Systematic review with meta‐analysis: anxiety and depression in children and adolescents with inflammatory bowel disease

• Published in: Alimentary pharmacology & therapeutics 2018-09, Vol.48 (5), p.496-506
• Main Authors: Stapersma, L., Brink, G., Szigethy, E. M., Escher, J. C., Utens, E. M. W. J.
• Format: Article
• Language: English
• Subjects: Adolescents; Anxiety; Children; Heterogeneity; Inflammatory bowel disease; Inflammatory bowel diseases; Intestine; Measuring instruments; Mental depression; Meta-analysis; Regression analysis; Studies; Systematic review
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/apt.14865

Summary Background The co‐existence of psychological problems and paediatric inflammatory bowel disease (IBD) is receiving increasing attention. Most studies investigated anxiety and depression, with prevalence rates varying from 0% to 50%. A systematic review is necessary to provide clear insight into the prevalence of anxiety and depression in paediatric IBD. Aim To systematically evaluate available data on the prevalence of anxiety and depressive symptoms and disorders in paediatric IBD (aged 6‐18 years). Methods Comprehensive searches were performed in Embase, Medline Ovid, Web of Science, Cochrane, PubMed, PsychInfo Ovid, and Google scholar for studies published from 1994 to 2017. Pooled prevalence rates were calculated using inverse variance heterogeneity models. Meta‐regression was used to study if disease type, disease activity and gender influence prevalence. Results Twenty‐eight studies (N = 8107, mean age: 14.3) were identified. Pooled prevalence estimates were 16.4% (95% confidence interval [CI] 6.8%‐27.3%) for anxiety symptoms and 4.2% (95% CI 3.6%‐4.8%) for anxiety disorders. Pooled prevalence estimates were 15.0% (95% CI 6.4%‐24.8%) for depressive symptoms and 3.4% (95% CI 0%‐9.3%) for depressive disorders. Meta‐regression showed no influence of disease type or gender on these prevalence rates, but studies with a higher percentage of active disease had a higher rate of depressive symptoms. Conclusions The described pooled prevalence of anxiety and depressive symptoms is lower than in adult IBD. However, due to varying instruments/cut‐offs for measuring symptoms and few studies investigating disorders, the results should be interpreted with caution. Cross‐cultural use of the same instruments is needed to gain better insight into prevalence rates. Linked ContentThis article is linked to Mikocka‐Walus and Knowles, and Stapersma et al papers. To view these articles visit https://doi.org/10.1111/apt.14912 and https://doi.org/10.1111/apt.14928.