Tina Rodriguez, GI Research Foundation Scholar, 2021-2022, spent this past year working hard in the Rubin lab on a complex issue of perennial interest to the IBD community: the connection between mental health disorders like anxiety and depression and Crohn’s disease and ulcerative colitis.

With the Rubin lab, Ms. Rodriguez utilized a novel instrument of measurement of mental health, the Computerized Adaptive Testing for Mental Health (CAT-MH), to screen patients for mental health comorbidities and evaluate depression and anxiety severity in real-time. Then, she and the team co-authored a study for the Journal of Crohn’s and Colitis evaluating CAT-MH data in comparison with demographic and clinical variables.

Ms. Rodriguez then worked with Ashley Sidebottom, PhD, and colleagues to publish a review of existing research on clinical and translational considerations for depression and anxiety and IBD. Previous research has established that Crohn’s disease and ulcerative colitis patients suffer from anxiety and depression at a rate higher than the general population, and that this affects both their quality of life (e.g., eating habits, sleep patterns) and treatment outcomes (e.g., hospital length of stay, treatment adherence). But the direction of this relationship is unknown—do anxiety and depression influence the development of Crohn’s disease and ulcerative colitis? Or does having IBD influence patients’ mental health? The review by Dr. Sidebottom, Ms. Rodriguez, and colleagues underscores the complexity of this relationship, and expands on the importance of the microbiome in the brain-gut connection, specifically with regard to the body’s use of small molecules, like tryptophan.

Tryptophan is a small molecule acquired through diet (e.g. poultry, meat, dairy, pumpkin seeds), and made into other components—or metabolites—used by the brain and body, things like melatonin, neurotransmitter serotonin, and vitamin B3 (niacin). Intestinal microbes, or the microbiome, convert tryptophan from the diet into several metabolites, some of which are transported to the brain (and the role of metabolites like serotonin in healthy brain function is well established). The possibility that a person’s microbiome may mediate this process is important, because it means that inflammation itself may influence a patient’s development of mental health disorders. In this way, treating inflammation could have benefits for a person’s mental state, beyond the many other health benefits accrued through treatment.

Sidebottom, Rodriguez, and colleagues’ review highlights the need for future study of the microbiome’s influence on mental health disorders. As Ms. Rodriguez is at the very beginning of her career in medical research, this opportunity affords her the “running start” early career scientists need in order to establish a strong foothold in their discipline, establish themselves in a competitive field, and eventually, secure additional research funding for their work.

“I have learned so much and grown my expertise in so many ways this past year,” says Ms. Rodriguez. “I am so thankful to the GI Research Foundation for their support.”