Effect of antidepressants on psychological comorbidities, disease activity, and quality of life in inflammatory bowel disease: a systematic review and meta-analysis.

IF 4.2 3区医学 Therapeutic Advances in Gastroenterology Pub Date : 2023-01-01 DOI:10.1177/17562848231155022

Liangfang Wang, Chang Liang, Pingrun Chen, Yubin Cao, Yan Zhang

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引用次数: 1

Abstract

Background: Patients with inflammatory bowel disease (IBD) are often accompanied by a more significant burden of depression or anxiety, and approximately one-third are prescribed antidepressants. However, previous studies on the efficacy of antidepressants in IBD have shown inconsistent results.

Objectives: To evaluate the effect of antidepressants on depression, anxiety, disease activity, and quality of life (QoL) in IBD patients.

Design: A systematic review and meta-analysis.

Methods: We searched MEDLINE via Ovid, EMBASE via Ovid, the Cochrane Library, CINAHL, PsycINFO, Chinese CBM Database, China National Knowledge Infrastructure, VIP, and Wanfang Database from inception to 13th July 2022 without language restrictions.

Results: In all, 13 studies containing 884 individuals were included. Compared with the control group, antidepressants were superior in reducing depression scores [standardized mean difference (SMD) = -0.791; 95% confidence interval (CI): -1.009 to -0.572; p < 0.001], anxiety scores (SMD = -0.877; 95% CI: -1.203 to -0.552; p < 0.001), and disease activity scores (SMD = -0.323; 95% CI: -0.500 to -0.145; p < 0.001). Antidepressants had a positive effect in reaching clinical remission [risk ratio (RR) = 1.383; 95% CI: 1.176-1.626; p < 0.001]. Higher physical QoL (SMD = 0.578; 95% CI: 0.025-1.130; p = 0.040), social QoL (SMD = 0.626; 95% CI: 0.073-1.180; p = 0.027), and Inflammatory Bowel Disease Questionnaire (SMD = 1.111; 95% CI: 0.710-1.512; p < 0.001) were found in the experimental group. No significant differences were observed in clinical response (RR = 1.014; 95% CI: 0.847-1.214; p = 0.881), psychological QoL (SMD = 0.399; 95% CI: -0.147 to 0.944; p = 0.152), and environmental QoL (SMD = 0.211; 95% CI: -0.331 to 0.753; p = 0.446).

Conclusion: Antidepressants are effective for ameliorating depression, anxiety, disease activity, and QoL in IBD patients. Due to most studies having a small sample size, further well-designed studies are required.

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抗抑郁药对炎症性肠病心理合并症、疾病活动性和生活质量的影响:一项系统回顾和荟萃分析

背景:炎症性肠病(IBD)患者通常伴有更严重的抑郁或焦虑负担，约三分之一的患者服用抗抑郁药。然而，先前关于抗抑郁药对IBD疗效的研究显示出不一致的结果。目的:评价抗抑郁药对IBD患者抑郁、焦虑、疾病活动性和生活质量的影响。设计:系统回顾和荟萃分析。方法:检索自成立至2022年7月13日的MEDLINE、EMBASE、Cochrane Library、CINAHL、PsycINFO、Chinese CBM Database、China National Knowledge Infrastructure、VIP、万方数据库，检索时间不限。结果:共纳入13项研究，共884人。与对照组相比，抗抑郁药在降低抑郁评分方面优于对照组[标准化平均差(SMD) = -0.791;95%置信区间(CI): -1.009 ~ -0.572;p p p p p = 0.040)，社会生活质量(SMD = 0.626;95% ci: 0.073-1.180;p = 0.027)，炎症性肠病问卷(SMD = 1.111;95% ci: 0.710-1.512;p = 0.881)，心理生活质量(SMD = 0.399;95% CI: -0.147 ~ 0.944;p = 0.152)，环境质量(SMD = 0.211;95% CI: -0.331 ~ 0.753;p = 0.446)。结论:抗抑郁药物可有效改善IBD患者的抑郁、焦虑、疾病活动性和生活质量。由于大多数研究的样本量较小，需要进一步设计良好的研究。

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来源期刊

Therapeutic Advances in Gastroenterology Medicine-Gastroenterology

自引率

2.40%

发文量

103

期刊介绍： Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area. The editors welcome original research articles across all areas of gastroenterology and hepatology. The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.