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Meta-Analysis
. 2018 Aug 15;14(11):1504-1512.
doi: 10.7150/ijbs.25001. eCollection 2018.

Depressive symptoms in patients with irritable bowel syndrome: a meta-analysis of comparative studies

Qing-E Zhang  1 , Fei Wang  2   3 , Geng Qin  4 , Wei Zheng  5 , Chee H Ng  6 , Gabor S Ungvari  7   8 , Zhen Yuan  3 , Songli Mei  9 , Gang Wang  1 , Yu-Tao Xiang  3
Affiliations
Meta-Analysis

Depressive symptoms in patients with irritable bowel syndrome: a meta-analysis of comparative studies

Qing-E Zhang et al. Int J Biol Sci. .

Abstract

Depression is common in patients with irritable bowel syndrome (IBS), but the reported prevalence across different studies is inconsistent. This meta-analysis systematically examined the presence and severity of depressive symptoms in patients with IBS. Two investigators independently performed a literature search. The pooled depressive symptom severity was calculated using a random effects model. Subgroup, sensitivity and meta-regression analyses were conducted to examine the moderating factors of the development of depressive symptoms. Twenty four studies (n=2,837) comparing depressive symptoms between IBS patients (n=1,775) and healthy controls (n=1,062) were identified; 14 (58.3%) studies were rated as high quality. Compared to healthy controls, IBS patients had more frequent (OR=9.21, 95%CI: 4.56-18.57, P<0.001; I2=76%) and more severe depressive symptoms (n=1,480, SMD=2.02, 95%CI: 1.56-2.48, P<0.001; I2=94%). Subgroup analyses revealed that patients with all IBS subtypes had more severe depressive symptoms than controls. In addition, versions of the Hamilton Depression Rating Scale (HAM-D) and IBS diagnostic criteria were significantly associated with depressive symptom severity. Meta-regression analyses revealed that female gender, younger age and small sample size were significantly associated with more severe depressive symptoms. In conclusion, meta-analytic data showed that IBS patients had more frequent and severe depressive symptoms than healthy controls. Adequate screening and treatment for depression should be developed and implemented in this patient population.

Keywords: IBS; controlled studies; depressive symptoms; meta-analysis.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
PRISMA flow diagram
Figure 2
Figure 2
Depressive symptoms in IBS: forest plot of HAMD total scores
Figure 3
Figure 3
Forest plot of the prevalence of depressive symptoms in IBS patients versus healthy controls
See this image and copyright information in PMC

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