Effects of standard treatments on depressive/anxiety symptoms in patients with inflammatory bowel disease: A systematic review and meta-analysis

Objective: A combination of inflammatory bowel disease (IBD) and psychological comorbidities can influence the natural course of IBD. A systematic review and meta-analysis was performed to examine whether a standard IBD medical therapy without any antipsychotic intervention has beneficial effects on depression/anxiety in IBD patients. Methods: PubMed and Web of Science databases were systematically searched for related literature from their inception to March 2020. The random-effects model was used to calculate the standardized mean difference (SMD). A total of 16 eligible studies were included in the present meta-analysis. Results: Compared with baseline assessments, IBD patients with standard IBD medication had significantly reduced depression assessment scores (pooled SMD = 0.500; 95% confidence interval: 0.207, 0.793; P = 0.001). These results were obtained without any psychological interventions. Additionally, no significant differences in anxiety-related scores were detected between the baseline assessments and the end of therapy assessments (pooled SMD = 0.083; 95% confidence interval: 0.120, 0.285; P = 0.425). The meta-regression and subgroup analyses revealed that differences in assessment tools and medications might be the main source of heterogeneity. Conclusion: Standard IBD treatments can significantly alleviate the depressive symptoms in IBD patients. However, more studies are needed to analyze this association.