Association between depression and anxiety with the risk and flare of inflammatory bowel disease: a systematic review and meta-analysis

Inflammatory bowel disease (IBD) is a chronic condition characterized by inflammation in the gastrointestinal tract. Previous studies have suggested a potential association between mental disorders, such as depression and anxiety, and the risk and flare of IBD. However, the findings have been inconsistent. This study aimed to conduct a systematic review and meta-analysis to assess the relationship between mental disorders and IBD. A comprehensive literature search was performed to identify relevant studies. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to determine the association between mental disorders and the risk and flare of IBD. Heterogeneity between studies was assessed using the I2 statistic. Sensitivity analysis was conducted to evaluate the stability of the results. A total of seven studies met the inclusion criteria and were included in the meta-analysis. The pooled results demonstrated a significant association between symptoms of depression at baseline and an increased risk of disease activity flare during longitudinal follow-up, with an OR of 1.69 (95% CI 1.34, 2.13). However, there was high heterogeneity between studies (I2 = 82%). Furthermore, patients who underwent surgery had a higher risk of disease activity flare (OR: 1.49, 95% CI 1.13, 1.95), and hospitalization was also identified as a contributing factor (OR: 1.22, 95% CI 1.10, 1.36). This meta-analysis provides evidence for a significant association between symptoms of depression and the risk of disease activity flare in IBD. However, the high heterogeneity observed between studies suggests the need for further research to explore potential moderators and underlying mechanisms. These findings highlight the importance of addressing mental health in the management and treatment of patients with IBD.