The level and prevalence of depression and anxiety among patients with different subtypes of irritable bowel syndrome: a network meta-analysis

Zhichao Hu, Meixuan Li, Liang Yao, Yinshu Wang, Enkang Wang, Jianye Yuan, Fengyun Wang, Kehu Yang, Zhaoxiang Bian*, Linda L. D. Zhong*

*Corresponding author for this work

Research output: Contribution to journalJournal articlepeer-review

52 Citations (Scopus)


Background: Irritable bowel syndrome (IBS) is a very common functional bowel disorder. However, the difference of depression and anxiety comorbidities among different IBS subtypes is still not well evaluated. This study aims to investigate the difference in the level and prevalence of depression and anxiety among healthy controls and patients with different subtypes of IBS.

Methods: PubMed, EMBASE and the Cochrane library were searched systematically until August 17, 2020. Studies that investigated depression and/or anxiety levels or prevalence among different IBS-subtype patients measured at baseline or the same point were included. Network meta-analysis was conducted to analyze standardized mean difference (SMD) of anxiety and depression levels, and single arm meta-analysis was performed for prevalence of anxiety and depression among different IBS subtypes.

Results: Eighteen studies involving 7095 participants were included. Network meta-analyses results showed healthy controls had a lower level of depression than IBS with mixed symptoms of constipation and diarrhea (IBS-M) [SMD = − 1.57; 95% confidence interval (CI) − 2.21, − 0.92], IBS with constipation (IBS-C) (SMD = − 1.53; 95% CI − 2.13, − 0.93) and IBS with diarrhea (IBS-D)(SMD = − 1.41; 95% CI − 1.97, − 0.85), while no significant difference was found between IBS unclassified (IBS-U) and healthy controls (SMD = − 0.58; 95% CI − 2.15, 1.00). There was also no significant difference in the level of depression among different IBS subtypes patients. The results of anxiety were similar to depression. Ranking probability showed that IBS-M was associated with the highest level of depression and anxiety symptoms, followed by IBS-C/IBS-D and IBS-U. Single-arm meta-analysis showed IBS-C had the highest prevalence of depression (38%) and anxiety (40%), followed by IBS-D, IBS-M and IBS-U.

Conclusion: The results indicated that IBS-M was more likely to be associated with a higher level of depression and anxiety, and the prevalence of depression and anxiety in IBS-C was highest. The psychological screening and appropriate psychotherapy are needed for patients with IBS-C, IBS-D and IBS-M instead of IBS-U.

Original languageEnglish
Article number23
JournalBMC Gastroenterology
Issue number1
Publication statusPublished - 7 Jan 2021

Scopus Subject Areas

  • Gastroenterology

User-Defined Keywords

  • Anxiety
  • Depression
  • Irritable bowel syndrome
  • Meta-analysis


Dive into the research topics of 'The level and prevalence of depression and anxiety among patients with different subtypes of irritable bowel syndrome: a network meta-analysis'. Together they form a unique fingerprint.

Cite this