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Systematic review with meta-analysis: the impact of a depressive state on disease course in adult inflammatory bowel disease

Alexakis, C; Kumar, S; Saxena, S; Pollok, R (2017) Systematic review with meta-analysis: the impact of a depressive state on disease course in adult inflammatory bowel disease. Alimentary Pharmacology & Therapeutics, 46 (3). pp. 225-235. ISSN 0269-2813 https://doi.org/10.1111/apt.14171
SGUL Authors: Pollok, Richard Charles G

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Abstract

Background Despite a higher prevalence of psychosocial morbidity in Inflammatory Bowel Disease (IBD), the association between depressive state and disease course in IBD is poorly understood. Aim To investigate the impact of depressive state on disease course in IBD. Methods We conducted a systematic review in MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews and PsychINFO for prospective studies evaluating the impact of baseline depressive state on subsequent disease course in adult IBD. Results Eleven studies matched our entry criteria, representing 3194 patients with IBD. Three reported on patients with ulcerative colitis (UC), four included patients with Crohn's disease (CD) exclusively, and four studies included both UC and CD. Five studies reported an association between depressive state and disease course. None of the UC‐specific studies found any association. In three of four CD‐specific studies, a relationship between depressive state and worsening disease course was found. In four of five studies including patients in remission at baseline, no association between depressive state and disease course was found. Pooled analysis of IBD studies with patients in clinical remission at baseline identified no association between depressive state and disease course (HR 1.04, 95%CI: 0.97‐1.12). Conclusion There is limited evidence to support an association between depressive state and subsequent deterioration in disease course in IBD, but what data that exist are more supportive of an association with CD than UC. Baseline disease activity may be an important factor in this relationship. Further studies are needed to understand the relationship between mental health and outcomes in IBD.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: Alexakis, C, Kumar, S, Saxena, S, Pollok, R. Systematic review with meta‐analysis: the impact of a depressive state on disease course in adult inflammatory bowel disease. Aliment Pharmacol Ther. 2017; 46: 225– 235, which has been published in final form at https://doi.org/10.1111/apt.14171. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Keywords: 1103 Clinical Sciences, 1115 Pharmacology And Pharmaceutical Sciences, Gastroenterology & Hepatology
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Alimentary Pharmacology & Therapeutics
ISSN: 0269-2813
Dates:
DateEvent
August 2017Published
2 June 2017Published Online
11 May 2017Accepted
Publisher License: Publisher's own licence
Projects:
Project IDFunderFunder ID
CDF-2011-04-048National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
URI: https://openaccess.sgul.ac.uk/id/eprint/109397
Publisher's version: https://doi.org/10.1111/apt.14171

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