Inflammatory Intestinal Diseases · doi:10.1159/000497323 · Cited by 7
Donahue, J. M., Hormes, J. M., Gordis, E. B., & Anderson, D. A. (2019) · Clinical Case Studies · doi:10.1177/1534650119845503 · Cited by 7
Hu, Y., Zhu, P., Deng, J., Yu, Y., Chen, Q., Wu, H., Zha, Z., Wang, H., & Ma, Y. (2025) · ACS Nano · doi:10.1021/acsnano.5c03843 · Cited by 8
Bruinooge, A., Liu, Q., Tian, Y., Jiang, W., Li, Y., Xu, W., Bernstein, C. N., & Hu, P. (2021) · Genomics · doi:10.1016/j.ygeno.2021.02.001 · Cited by 7
Minaiyan, M., Hajhashemi, V., Rabbani, M., Fattahian, E., & Mahzouni, P. (2014) · International Scholarly Research Notices · doi:10.1155/2014/359841 · Cited by 5
“The presence of clinical depression in patients with IBDmay influence disease activity, aggravate disease symptoms, impact on the evolution of the disease, andmay affect their response to standard treatment for IBD [11].”
BackgroundCould stress play a role in IBD?
Levenstein, S. (2008) · Inflammatory Bowel Diseases · doi:10.1002/ibd.20663 · Cited by 8
Cong, G., Ao, D., Mei, X., Zhao, R., Guo, R., Ke, X., Ma, Z., Gu, L., & Zheng, H. (2026) · International Immunopharmacology · doi:10.1016/j.intimp.2026.116237 · Cited by 4
Popa, D. E., Pîrlog, M. C., Alexandru, D., & Gheonea, D.-I. (2022) · PubMed Central · doi:10.12865/chsj.48.01.01 · Cited by 4
“Initially IBD were considered psychosomatic diseases, lately they were viewed as organic diseases [17] while currently it is stated that psychological disturbances can augment IBD severity [18,19], in-creasing the risk of flare-ups [20,21].”
BackgroundPsychiatric Comorbidities in Inflammatory Bowel Disease
Larion, S., DeCecchis, D., Arnold, J. M., Vanslyke, J. A., & Tavakoli, H. R. (2015) · Current Psychiatry Reviews · doi:10.2174/157340051102150502083333 · Cited by 3
Outcomes of surgery for inflammatory bowel disease among patients with psychiatric disorders
Ng, A. P., Porter, G. M., Vadlakonda, A., Chervu, N. L., Khan, A., Benharash, P., & Lee, H. R. (2024) · Journal of Gastrointestinal Surgery · doi:10.1016/j.gassur.2024.09.025 · Cited by 4
A computational account of joint SSRI and anti-inflammatory treatment
Reneaux, M., Mayberg, H. S., Friston, K. J., & Pinotsis, D. A. (2025) · Frontiers in Immunology · doi:10.3389/fimmu.2025.1472732 · Cited by 2
“Peripheral administration of TNF α antagonist has been shown to improve depressive mood [Tyring et al. 2006], reduce fatigue [Monk et al. 2006] and alleviate depression [Persoons et al. 2005].”
BackgroundPatient and economic benefits of psychological support for noncompliant patients
Reed, P. R., Osborne, L., Whittall, C. M., Emery, S., & Truzoli, R. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.829880 · Cited by 3
“There are many psychological comorbidities presenting in patients referred for medical treatment, and these psychological comorbidities will vary from condition to condition (Persoons et al., 2005).”
BackgroundA Study on the Presenteeism of Call Center Workers in the Customer Service Business
Jung, M., & Jung, H.-S. (2015) · Korean Journal of Occupational Health Nursing · doi:10.5807/kjohn.2015.24.2.142 · Cited by 3
“접손실을 측정하는 중요한 요소이다(Lee & Jung, 2008). 프 리젠티즘과 건강문제와의 선행연구를 살펴보면, Lee와 Jung (2008)은 불면이나 수면장애의 경우 41.”
Concepts in Inflammatory Bowel Disease Management
Messaris, E., & Dassopoulos, T. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-40232-3.00161-8 · Cited by 4
Pimpinelli, M. (2024) · Annals of Gastroenterology · doi:10.20524/aog.2024.0866 · Cited by 2
“Anxiety and mood disorder diagnoses also correlate with more active or severe IBD, including more frequent relapses [9], a greater number of hospitalizations, and less likelihood of achieving remission with biologic therapy [10].”
BackgroundCommon psychological issues and management in patients with inflammatory bowel disease
Li, M., & Fan, Y. (2022) · World Chinese Journal of Digestology · doi:10.11569/wcjd.v30.i8.370 · Cited by 2
Vadarlis, A., Germanidis, G. S., Maris, T., Pramateftakis, M. G., & Chourdakis, M. (2026) · Digestive Diseases and Sciences · doi:10.1007/s10620-026-09880-z · Cited by 1
Psychosocial care needs of emerging adults with inflammatory bowel disease
Lieto, S., Hewitt, T., & Keefer, L. (2025) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2025.2529208 · Cited by 1
“…may be an increased risk of surgery for patients with CD if they have comorbid depressive disorder or generalized anxiety disorder, and depressive disorder has been shown to be correlated with an increased risk of failing to achieve remission with infliximab therapy in patients with CD [20,21].”
Densil, A., George, M. E., Mahdi, H., Chami, A., Mark, A., Luo, C., Wang, Y., Ali, A., Tang, P., Dong, A., et al. (2023) · Frontiers in Systems Biology · doi:10.3389/fsysb.2023.1274184 · Cited by 1
Mehta, K., & Kurtz, M. T. (2021) · Military Medicine · doi:10.1093/milmed/usab517 · Cited by 2
“15,16 During the course of evaluation and implementation of medical therapy for CD, the patient received treatment for his depression from his primary care provider and behavioral health specialist.”
BackgroundMazurak, N., & Stengel, A. (2021) · Psychotherapeut · doi:10.1007/s00278-021-00509-2 · Cited by 2
Salwen‐Deremer, J. K., & Speed, B. C. (2019) · Crohn s & Colitis 360 · doi:10.1093/crocol/otz051
Tow, K. E., Rogge, C., Lee, T., Caputi, P., & Knowles, S. R. (2019) · Gastroenterology Research and Practice · doi:10.1155/2019/7618468 · Cited by 3
Letter: psychological remission ‐ a future endpoint in inflammatory bowel disease? Authors’ reply
Panara, A. J., Yarur, A. J., & Sussman, D. A. (2014) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.12784
The mood–immunity relationship in multiple sclerosis
Ristori, G., Annibali, V., & Salvetti, M. (2012) · Experimental Neurology · doi:10.1016/j.expneurol.2012.11.030 · Cited by 1
“Tumor necrosis factor antagonism has also been found to impact on depression in patientswith Crohn's disease (Persoons et al., 2005).”
BackgroundCommentary: psychiatric co‐morbidity is associated with increased risk of surgery in Crohn's disease
Ng, S. C. (2013) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.12224
Quantification of antineural antibodies in autoimmune neurological disorders
Boscolo, S., & Tongiorgi, E. (2007) · Expert Review of Clinical Immunology · doi:10.1586/1744666x.3.6.949 · Cited by 1
Insulin Resistance, Glucose Regulation, Obesity, and Mood
Keegan, R. J., & Naumovski, N. (2016) · Springer eBooks · doi:10.1007/978-981-287-206-7_64 · Cited by 2
Principles of Medical Management of Ulcerative Colitis
Vu, H. T., & Dassopoulos, T. (2014) · Springer eBooks · doi:10.1007/978-1-4939-1677-1_4
Apoyo y tratamiento psicológico en la enfermedad inflamatoria intestinal: relación médico-paciente
Martel, L. C. (2009) · Gastroenterología y Hepatología · doi:10.1016/s0210-5705(09)72600-7 · Cited by 6
Patients with refractory inflammatory bowel disease: an international consensus
Knyazev, O. V., Валерьевна, К. А., & Bazarov, A. S. (2026) · Medical alphabet · doi:10.33667/2078-5631-2026-16-7-13
Metadata
- Authors
- PERSOONS, P., VERMEIRE, S., DEMYTTENAERE, K., FISCHLER, B., VANDENBERGHE, J., VAN OUDENHOVE, L., PIERIK, M., HLAVATY, T., VAN ASSCHE, G., NOMAN, M., & RUTGEERTS, P.
- Affiliations
- KU Leuven (BE)
- Corresponding author
- RUTGEERTS, P.
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2005-07
- Volume
- 22
- Issue
- 2
- Pages
- 101-110
- ISSN
- 0269-2813 (ISSN-L)
- 1365-2036
- OpenAlex
- W2025629977
- Cited by
- 253
- References
- 0
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 12 · 2023: 12 · 2022: 17 · 2021: 13 · 2020: 9 · 2019: 16 · 2018: 19 · 2017: 18 · 2016: 19 · 2015: 15 · 2014: 18 · 2013: 13 · 2012: 9
- FWCI
- 3.25
- Type
- journal article
- Language
- en
- Open access
- green
- lirias.kuleuven.be
- Licence
- Locations
- Alimentary Pharmacology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Lirias (submittedVersion, other-oa)
- Funders
- Vlaamse regering
- Topics
- Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Keywords
- major depressive disorder, Crohn's disease, infliximab, treatment response, remission, retreatment, disease flares, psychiatric comorbidity, luminal Crohn's disease, biologic therapy
- MeSH terms
- Infliximab, Adult, Affective Symptoms, Antibodies, Monoclonal, Anxiety, Crohn Disease, Depressive Disorder, Major, Major Depressive Disorder, Female, Gastrointestinal Agents, Humans, Male, Prospective Studies, Regression Analysis, Risk Factors, Sleep Wake Disorders, Social Support, Multivariate Analysis, Treatment Outcome
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