Predictors of healthcare-seeking behavior among Chinese patients with irritable bowel syndrome

Alizadeh-Tabari

2019

Aliment Pharmacol Ther

291

195

Background: Irritable bowel syndrome (IBS) is a common and potential disabling functional gastrointestinal disorder. Studies have revealed a possible association between IBS and psychological problems, such as anxiety and depression. Existing systematic reviews have addressed only the levels of anxiety or depression in patients with IBS. Aim:To investigate systematically the prevalence of anxiety or depression in IBS patients Methods: A literature search was conducted using the related keywords from the bibliographic databases of Embase, PubMed, Scopus, Web of Science and POPLINE published until 1 January 2019 with no language restriction. Studies reporting the prevalence of anxiety/depressive symptoms/disorders in adult (≥15 years) IBS patients were evaluated. The pooled prevalence, odds ratio (OR) and 95% CI were calculated using stata software.Results: A total of 14 926 articles were initially screened, and finally 73 papers were included. The prevalence rates of anxiety symptoms and disorders in IBS patients were 39.1% (95% CI: 32.4-45.8) and 23% (95% CI: 17.2-28.8) respectively. The ORs for anxiety symptoms and disorders in IBS patients compared with healthy subjects were 3.11 (95% CI: 2.43-3.98) and 2.52 (95% CI: 1.99-3.20) respectively. The prevalence estimates of depressive symptoms and disorders in IBS patients were 28.8% (95% CI: 23.6-34) and 23.3% (95% CI: 17.2-29.4) respectively. The ORs for depressive symptoms and disorders in IBS patients compared to healthy subjects were 3.04 (95% CI: 2.37-3.91) and 2.72 (95% CI: 2.45-3.02) respectively. Conclusion: Patients with IBS have a three-fold increased odds of either anxiety or depression, compared to healthy subjects. | 133 ZAMANI et Al. S U PP O RTI N G I N FO R M ATI O N Additional supporting information will be found online in the Supporting Information section at the end of the article. How to cite this article: Zamani M, Alizadeh-Tabari S, Zamani V. Systematic review with meta-analysis: the prevalence of anxiety and depression in patients with irritable bowel syndrome. Aliment Pharmacol Ther. 2019;50:132-143. https ://

Section: Resultsmentioning

confidence: 99%

Systematic review with meta‐analysis: the prevalence of anxiety and depression in patients with irritable bowel syndrome

Alizadeh-Tabari

2019

Aliment Pharmacol Ther

291

195

J Neurogastroenterol Motil

“…Patients with organic GI diseases, connective tissue diseases, and metabolic diseases as confirmed by laboratory and endoscopy examinations in the last year were excluded. 15 All patients were informed about the study, after which they provided either written or verbal consent to participate. This study was approved by the Ethics Committee of hospital (Approval No.…”

Section: Study Populationmentioning

confidence: 99%

“…18,19 The HAMD was administered by 3 specially trained professionals through conversation and observation. Depression states were defined as follows: normal (total HAMD score of ≤ 7), possible depression (8)(9)(10)(11)(12)(13)(14)(15)(16), mild depression (17)(18)(19)(20)(21)(22)(23), and moderate to severe depression (≥ 24). The 17 items were grouped into 5 structural factors: "anxiety/somatization" (including items of psychic anxiety, somatic anxiety, GI symptoms, general somatic symptoms, hypochondriasis [self-absorption, ie, bodily, hypochondriacal delusions, etc], and insight), "mental disorders" (including items of guilt, suicide, and agitation), "retardation symptoms" (including items of depressed mood, work and interests, retardation, and genital symptoms), "sleep disturbances" (including items of initial insomnia, middle insomnia, and delayed insomnia), and "weight loss."…”

Section: Instrumental Evaluationmentioning

confidence: 99%

Depression and Structural Factors Are Associated With Symptoms in Patients of Irritable Bowel Syndrome With Diarrhea

Lü

Shi

Huang

et al. 2020

Self Cite

Background/Aims A strong correlation between depression and irritable bowel syndrome with diarrhea (IBS-D) has been identified. The aim of this study is to identify the correlations among depression, structural factors, gastrointestinal (GI) and extra-GI symptoms, and efficacy of neuromodulators in patients with IBS-D. Methods Patients meeting the Rome III Diagnostic Criteria for IBS-D were enrolled. The intestinal symptoms and psychological states were evaluated using IBS-specific symptom questionnaires and Hamilton Depression Rating Scale. Results In total, 410 patients with IBS-D were enrolled, 28.8% (118/410) had comorbid depression. Patients with depression did not readily experience improvement in abdominal pain/discomfort after defecation, and had a higher prevalence of passing mucus, overlapping functional dyspepsia, and extra-GI symptoms. The structural factor "mental disorders" significantly correlated with main bowel symptom score and degree of pre-defecation abdominal pain/discomfort. No structural factor significantly correlated with bowel movements or stool form. Patients who had passing mucus, overlapping functional dyspepsia and extra-GI painful symptoms have higher score of "anxiety/somatization." Patients with sexual dysfunction have higher score of "retardation symptoms." In total, 28.3% of patients with IBS-D were prescribed neuromodulators. Baseline scores of "anxiety/somatization" and "retardation symptoms" positively correlated with improvement of diarrhea after paroxetine, and "sleep disturbances" positively correlated with improvement of abdominal pain/discomfort and diarrhea after mirtazapine. Conclusions Comorbid depression and higher scores of structural factors might aggravate GI and extra-GI symptoms other than bowel movements and stool form. Structural factors of Hamilton Depression Rating Scale correlated with efficacy of paroxetine and mirtazapine in patients with IBS-D.

“…It should be noted that the magnitude of reduction in disease severity observed in our study is uncommon. Further, during the present study, the majority of patients shifted to lower IBS severity categories, some moving from a severe to a mild form of the disease, which has been associated in the literature with a decrease in health care seeking and an improvement of quality of life[ 2 , 21 ].…”

Section: Discussionmentioning

confidence: 73%

Effect of Bifidobacterium longum 35624 on disease severity and quality of life in patients with irritable bowel syndrome

Sabaté¹,

Iglicki²

2022

WJG

BACKGROUND Bifidobacterium longum 35624 has shown efficacy in improving irritable bowel syndrome (IBS) symptoms compared with placebo in double-blind randomized studies. However, few data are available from real-life clinical practice or from studies that used Rome IV criteria to diagnose IBS. AIM To assess the effect of B. longum 35624 on IBS severity and quality of life in a real-life setting. METHODS From November 2018 to January 2020, 278 patients with IBS (according to Rome IV criteria) were enrolled in a prospective, open-label, multicenter observational study by private practice gastroenterologists to received one capsule of B. longum 35624 (10 9 colony-forming units) per day for 30 d. Participation in the study was independently proposed to patients during spontaneous consultations. Disease severity (assessed by the IBS severity scoring system) and patient quality of life (assessed by the IBS quality of life questionnaire) were compared between the inclusion visit (baseline) and the visit at the end of 30 d of treatment. The characteristics of patients were described at baseline. Continuous variables comparisons between inclusion and end-of-treatment visits were performed using the t-test and Kruskal-Wallis test. Categorical variables comparisons were performed using the χ2 test. RESULTS A total of 233 patients, with a mean age of 51.4 years and composed of 71.2% women, were included in the study. Of these patients, 48.1% had moderate IBS and 46.4% had severe IBS. After a 30-d treatment period with one B. longum 35624 capsule per day, a significant decrease in IBS severity was observed compared to baseline (mean ± SD, IBS severity scoring system scores: 208 ± 104 vs 303 ± 81, P < 0.001) and 57% of patients moved to lower severity categories or achieved remission. The quality of life of patients was also improved by the treatment (IBS Quality of Life questionnaire score: 68.8 ± 20.9 vs 60.2 ± 20.5; P < 0.001) and 63.8% of patients were satisfied with the treatment. CONCLUSION Thirty days of treatment with B. longum 35624 reduces disease severity and improves the quality of life of patients with IBS, particularly those with the most severe forms of IBS.