Prevalence of Subthreshold Depression Among Constipation-Predominant Irritable Bowel Syndrome Patients

Abstract

Patients suffering from irritable bowel syndrome (IBS) may have some form of affective disorders that may worsen their symptoms. Lack of screening among IBS patients is one of the reasons for depression unawareness among healthcare providers. The present study was conducted to evaluate the prevalence of depression among patients with constipation-predominant IBS (IBS-C). A total of 240 IBS patients who fulfilled Rome III criteria were enrolled. The psychiatric assessment was evaluated using the Center for Epidemiologic Studies Depression Scale Revised (CESD-R). Twenty items in CESD-R scale measured symptoms of depression in nine separate groups. Patients were categorized into five different subgroups: major depressive episode, probable major depressive episode, possible major depressive episode, subthreshold depressive symptoms, and without clinical significance of depression. Out of the 240 patients with IBS-C, the majority (n = 161, 67.1%) had no clinical significance of depression. Seventy seven (32.1%) had subthreshold depression and only two (0.83%) patients were regarded as having probable a major depressive episode. No patient was categorized into a major or possible major depressive episode. The prevalence of subthreshold depression was the highest among female (72.3%) patients with 51.1% being single, 44.7% were married, and 4.3% were divorcees. When stratified according to ethnicity, subthreshold depression was highly prevalent among Malays (76.6%), followed by Chinese (19.2%), and Indians (2.1%). A high percentage of the patients were found to be non-smokers (93.6%) and had lower income of less than RM 5000 (USD 1250) per month (89.4%). The moderately high prevalence of subthreshold depression among patients with IBS, justifies psychological evaluation in all patients with functional gastrointestinal disorders.

Irritable Bowel Syndrome, Depression, and Neurodegeneration: A Bidirectional Communication from Gut to Brain

“…Clinical unipolar depression or major depression disorder is a common mental illness, affecting more than 300 million people worldwide [ 35 ]. Depression is a form of behavioral dysregulation caused by an interplay of many factors, such as the environment, gender, age, and comorbidity with other pre-existing illnesses, including IBS [ 36 , 37 ]. Patients with IBS often suffer from significantly higher levels of depression compared to healthy subjects [ 38 , 39 , 40 , 41 ] as well as individuals affected by inflammatory bowel disease (IBD) [ 42 ].…”

“…Further sub-analysis in which IBS subtypes were considered separately showed the highest depression among IBS-C patients [ 40 ]. More recently, our research team demonstrated that about 32.1% of the IBS-C patient population in Malaysia has sub-threshold or subclinical depression, which can be easily missed in clinical practice [ 37 ]. According to Bahrudin et al (2020), the consumption of cultured drinks (probiotics) containing prebiotics in the form of polydextrose can significantly improve bowel function in IBS-C patients [ 111 ].…”

Stable abnormalities of contrast discrimination sensitivity in subthreshold depression: A longitudinal study

“…Investigating whether individuals with StD could have deficits in visual functioning is necessary for several reasons. Firstly, the prevalence of StD is higher than that of MDD (Cuijpers et al, 2007; Cuijpers et al, 2013; Mokhtar et al, 2020; Vaccaro et al, 2017). For example, a meta‐analysis of 22 studies about StD and MDD showed that the pooled prevalence rate of StD and MDD were 0.17 and 0.10, respectively (Cuijpers et al, 2013).…”

Hypnotherapy and IBS: Implicit, long-term stress memory in the ENS?

“…Subthreshold mental disorders (SMDs) (that do not meet full diagnostic criteria for mental disorders) are attracting increased attention in scientific research because SMDs can be an important source of countless other diseases and poor quality of life and thus may also be a cause of IBS development [ [104] , [105] , [106] , [107] , [108] , [109] , [110] , [111] , [112] , [113] ]. SMDs are often undiagnosed, although the prevalence of SMDs is higher than that of diagnosed mental disorders [ 104 ]. Furthermore, SMDs include the same symptoms as diagnosed mental disorders, except that they differ in the number, duration, severity, and frequency of symptoms and exclusion criteria [ 107 ].…”