Systematic review of interventions for depression and anxiety in persons with inflammatory bowel disease.

Carol A Hitchon,Kirsten M Fiest,Jitender Sareen,Ryan Zarychanski,Scott B Patten,Lesley A Graff,Ruth Ann Marrie,Christine A Peschken,Alexander Singer,John R Walker,James Bolton,Ahmed Abou-Setta,Charles N Bernstein

doi:10.1186/s13104-016-2204-2

Abstract

BackgroundDepression and anxiety are common in inflammatory bowel disease (IBD) and can affect disease outcomes, including quality of life and success of disease treatment. Successful management of psychiatric comorbidities may improve outcomes, though the effectiveness of existing treatments in IBD is unknown.MethodsWe searched multiple online databases from inception until March 25, 2015, without restrictions on language, date, or location of publication. We included controlled clinical trials conducted in persons with IBD and depression or anxiety. Two independent reviewers reviewed all abstracts and full-text articles and extracted information including trial and participant characteristics. We also assessed the risk of bias.ResultsOf 768 unique abstracts, we included one trial of pharmacological anxiety treatment in IBD (48 participants), which found an improvement in anxiety symptoms (p < 0.001). There was a high risk of bias in this trial. We found no controlled clinical trials on the treatment of depression in persons with IBD and depression and no controlled clinical trials reporting on psychological interventions for anxiety or depression in IBD.ConclusionsOnly one trial examined an intervention for anxiety in adults with IBD and no trials studied depression in adults with IBD. The level of evidence is low because of the risk of bias and limited evidence.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2204-2) contains supplementary material, which is available to authorized users.

Highlights

Depression and anxiety are common in inflammatory bowel disease (IBD) and can affect disease out‐ comes, including quality of life and success of disease treatment
Over 50 % (399/733) were excluded because they were not conducted in a population of persons with IBD, almost 29 % (210/733) were excluded as the study population did not have depression or anxiety, while 16 % (117/733) were excluded as they did not study depression or anxiety, and the final abstracts were excluded because they were duplicates (Fig. 1)
A second abstract review was completed where a further 17 abstracts were excluded because they were not controlled clinical trials; others were excluded as they were not conducted in a population with depression or anxiety

Summary

Introduction

Depression and anxiety are common in inflammatory bowel disease (IBD) and can affect disease out‐ comes, including quality of life and success of disease treatment. Successful management of psychiatric comorbidities may improve outcomes, though the effectiveness of existing treatments in IBD is unknown. IBD emerges in children, but the peak age of onset is in the third and fourth decades [2,3,4]. This disease impacts affected individuals in the prime of their lives from social and work perspectives, and is associated with considerable disability [5,6,7]. Used pharmacological treatments for depression and anxiety may be less effective in those who use anti-inflammatory therapies, [11] or lead to potentially

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Conclusion