Gastrointestinal symptoms are closely associated with depression in iron deficiency anemia: a comparative study

Abstract

BACKGROUND AND OBJECTIVESUntil now, very few studies evaluated the association between gastrointestinal and psychiatric symptoms in iron deficiency anemia (IDA). The study investigated the frequency of functional dyspepsia (FD) in IDA patients and determined its association with depression and somatization.DESIGN AND SETTINGSThe study was conducted at the Hematology Department of Trakya University Medical Faculty, which is a tertiary referral center in northwestern Turkey. It was a case-control study.MATERIALS AND METHODSA total of 125 consecutive IDA patients and 57 healthy control subjects were included. Patients and controls were questioned about the severity of their gastrointestinal system (GIS)-related symptoms and the presence of constipation and associated symptoms using a visual analog scale. In addition, IDA patients were administered a validated depression scale (Beck Depression Inventory, BDI) and somatization symptoms checklist.RESULTSIDA patients had more frequent self-reported constipation compared with controls (56% vs 22.8%, P<.001). The mean scores of bloating, dyspepsia, and constipation-related quality of life (QoL) disturbance were significantly higher in the IDA group than in the control group (all P values ≤.01). A total of 71 IDA patients were depressed according to the BDI. Depressed IDA patients had higher mean reflux, bloating, halitosis, and dyspepsia-related QoL disturbance scores compared with nondepressed patients (all P values ≤.01). Their frequency of self-reported constipation and mean constipation-related QoL disturbance score (P values, .002 and <.001) were also higher. Depressed IDA patients had significantly higher somatization scores compared with others (P=.001).CONCLUSIONAn increased frequency of dyspepsia symptoms and constipation-related QoL disturbance were observed in IDA patients. The findings of this study suggested that in IDA patients without red flags in favor of malignancy, physicians should try to uncover any psychiatric factors before undertaking extensive GIS investigation.

Association between iron‐deficiency anemia and depression: A web‐based Japanese investigation

“…Our findings in the controls are somewhat consistent with previously reported associations between IDA and depression severity as previously reported in non-psychiatric populations. 5,6 However, considering the effect sizes (all |φ| < 0.1) and the fact that, in participants with a self-reported history of IDA, 88.5% had no depression and 70.8% had a K6 score lower than the cutoff score, the association of IDA with depression risk and abnormally higher psychological distress is quite weak. Furthermore, we used the K6 test, which was not intended to evaluate depression severity.…”

“…Although studies reporting on iron‐deficiency anemia (IDA), which is the most common single nutritional deficiency, are limited, an association of IDA with depression severity and its relation to somatic (particularly gastrointestinal) symptoms was reported in 125 patients with IDA, compared with 57 healthy controls . Furthermore, IDA had a worsening influence on sleep quality, anxiety, and depression scores in 104 patients with IDA, compared with 80 healthy controls .…”

Evaluation of factors in a primary care setting which may cause failure to respond to oral iron treatment in iron deficiency anaemia patients

“…Appropriate management of IDA is essential to avoid negative consequences and complications among vulnerable populations . Additionally, several studies showed an association between management of IDA and improvement in quality of life . The results of this study showed that more than half of patients on oral iron therapy did not show appropriate response to treatment.…”

The Role of Iron, Zinc, Copper and Magnesium in the Prevention and Treatment of Depression

“…25 Demir eksikliği ve depresyon şiddeti arasındaki ilişkiyi inceleyen bir başka çalışmada, 57 sağlıklı kontrolle karşılaştırıldığında, 125 anemili hastanın depresyon ve somatik semptom şikâyetleri rapor ettiği gözlemlenmiştir. 26 Semiz ise 104 anemili hastanın 80 sağlıklı hastaya kıyasla uyku kalitesi, anksiyete ve depresyon durumunda kötüleşme bildirdiğini rapor etmiştir. 27 2018 yılında 11.876 Japon vatandaş üzerinde yapılan bir çalışmada, demir eksikliği anemisi, cinsiyet ve depresyon ilişkileri incelenmiştir.…”

“…Demirin hem yeterli diyetsel alımını hem de normal kan seviyelerinin depresyon üzerindeki olumlu etkisini gösteren birçok çalışma mevcuttur. 19,21,[23][24][25][26] Demirin yetersizliği depresyona sebep olabileceği gibi, depresyon sahibi bireylerde demir eksikliği görülme riski de fazladır. Dolayısıyla normal serum demir düzeylerinin ve diyetle yeterli demir tüketiminin, hem depresyon önleyici hem de antidepresan benzeri görev gösterdiği söylenebilir.…”