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A systematic review with meta-analysis of the role of anxiety and depression in irritable bowel syndrome onset

Published online by Cambridge University Press:  08 September 2016

A. Sibelli ,
T. Chalder ,
H. Everitt ,
P. Workman ,
S. Windgassen  and
R. Moss-Morris
A. Sibelli
Affiliation:
Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th Floor Bermondsey Wing, Guy's Hospital Campus, London Bridge, London SE1 9RT, UK
T. Chalder
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK
H. Everitt
Affiliation:
Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Aldermoor Close, Southampton SO16 5ST, UK
P. Workman
Affiliation:
Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th Floor Bermondsey Wing, Guy's Hospital Campus, London Bridge, London SE1 9RT, UK
S. Windgassen
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Chronic Fatigue Research and Treatment Unit, Mapother House, De Crespigny Park, Denmark Hill, London SE5 8AZ, UK
R. Moss-Morris*
Affiliation:
Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th Floor Bermondsey Wing, Guy's Hospital Campus, London Bridge, London SE1 9RT, UK
*
*Address for correspondence: R. Moss-Morris, Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th Floor Bermondsey Wing, Guy's Hospital Campus, London Bridge, London SE1 9RT, UK. (Email: [email protected])
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Abstract

Background

It is well established that people with irritable bowel syndrome (IBS) have higher levels of anxiety and depression compared with controls. However, the role of these as risk factors is less clearly established. The aims of this systematic review were to investigate: (1) whether anxiety and/or depression predict IBS onset; (2) the size of the relative risk (RR) of anxiety versus depression in IBS onset. Subgroup analyses explored if methodological factors affected the overall findings.

Method

Prospective cohort or case–control studies were included if they: (1) focused on the development of IBS in population-based or gastroenteritis cohorts; (2) explored the effects of anxiety and/or depression at baseline as predictors of IBS onset at a future point. In all, 11 studies were included of which eight recruited participants with a gastrointestinal infection. Meta-analyses were conducted.

Results

The risk of developing IBS was double for anxiety cases at baseline compared with those who were not [RR 2.38, 95% confidence interval (CI) 1.58–3.60]. Similar results were found for depression (RR 2.06, 95% CI 1.44–2.96). Anxiety and depression seemed to play a stronger role in IBS onset in individuals with a gastrointestinal infection although this could be attributed to other differences in methodology, such as use of diagnostic interviews rather than self-report.

Conclusions

The findings suggest that self-reported anxiety and depression provide a twofold risk for IBS onset. There is less support for the role of anxiety or depressive disorder diagnosed using clinical interview. These findings may have implications for the development of interventions focused on IBS prevention and treatment.

Keywords

Anxietydepressionirritable bowel syndromemeta-analysessystematic reviews
Type
Review Article
Information
Psychological Medicine , Volume 46 , Issue 15 , November 2016 , pp. 3065 - 3080
Copyright
Copyright © Cambridge University Press 2016 

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