TY - JOUR
T1 - The prevalence and incidence of irritable bowel syndrome and inflammatory bowel disease in depression and bipolar disorder: a systematic review and meta-analysis
AU - Nikolova, Viktoriya
AU - Pelton, Lucy
AU - Moulton, Calum
AU - Zorzato, Daniele
AU - Cleare, Anthony
AU - Young, Allan
AU - Stone, James
N1 - Funding Information:
Source of Funding and Conflicts of Interest: The authors declare no conflict of interest relating to the work presented here. The authors received no specific financial support for the research, authorship, and/or publication of this article. J.M.S., A.J.C., and A.H.Y. have received research grant support by ADM Protexin Probiotics Ltd. V.L.N. has received honoraria for consulting from Janssen. J.M.S. has received honoraria for consulting from Janssen and research support from Takeda in the last 3 years. In the last 3 years, A.J.C. has received honoraria for consulting from Allergan and Janssen. A.H.Y. has received honoraria for speaking from Astra Zeneca, Lundbeck, Eli Lilly, and Sunovion; honoraria for consulting from Allergan, Livanova and Lundbeck, Sunovion, and Janssen; and research grants from Janssen and Compass in the last 3 years.
Funding Information:
Source of Funding and Conflicts of Interest: The authors declare no conflict of interest relating to the work presented here. The authors received no specific financial support for the research, authorship, and/or publication of this article. J.M.S., A.J.C., and A.H.Y. have received research grant support by ADM Protexin Probiotics Ltd. V.L.N. has received honoraria for consulting from Janssen. J.M.S. has received honoraria for consulting from Janssen and research support from Takeda in the last 3 years. In the last 3 years, A.J.C. has received honoraria for consulting from Allergan and Janssen. A.H.Y. has received honoraria for speaking from Astra Zeneca, Lundbeck, Eli Lilly, and Sunovion; honoraria for consulting from Allergan, Livanova and Lundbeck, Sunovion, and Janssen; and research grants from Janssen and Compass in the last 3 years.
Publisher Copyright:
© 2022 by the American Psychosomatic Society
PY - 2022/4
Y1 - 2022/4
N2 - Objective: The increased prevalence and incidence of affective disorders among patients with gastrointestinal disease have been well established. However, few studies have investigated the inverse relationship. We aimed to identify all pieces of evidence of the prevalence and incidence of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) in people with depression and bipolar disorder. Methods: We conducted a systematic review of studies reporting the association between affective disorders (exposure) and IBS or IBD (outcome) in adults. Evidence was evaluated for quality using Joanna Briggs Institute Critical Appraisal tools. Where suitable data were available, meta-analyses were performed. Results: We identified 18 studies that met the selection criteria, of which 11 provided data on IBS, 5 on IBD, and 2 on both. Overall, people with depression were significantly more likely to have comorbid IBS (risk ratio = 2.42, 95% confidence interval = 1.98-2.96) and to develop new-onset IBS (risk ratio = 1.90, 95% confidence interval = 1.41-2.56) compared with people without depression. They were also more likely to have and develop IBD, and among patients with IBD, significantly increased rates of depression were observed as early as 5 years before diagnosis. Bipolar disorder was not consistently associated with risk of either condition. Conclusions: People with depression are at an increased risk of both having and developing lower gastrointestinal disorders. These findings have important implications for how we understand, manage, and prevent this comorbidity in clinical practice. Further studies are needed to improve our understanding of the relationship between bipolar disorder and bowel disease as well as the role of psychotropic medication, particularly selective serotonin reuptake inhibitors.
AB - Objective: The increased prevalence and incidence of affective disorders among patients with gastrointestinal disease have been well established. However, few studies have investigated the inverse relationship. We aimed to identify all pieces of evidence of the prevalence and incidence of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) in people with depression and bipolar disorder. Methods: We conducted a systematic review of studies reporting the association between affective disorders (exposure) and IBS or IBD (outcome) in adults. Evidence was evaluated for quality using Joanna Briggs Institute Critical Appraisal tools. Where suitable data were available, meta-analyses were performed. Results: We identified 18 studies that met the selection criteria, of which 11 provided data on IBS, 5 on IBD, and 2 on both. Overall, people with depression were significantly more likely to have comorbid IBS (risk ratio = 2.42, 95% confidence interval = 1.98-2.96) and to develop new-onset IBS (risk ratio = 1.90, 95% confidence interval = 1.41-2.56) compared with people without depression. They were also more likely to have and develop IBD, and among patients with IBD, significantly increased rates of depression were observed as early as 5 years before diagnosis. Bipolar disorder was not consistently associated with risk of either condition. Conclusions: People with depression are at an increased risk of both having and developing lower gastrointestinal disorders. These findings have important implications for how we understand, manage, and prevent this comorbidity in clinical practice. Further studies are needed to improve our understanding of the relationship between bipolar disorder and bowel disease as well as the role of psychotropic medication, particularly selective serotonin reuptake inhibitors.
UR - http://www.scopus.com/inward/record.url?scp=85128161062&partnerID=8YFLogxK
U2 - 10.1097/PSY.0000000000001046
DO - 10.1097/PSY.0000000000001046
M3 - Review article
SN - 1534-7796
VL - 84
SP - 313
EP - 324
JO - Psychosomatic medicine
JF - Psychosomatic medicine
IS - 3
ER -