Bidirectional brain–gut axis effects influence mood and prognosis in IBD: a systematic review and meta-analysis
Objective
The role of the brain–gut axis is of increasing interest in IBD, as the link between common mental disorders and GI inflammation may be bidirectional. We performed a systematic review examining these issues.
Design
We searched EMBASE Classic and EMBASE, Medline, and APA PsychInfo (to 11 July 2021) for longitudinal follow-up studies examining effect of symptoms of anxiety or depression on subsequent adverse outcomes in IBD, or effect of active IBD on subsequent development of symptoms of anxiety or depression. We pooled relative risks (RRs) and HRs with 95% CIs for adverse outcomes (flare, escalation of therapy, hospitalisation, emergency department attendance, surgery or a composite of any of these) according to presence of symptoms of anxiety or depression at baseline, or RRs and HRs with 95% CIs for new onset of symptoms of anxiety or depression according to presence of active IBD at baseline.
Results
We included 12 separate studies, recruiting 9192 patients. All 12 studies examined brain-to-gut effects. Anxiety at baseline was associated with significantly higher risks of escalation of therapy (RR=1.68; 95% CI 1.18 to 2.40), hospitalisation (RR=1.72; 95% CI 1.01 to 2.95), emergency department attendance (RR=1.30; 95% CI 1.21 to 1.39), or a composite of any adverse outcome. Depression at baseline was associated with higher risks of flare (RR=1.60; 95% CI 1.21 to 2.12), escalation of therapy (RR=1.41; 95% CI 1.08 to 1.84), hospitalisation (RR=1.35; 95% CI 1.17 to 1.57), emergency department attendance (RR=1.38; 95% CI 1.22 to 1.56), surgery (RR=1.63; 95% CI 1.19 to 2.22) or a composite of any of these. Three studies examined gut-to-brain effects. Active disease at baseline was associated with future development of anxiety or depression (RR=2.24; 95% CI 1.25 to 4.01 and RR=1.49; 95% CI 1.11 to 1.98, respectively).
Conclusion
Bidirectional effects of the brain–gut axis are present in IBD and may influence both the natural history of the disease and psychological health.
Топ-30
Журналы
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Alimentary Pharmacology and Therapeutics
8 публикаций, 5.16%
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Frontiers in Immunology
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Inflammatory Bowel Diseases
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International Journal of Molecular Sciences
4 публикации, 2.58%
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Scientific Reports
4 публикации, 2.58%
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American Journal of Gastroenterology
3 публикации, 1.94%
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Journal of Psychosomatic Research
3 публикации, 1.94%
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Neurogastroenterology and Motility
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The Lancet Gastroenterology and Hepatology
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Biomedicines
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BMC Gastroenterology
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International Journal of Environmental Research and Public Health
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Gastroenterology
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EClinicalMedicine
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Frontiers in Microbiology
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Gut
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Crohn s & Colitis 360
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Journal of Clinical Medicine
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Journal of Agricultural and Food Chemistry
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Food Bioscience
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Journal of Crohn's and Colitis
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Frontline Gastroenterology
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Journal of Translational Medicine
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Journal of Clinical Gastroenterology
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Journal of Digestive Diseases
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PLoS ONE
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Journal of Inflammation
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Reviews in the Neurosciences
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Mediators of Inflammation
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Elsevier
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Springer Nature
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Wiley
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MDPI
14 публикаций, 9.03%
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Oxford University Press
13 публикаций, 8.39%
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Frontiers Media S.A.
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Ovid Technologies (Wolters Kluwer Health)
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BMJ
5 публикаций, 3.23%
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Taylor & Francis
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American Chemical Society (ACS)
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SAGE
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Georg Thieme Verlag KG
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Public Library of Science (PLoS)
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Hindawi Limited
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Baishideng Publishing Group
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Mark Allen Group
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American Physiological Society
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Cold Spring Harbor Laboratory
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AME Publishing Company
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