A systematic review with meta-analysis of the role of anxiety and depression in Irritable Bowel Syndrome onset

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It is well established that people with IBS have higher levels of anxiety and depression compared to 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 of anxiety versus depression in IBS onset. Sub-group analyses explored if methodological factors affected the overall findings.

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. Eleven studies were included of which 8 recruited participants with a gastrointestinal infection. Meta-analyses were conducted.

The risk of developing IBS was double for anxiety cases at baseline compared to those who were not: RR 2.38, 95% 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.

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.
Original languageEnglish
JournalPsychological medicine
Early online date8 Sept 2016
Publication statusE-pub ahead of print - 8 Sept 2016


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