Int J Biol Sci 2018; 14(11):1504-1512. doi:10.7150/ijbs.25001

Research Paper

Depressive symptoms in patients with irritable bowel syndrome: a meta-analysis of comparative studies

Qing-E Zhang1#, Fei Wang2,3#, Geng Qin4#, Wei Zheng5, Chee H. Ng6, Gabor S. Ungvari7,8, Zhen Yuan3, Songli Mei9, Gang Wang1✉, Yu-Tao Xiang3✉

1. The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China;
2. Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China;
3. Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China;
4. Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, China;
5. The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China;
6. Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia;
7. University of Notre Dame Australia, Perth, Australia;
8. Division of Psychiatry, University of Western Australia Medical School, Perth, Australia;
9. School of Public Health, Jilin University, Jilin province, China
# These authors contributed equally to the work.


Depression is common in patients with irritable bowel syndrome (IBS), but the reported prevalence across different studies is inconsistent. This meta-analysis systematically examined the presence and severity of depressive symptoms in patients with IBS. Two investigators independently performed a literature search. The pooled depressive symptom severity was calculated using a random effects model. Subgroup, sensitivity and meta-regression analyses were conducted to examine the moderating factors of the development of depressive symptoms. Twenty four studies (n=2,837) comparing depressive symptoms between IBS patients (n=1,775) and healthy controls (n=1,062) were identified; 14 (58.3%) studies were rated as high quality. Compared to healthy controls, IBS patients had more frequent (OR=9.21, 95%CI: 4.56-18.57, P<0.001; I2=76%) and more severe depressive symptoms (n=1,480, SMD=2.02, 95%CI: 1.56-2.48, P<0.001; I2=94%). Subgroup analyses revealed that patients with all IBS subtypes had more severe depressive symptoms than controls. In addition, versions of the Hamilton Depression Rating Scale (HAM-D) and IBS diagnostic criteria were significantly associated with depressive symptom severity. Meta-regression analyses revealed that female gender, younger age and small sample size were significantly associated with more severe depressive symptoms. In conclusion, meta-analytic data showed that IBS patients had more frequent and severe depressive symptoms than healthy controls. Adequate screening and treatment for depression should be developed and implemented in this patient population.

Keywords: IBS, depressive symptoms, controlled studies, meta-analysis

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How to cite this article:
Zhang QE, Wang F, Qin G, Zheng W, Ng CH, Ungvari GS, Yuan Z, Mei S, Wang G, Xiang YT. Depressive symptoms in patients with irritable bowel syndrome: a meta-analysis of comparative studies. Int J Biol Sci 2018; 14(11):1504-1512. doi:10.7150/ijbs.25001. Available from