Association of Alterations in Intestinal Microbiota With Impaired Psychological Function in Patients With Inflammatory Bowel Diseases in Remission

Fabienne Humbel; Jessica Harrell Rieder; Yannick Franc; Pascal Juillerat; Michael Scharl; Benjamin Misselwitz; Philipp Schreiner; Stefan Begré; Gerhard Rogler; Roland von Känel; Bahtiyar Yilmaz; Luc Biedermann; Swiss IBD Cohort Study Group

doi:10.1016/j.cgh.2019.09.022

Association of Alterations in Intestinal Microbiota With Impaired Psychological Function in Patients With Inflammatory Bowel Diseases in Remission

Clin Gastroenterol Hepatol. 2020 Aug;18(9):2019-2029.e11. doi: 10.1016/j.cgh.2019.09.022. Epub 2019 Sep 20.

Affiliations

¹ Department of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
² Maurice Müller Laboratories, Department for Biomedical Research, Inselspital, University of Bern, Bern, Switzerland.
³ Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
⁴ Maurice Müller Laboratories, Department for Biomedical Research, Inselspital, University of Bern, Bern, Switzerland; Gastroenterology, Clinic for Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.
⁵ Department of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Maurice Müller Laboratories, Department for Biomedical Research, Inselspital, University of Bern, Bern, Switzerland; Gastroenterology, Clinic for Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.
⁶ Neurology, Department of Biomedical Research, Bern University Hospital, University of Bern, Bern, Switzerland; ISFOM - Institute of Stress Diseases and Stress management, Zurich, Switzerland.
⁷ Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
⁸ Maurice Müller Laboratories, Department for Biomedical Research, Inselspital, University of Bern, Bern, Switzerland. Electronic address: Bahtiyar.yilmaz@dbmr.unibe.ch.
⁹ Department of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. Electronic address: luc.biedermann@usz.ch.

PMID: 31546058
DOI: 10.1016/j.cgh.2019.09.022

Abstract

Background & aims: Depression and anxiety are frequent comorbidities with inflammatory bowel diseases (IBD). Alterations to the intestinal microbiome promote not only intestinal inflammation but also psychologic function. We studied the interactions between the composition of the intestinal microbiota and psychological outcomes in patients with IBD in Switzerland.

Methods: We performed a prospective study of psychological comorbidities and quality of life (QoL) in 171 participants in the Swiss IBD Cohort Study with IBD in remission. Participants complete the Hospital Anxiety and Depression Scale, Perceived Stress Questionnaire, the 36-Item Short Form Survey, and the IBD QoL Questionnaire. Microbes were collected from intestinal biopsies and analyzed by 16S rRNA high-throughput sequencing.

Results: Microbiomes of patients with higher perceived stress had significantly lower alpha diversity. Anxiety and depressive symptoms were significantly associated with beta diversity. We found a negative correlation between psychological distress and abundance of Clostridia, Bacilli, Bacteroidia, and Beta- and Gamma-proteobacteria. Psychological distress was also associated with decreases in operational taxonomic units from the lineages of Lachnospiraceae, Fusobacteriaceae, Ruminococcaceae, Veillonellaceae, Alcaligenaceae, Desulfovibrionaceae, and Bacteroidaceae families. The relative abundance of Bifidobacterium in patients with Crohn's disease and Desulfovibrio in patients with ulcerative colitis correlated with depression, whereas abundance of Sutterella, RF 32, and Lactococcus correlated with quality of life in patients with Crohn's disease.

Conclusions: We identified correlations between the composition of the intestinal microbiota in patients with IBD and remission, psychological well-being, and QoL. Further studies should investigate how intestinal inflammation, the microbiome, and microbial metabolites affect psychological well-being and whether these components are mono- or bi-directionally linked.

Keywords: Bacteria; CD; Gut–Brain Interactions; Psychology.

MeSH terms

Cohort Studies
Colitis, Ulcerative*
Feces
Gastrointestinal Microbiome*
Humans
Inflammatory Bowel Diseases* / complications
Prospective Studies
Quality of Life
RNA, Ribosomal, 16S

Substances

RNA, Ribosomal, 16S