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. 2023 Nov 2;29(11):1805-1818.
doi: 10.1093/ibd/izad091.

Gut Microbiota Signatures Are Associated With Psychopathological Profiles in Patients With Ulcerative Colitis: Results From an Italian Tertiary IBD Center

Franco Scaldaferri  1   2 , Antonio Maria D'Onofrio  3 , Rosaria Calia  4   5 , Federica Di Vincenzo  1 , Gaspare Filippo Ferrajoli  3 , Valentina Petito  1 , Eleonora Maggio  4   5 , Pia Clara Pafundi  6 , Daniele Napolitano  1 , Letizia Masi  1 , Elisa Schiavoni  1 , Caterina Fanali  1 , Pierluigi Puca  1 , Laura Turchini  1 , Loris Riccardo Lopetuso  1 , Federica Del Chierico  7 , Lorenza Putignani  8 , Antonio Gasbarrini  1   2 , And Giovanni Camardese  3
Affiliations

Gut Microbiota Signatures Are Associated With Psychopathological Profiles in Patients With Ulcerative Colitis: Results From an Italian Tertiary IBD Center

Franco Scaldaferri et al. Inflamm Bowel Dis. .

Abstract

Background: Several patients with ulcerative colitis (UC) suffer from psychiatric disorders, such as major depressive disorder, anxiety, or bipolar disorder, and show specific personality traits. Despite this, there are few data about personality profiles' characterization in UC patients and about correlation of their psychopathological profile with their intestinal microbiota.The aim of our study is to analyze the psychopathological and personality profile of UC patients and correlate it with specific signatures of their gut microbiota.

Methods: This is a prospective interventional longitudinal cohort study. We enrolled consecutive patients affected by UC attending to the IBD Unit of Center for Digestive Disease of "A. Gemelli" IRCCS Hospital in Rome and a group of healthy subjects, matched for specific characteristics. Each patient was evaluated by a gastroenterologist and a psychiatrist. Moreover, all participants underwent psychological tests and a collection of stool samples.

Results: We recruited 39 UC patients and 37 healthy subjects. Most patients showed high level of alexithymia, anxiety symptoms, depressive symptoms, as well as neuroticism and hypochondria, with obsessive-compulsive features at the behavioral level, which significantly impaired their quality of life and abilities at work. Gut microbiota analysis in UC patients demonstrated an increase in actinobacteria, Proteobacteria and Saccharibacteria (TM7), with a reduction in verrucomicrobia, euryarchaeota and tenericutes.

Conclusions: Our study confirmed the presence of high levels of psycho-emotional distress in UC patients, alongside alterations of the intestinal microbiota, and highlighted some families and genera of bacteria (Enterobacteriaceae, Streptococcus, Veillonella, Klebsiella, and Clostridiaceae) as potential markers of an altered gut-brain axis in these patients.

Keywords: behavioral disorders; gut microbiota; psychopathology; ulcerative colitis.

Plain language summary

Psychiatric disorders are more prevalent in IBD patients than in general population. In this prospective cohort study, we found a correlation between active UC, peculiar psychiatric distress (anxiety and depression above all), and specific taxonomic gut microbiota signatures.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Psychometric data.
Figure 2.
Figure 2.
Psychometric data. A, Percentage of patients above the cutoff at the psychometrical scales. B, Percentage of patients above the cutoff at the MMPI-2 scales. C, Average ± SD of clinical scales (MMPI-2). D, Average ± SD of content scales (MMPI-2). E, Average ± SD of PSY-5 (MMPI-2).
Figure 3.
Figure 3.
Bacterial abundance between UC patients and HC. A, Phylum-level analysis. B, Genus-level analysis. Abbreviations: HC, health control; UC, ulcerative colitis patients.
Figure 4.
Figure 4.
Bacterial diversity between UC patients grouped by disease severity and HC. A, Shannon Index. B, Chao Index.
Figure 5.
Figure 5.
MANCOVA Analysis. The analysis shows the difference in mean bacterial abundance values between patients who did not overcome the cutoff on psychometric scales and those who did. The graphs show all the statistically significant differences detected: A negative value indicates a greater presence of the involved specific bacterium in the group of patients that exceeded the cutoff.
Figure 6.
Figure 6.
Bacteria associated with anxiety and depression scales.
Figure 7.
Figure 7.
Correlations amongst clinical and endoscopic disease activity and all psychometrics parameters.
See this image and copyright information in PMC

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