Association Between Anxiety/Depression and Gastroesophageal Reflux: A Systematic Review and Meta-Analysis

Zamani, Mohammad; Alizadeh-Tabari, Shaghayegh; Chan, Walter W.; Talley, Nicholas J.

doi:10.14309/ajg.0000000000002411

Cited by 15 publications

(6 citation statements)

References 72 publications

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“…GERD may lead to dysbiosis of the gut microbiota [ 71 ], thereby affecting the levels of tumor necrosis factor-alpha and serotonin in the trigeminal nociceptive system, involved in the normal mechanical nociception and pathogenesis of migraine [ 72 , 73 ]. Many studies suggest an association between GERD and psychiatric symptoms, particularly depression, with up to one-third of patients with GERD reportedly experiencing depression [ 74 , 75 ]. Existing evidence hints at depression as a risk factor for migraine [ 76 , 77 ].…”

Section: Discussionmentioning

confidence: 99%

Migraine and gastroesophageal reflux disease: Disentangling the complex connection with depression as a mediator

Shen,

Bian,

Huang

et al. 2024

PLoS ONE

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Objective Gastroesophageal reflux disease (GERD) and migraine are public health concerns worldwide. No observational study has conclusively elucidated the causal relationship between these two conditions. We employed Mendelian randomization (MR) methods to explore the potential causal links between GERD and migraine. Methods Genome-wide association studies were subjected to MR to infer the causality between GERD and migraine. Bidirectional two-sample MR was performed to establish causal relationships. Multivariable MR analysis was conducted to adjust potential confounding factors, and mediation MR analysis was utilized to assess the role of depression between GERD and migraine as a mediator. We primarily utilized the inverse variance weighted method (IVW) and sensitivity analysis methods, including MR-Egger, weighted median, and leave-one-out methods. We assessed heterogeneity and pleiotropy to ensure the reliability of the results. Results Bidirectional two-sample MR revealed a positive causal effect of GERD on migraine (IVW: OR = 1.49, 95% CI: 1.34–1.66, p = 3.70E-13). Migraine did not increase the risk of GERD (IVW: OR = 1.07, 95% CI: 0.98–1.17, p = 0.1139). Multivariable MR indicated that the positive causal effect of GERD on migraine remained after adjustment for factors, such as smoking, alcohol consumption, obesity, type 2 diabetes, and depression. Mediation MR revealed that depression mediated 28.72% of GERD’s effect on migraine. MR analysis was supported by all sensitivity analyses and was replicated and validated in another independent dataset on migraine. Conclusion Our findings elucidate the positive causal effect of GERD on migraine and underscores the mediating role of depression in increasing the risk of migraine due to GERD. Effective control of GERD, particularly interventions targeting depression, may aid in preventing the occurrence of migraine. Future research should delve deeper into the specific pathophysiological mechanisms through which GERD affects migraine risk, facilitating the development of more effective drug targets or disease management strategies.

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Section: Discussionmentioning

confidence: 99%

Migraine and gastroesophageal reflux disease: Disentangling the complex connection with depression as a mediator

Shen,

Bian,

Huang

et al. 2024

PLoS ONE

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“…For example, studies in Spain [15], China [14,16], and the Netherlands [17], reported that all dimensions of SF-36 that measure HRQoL were negatively correlated with anxiety and depression in GERD patients. According to recent a systematic review and meta-analysis, GERD patients' levels of anxiety and depression were higher than those of healthy controls [20]. Based on the pooled results of 30 studies, the prevalences of anxiety and depressive symptoms were 34.4% and 24.2% in GERD patients, respectively [20].…”

Section: Discussionmentioning

confidence: 99%

“…According to recent a systematic review and meta-analysis, GERD patients' levels of anxiety and depression were higher than those of healthy controls [20]. Based on the pooled results of 30 studies, the prevalences of anxiety and depressive symptoms were 34.4% and 24.2% in GERD patients, respectively [20]. Additionally, a positive correlation between heartburn symptoms and psychological disorders was discovered [21].…”

Section: Discussionmentioning

confidence: 99%

Anxiety and Depression and Health-Related Quality of Life in Adults with Gastroesophageal Reflux Disease: A Population-Based Study

Alwhaibi

2023

Healthcare

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Background: Adults with gastroesophageal reflux disease (GERD) are susceptible to mental disorders that might significantly affect their health-related quality of life (HRQoL). Therefore, the purpose of this study was to evaluate how HRQoL in individuals with GERD is related to coexisting anxiety and depression. Methods: A cross sectional study was conducted among 3068 adult patients 22 years of age and older with GERD diagnoses have been identified using the data from the Medical Expenditure Panel Survey from 2017 to 2020 for United States adults. Data are gathered by MEPS using an overlapping panel design over a period of two and a half years. HRQoL was established using the Physical and Mental Component Summary (PCS & MCS) values from the SF-12. Multivariate forward linear regression analysis was used to assess the relationship between anxiety, depression, and HRQoL in people with GERD after accounting for various factors. Results: Of the 3068 people with GERD who had been identified, 56.4% were women, 59.4% were in their 50s or 60s and 64.8% were employed. Thirteen per cent of people with GERD had depression, thirteen per cent had anxiety, and ten per cent had both. Adults with concurrent anxiety and depression had the lowest mean PCS and MCS scores compared to those with GERD. After adjusting for all independent factors, GERD patients with anxiety (MCS = −10.819, p-value < 0.0001), depression (MCS = −6.395, p-value < 0.0001), and both (MCS= −42.869, p-value < 0.0001) had substantially worse HRQoL than those without these comorbidities. Notably, better HRQoL scores were positively associated with marital status, employment, perceived overall health, and physical activity. Conclusions: The results from this nationally representative sample shed insight into the relationships between low HRQoL and anxiety and depression among individuals with GERD. It also demonstrated the detrimental impacts of co-occurring chronic illnesses, low socioeconomic status, and the positive benefits of employment and exercise on HRQoL. This study emphasizes the clinical, policy, and public health implications for better healthcare, allocation of resources, and promotion of lifestyle modifications to improve the HRQoL in patients with GERD.

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“…The MR method generally utilises particular genetic markers (single-nucleotide polymorphisms [SNPs]) highly correlated with exposure as instrumental variables. 13,14 These studies must provide the risk estimates obtained using the inverse variance-weighted (IVW) method and through sensitivity analysis using the MR-Egger regression method. In MR, SNPs correlated with IBD genetic susceptibility act as quasi-randomised variables.…”

Section: Information Sources and Search Strategymentioning

confidence: 99%

Meta‐analysis: Risk of pancreatic cancer in patients with inflammatory bowel disease

Zamani,

Alizadeh‐Tabari,

Murad

et al. 2024

Aliment Pharmacol Ther

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SummaryBackgroundStudies exploring the association between inflammatory bowel disease (IBD) and pancreatic cancer have reported inconsistent results.AimsTo provide a comprehensive overview of the risk of pancreatic cancer development in patients with IBD.MethodsWe searched Embase, PubMed, Scopus and ProQuest from inception to 31 October 2023. We included population‐based cohort studies examining the risk of incident pancreatic cancer in adult patients with IBD compared to the non‐IBD population. We also retrieved Mendelian randomisation (MR) studies investigating the relationship of IBD with pancreatic cancer risk. We conducted random‐effects meta‐analyses and provided pooled relative risks (RRs) with 95% confidence intervals (CIs).ResultsWe included 13 studies. Among 11 cohort studies, the risk of developing pancreatic cancer increased by 79% in patients with IBD (RR = 1.79 [95% CI: 1.16–2.75]; I2 = 95.7%). Patients either with Crohn's disease (RR = 1.42 [95% CI: 1.24–1.63]) or ulcerative colitis (RR = 1.50 [95% CI: 1.17–1.92]) had increased risk (p for interaction = 0.72). The annual incidence of pancreatic cancer potentially attributable to IBD increased by 55 cases (95% CI: 17–103) per million. Two MR studies demonstrated that genetic liability to IBD was associated with an increased risk of pancreatic cancer.ConclusionsOur results suggest a moderate increase in the risk of pancreatic cancer in patients with IBD, which may be further heightened by genetic predisposition to IBD. The increased risk of pancreatic cancer is probably similar in Crohn's disease and ulcerative colitis.

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Association Between Anxiety/Depression and Gastroesophageal Reflux: A Systematic Review and Meta-Analysis

Cited by 15 publications

References 72 publications

Migraine and gastroesophageal reflux disease: Disentangling the complex connection with depression as a mediator

Migraine and gastroesophageal reflux disease: Disentangling the complex connection with depression as a mediator

Anxiety and Depression and Health-Related Quality of Life in Adults with Gastroesophageal Reflux Disease: A Population-Based Study

Meta‐analysis: Risk of pancreatic cancer in patients with inflammatory bowel disease

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