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. 2021 Jan 7;21(1):23.
doi: 10.1186/s12876-020-01593-5.

The level and prevalence of depression and anxiety among patients with different subtypes of irritable bowel syndrome: a network meta-analysis

Zhichao Hu  1 , Meixuan Li  2 , Liang Yao  3 , Yinshu Wang  4 , Enkang Wang  4 , Jianye Yuan  4 , Fengyun Wang  5 , Kehu Yang  2 , Zhaoxiang Bian  6 , Linda L D Zhong  7
Affiliations

The level and prevalence of depression and anxiety among patients with different subtypes of irritable bowel syndrome: a network meta-analysis

Zhichao Hu et al. BMC Gastroenterol. .

Abstract

Background: Irritable bowel syndrome (IBS) is a very common functional bowel disorder. However, the difference of depression and anxiety comorbidities among different IBS subtypes is still not well evaluated. This study aims to investigate the difference in the level and prevalence of depression and anxiety among healthy controls and patients with different subtypes of IBS.

Methods: PubMed, EMBASE and the Cochrane library were searched systematically until August 17, 2020. Studies that investigated depression and/or anxiety levels or prevalence among different IBS-subtype patients measured at baseline or the same point were included. Network meta-analysis was conducted to analyze standardized mean difference (SMD) of anxiety and depression levels, and single arm meta-analysis was performed for prevalence of anxiety and depression among different IBS subtypes.

Results: Eighteen studies involving 7095 participants were included. Network meta-analyses results showed healthy controls had a lower level of depression than IBS with mixed symptoms of constipation and diarrhea (IBS-M) [SMD = - 1.57; 95% confidence interval (CI) - 2.21, - 0.92], IBS with constipation (IBS-C) (SMD = - 1.53; 95% CI - 2.13, - 0.93) and IBS with diarrhea (IBS-D)(SMD = - 1.41; 95% CI - 1.97, - 0.85), while no significant difference was found between IBS unclassified (IBS-U) and healthy controls (SMD = - 0.58; 95% CI - 2.15, 1.00). There was also no significant difference in the level of depression among different IBS subtypes patients. The results of anxiety were similar to depression. Ranking probability showed that IBS-M was associated with the highest level of depression and anxiety symptoms, followed by IBS-C/IBS-D and IBS-U. Single-arm meta-analysis showed IBS-C had the highest prevalence of depression (38%) and anxiety (40%), followed by IBS-D, IBS-M and IBS-U.

Conclusion: The results indicated that IBS-M was more likely to be associated with a higher level of depression and anxiety, and the prevalence of depression and anxiety in IBS-C was highest. The psychological screening and appropriate psychotherapy are needed for patients with IBS-C, IBS-D and IBS-M instead of IBS-U.

Keywords: Anxiety; Depression; Irritable bowel syndrome; Meta-analysis.

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Conflict of interest statement

All authors have no potential competing interests relevant to this article.

Figures

Fig. 1
Fig. 1
Flow diagram of the study selection process
Fig. 2
Fig. 2
Network maps for depression and anxiety level
Fig. 3
Fig. 3
Direct comparison of depression level among different IBS subtypes and healthy controls
Fig. 4
Fig. 4
Direct comparison of depression level among different IBS subtypes
Fig. 5
Fig. 5
Direct comparison of anxiety level among different IBS subtypes and healthy controls
Fig. 6
Fig. 6
Direct comparison of anxiety level among different IBS subtypes
Fig. 7
Fig. 7
Ranking for depression level among different IBS subtypes and healthy controls
Fig. 8
Fig. 8
Ranking for anxiety level among different IBS subtypes and healthy controls
Fig. 9
Fig. 9
Prevalence of depression among different IBS subtypes
Fig. 10
Fig. 10
Prevalence of anxiety among different IBS subtypes
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