The Burden of Psychiatric Manifestations in Inflammatory Bowel Diseases: A Systematic Review With Meta-analysis

被引：5

作者：

Massironi, Sara ^{[1
,2
]}

Pigoni, Alessandro ^{[3
]}

Vegni, Elena Anna Maria ^{[4
,5
]}

Keefer, Laurie ^{[6
]}

Dubinsky, Marla C. ^{[7
]}

Brambilla, Paolo ^{[3
,8
]}

Delvecchio, Giuseppe ^{[3
]}

Danese, Silvio ^{[9
,10
]}

机构：

[1] Univ Milano Bicocca, Dept Med & Surg, Monza, Italy

[2] Fdn IRCCS San Gerardo Tintori, Div Gastroenterol, Monza, Italy

[3] Osped Maggiore Policlin, Fdn IRCCS CaGranda, Dept Neurosci & Mental Hlth, Milan, Italy

[4] ASST Santi Paolo & Carlo, Dept Mental Hlth, Milan, Italy

[5] Univ Milan, Dept Hlth Sci, Milan, Italy

[6] Icahn Sch Med Mt Sinai, Div Gastroenterol, New York, NY USA

[7] Icahn Sch Med, Div Pediat Gastroenterol & Nutr, New York, NY USA

[8] Univ Milan, Dept Pathophysiol & Transplantat, Milan, Italy

[9] IRCCS San Raffaele Hosp, Gastroenterol & Endoscopy, Milan, Italy

[10] Univ Vita Salute San Raffaele, Sch Med, Milan, Italy

来源：

INFLAMMATORY BOWEL DISEASES | 2025年 / 31卷 / 05期

关键词：

inflammatory bowel disease; Crohn's disease; ulcerative colitis; psychiatric manifestations; depression; anxiety; systematic review; meta-analysis; DEPRESSIVE SYMPTOMS; BIPOLAR DISORDER; YOUNG-ADULTS; ANXIETY; COMORBIDITY; POPULATION; ASSOCIATION; QUALITY; BRAIN; RISK;

D O I：

10.1093/ibd/izae206

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: Psychiatric disorders in patients with inflammatory bowel disease (IBD) represent a significant but uncertain facet of the disease, with unsolved questions regarding their overall magnitude, their impact on intestinal disease, and the whole burden of psychiatric manifestations. Aim: This systematic review summarizes the evidence on the prevalence and impact of psychiatric disorders, including depression, anxiety, bipolar disorder (BD), and schizophrenia, among patients with IBD. Methods: A systematic search across PubMed/MEDLINE, Embase, and Scopus databases from January 2010 to January 2023 was performed to identify relevant studies. The focus was on studies exploring the prevalence of specific psychiatric disorders in IBD patients compared to the general population and that reported specific outcome measures. A subsequent meta-analysis (MA) assessed the strength of the association between IBD and these psychiatric disorders, with data reliability ensured through rigorous extraction and quality assessment. Results: Out of 3,209 articles, 193 met the inclusion criteria and only 26 provided complete data for comprehensive analysis. These studies showed a significantly higher overall prevalence of psychiatric comorbidities in IBD patients compared to the general population. The MA showed a significant association between IBD and depression (pooled OR 1.42, 95% CI = 1.33-1.52, P < .0001) and anxiety (pooled OR 1.3, 95% CI = 1.22-1.44, P < .0001). The association between IBD and BD was significant (pooled OR 1.64, 95% CI = 1.20-2.24, P < .0001) but showed considerable heterogeneity (I-2 = 94.01%). Only 3 studies examined the association between schizophrenia and IBD, providing widely heterogeneous results, with an inconclusive OR, estimated at 0.93 (95% CI = 0.62-1.39, P = .73). Conclusions: This MA highlights the high prevalence of psychiatric disorders, particularly depression and anxiety, in IBD patients, which exceeds rates in the general population. BD in IBD is proving to be an important but under-researched area. The sparse and contradictory data on schizophrenia requires further investigation. These findings highlight the need for better understanding, early detection, and tailored mental health interventions in the management of IBD to significantly improve patients' quality of life.

引用

页码：1441 / 1459

页数：19

共 76 条

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