Anxiety & depression in IBD

June 22, 2021

Issue 12

Clinical Question

How prevalent are symptoms of anxiety and depression in patients with IBD?

Editor’s Bottom Line

Anxiety and depression are common among patients with both Crohn’s disease and ulcerative colitis, and are more common among women with IBD.

Reference

Barberio B, Zamani M, Black CJ, et al. Prevalence of symptoms of anxiety and depression in patients with inflammatory bowel disease: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol Epub ahead of print March 12, 2021; https://doi.org/10.1016/S2468-1253(21)00014-5

Synopsis

This systematic review and meta-analysis included 77 published studies that used validated screening instruments to report the prevalence of anxiety or depression among IBD patients.

The authors found that, of the total of 30,118 patients included in the data, a pooled 32% had symptoms of anxiety (95% Confidence Interval, 28.3–36) and 25.2% had symptoms of depression (95% CI, 22–28.5). Studies that parsed data according to IBD subtype showed that 37% of patients with Crohn’s disease had symptoms of anxiety, compared to 34% of those with ulcerative colitis (Odds Ratio [OR]: 1.2; 95% Confidence Interval, 1.1–1.4). Overall, 25% and 24% of patients with Crohn’s disease and ulcerative colitis, respectively, had symptoms of depression (OR: 1.2; 95% CI, 1.1–1.4).

Additionally, 58% and 39% of those with active IBD had symptoms of anxiety or depression, respectively, compared with 38.1% and 24.2% with inactive disease (OR for anxiety with active vs. inactive disease: 2.5; 95% CI, 1.5–4.1 and OR for depression for active vs. inactive disease: 3.1; 95% CI, 1.9–4.9).

Women with IBD were 70% more likely than men with IBD to have symptoms of anxiety (OR: 1.7; 95% CI, 1.2–2.3) and 30% more likely to have symptoms of depression (OR: 1.3; 95% CI, 1.0–1.8).

The authors noted that heterogeneity in the design of the studies included in their research was a limitation of their analyses.

Details

Study Design: Systematic review and meta-analysis

Funding: None

Allocation: None

Setting: Multicenter

Level of Evidence: 3a