Author's reply to comment on the article: Psychological issues in patients with irritable bowel syndrome: Throwing more light is necessary

Anxiety and depression in Indian patients with irritable bowel syndrome: A meta-analysis

BACKGROUND

Functional gastrointestinal disorders (FGIDs), including irritable bowel syndrome (IBS), are associated with psychological abnormalities, such as anxiety and depression. Though the data on this are plenty in global literature, Indian data are sparse. We performed a systematic review and meta-analysis of Indian data on anxiety and depression among patients with IBS to estimate their pooled prevalence and to identify the shortcomings so that future areas of research can be identified.

METHOD

A comprehensive literature search was performed for studies applying tests for psychological issues in patients with IBS. After applying prospectively decided exclusion criteria, the eligible papers were examined using a meta-analysis approach for the prevalence of anxiety and depression in IBS patients using different tests. The odds ratios (OR) of anxiety and depression among subjects with IBS were calculated compared to controls.

RESULTS

Of seven studies (590 IBS patients and 1520 controls) included in the meta-analysis, the pooled OR of anxiety was 8.060 (95% confidence interval [CI] 4.007-16.213) as compared to controls (random-effect model). The pooled OR of depression was 7.049 (95% CI 3.281-15.147) compared to controls (random-effect model). There was significant heterogeneity in the included studies.

CONCLUSION

The current meta-analysis shows that the patients with IBS from India have eightfold greater risks of anxiety and sevenfold greater risks of depression than the controls. However, most of these data were from tertiary urban centers, and hence, there might be recruitment bias over-estimating the frequency.