The Increased Level of Depression and Anxiety in Irritable Bowel Syndrome Patients Compared with Healthy Controls: Systematic Review and Meta-analysis

作者：Lee Changhyun; Doo Eunyoung; Choi Ji Min; Jang Seung ho; Ryu Han Seung; Lee Ju Yup; Oh Jung Hwan; Park Jung Ho; Kim Yong Sung^*

来源：Journal of Neurogastroenterology and Motility, 2017, 23(3): 349-362.

DOI：10.5056/jnm16220

• Anxiety
• Depression
• Irritable bowel syndrome
• Meta-analysis

Background/Aims
Irritable bowel syndrome (IBS) patients commonly experience psychiatric disorders, such as depression and anxiety. This meta-analysis sought to compare depression and anxiety levels between IBS patients and healthy controls.
Methods
We searched major electronic databases (PubMed, EMBASE, MEDLINE, and Cochrane library) to find comparative studies on IBS patients and healthy controls. The primary outcome was a standardized mean difference (SMD) of anxiety and depression levels; subgroup analyses were conducted according to IBS-subtypes.
Results
In total, 2293 IBS patients and 4951 healthy controls from 27 studies were included. In random effect analysis, depression and anxiety levels were significantly higher in IBS patients (pooled SMD = 0.76; 95% CI, 0.62-0.90; P < 0.001; I-2 = 77.2% and pooled SMD = 0.84; 95% CI, 0.67-1.01; P < 0.001; I-2 = 85.6%, respectively). Both analyses' funnel plots showed symmetry. In meta-regression analysis, heterogeneity was due to the studied region and questionnaire type for both depression and anxiety. In sub-group analyses of IBS-subtype, the pooled SMDs of depression and anxiety levels (IBS with predominant constipation: 0.83 and 0.81, IBS with predominant diarrhea: 0.73 and 0.65, and IBS with mixed bowel habits: 0.62 and 0.75; P < 0.001, respectively) were significantly higher in all IBS-subtypes.
Conclusions
The present meta-analysis showed depression and anxiety levels to be higher in IBS patients than in healthy controls, regardless of IBS subtype. However, the gender effect on psychological factors among IBS patients could not be determined and should be evaluated in prospective studies.

• 出版日期2017-7