Associations between Anxiety, Depression, and Poor Quality of Sleep on the Risk of Irritable Bowel Syndrome: A Meta-Analysis
DOI:
https://doi.org/10.26911/jepublichealth.2023.08.01.05Abstract
Background: Risk factors for Irritable Bowel Syndrome (IBS) are mental disorders such as anxiety and depression, while sleep disorders affect 50% of patients with IBS. The condition of IBS if it is chronic can have a negative impact on quality of life and work productivity. The purpose of this study was to estimate the relationship between anxiety, depression and poor sleep quality with the risk of irritable bowel syndrome by means of a systematic review and meta-analysis study.
Subjects and Method: This article was prepared using systematic review and meta-analysis studies. This study uses the PICO Model. Meta-analytic studies were conducted by searching for articles from databases in electronic form using Google Scholar, PubMed, Springerlink, Sciencedirect, and the Cochrane Library. An article search was conducted on 15-30 October 2022. The keywords used were “irritable bowel syndrome” or “IBS” or “Functional gastrointestinal disorder” or “Anxiety” or “Depression” or “Mental Disorders” or “Psychological stress” or “Sleep quality” or “Sleep disturbances” or “Cross-Sectional”. The inclusion criteria for this study were complete articles using a Cross-Sectional study, with the year of publication 2009-2022. Analysis of the articles in this study used RevMan 5.3 software.
Results: A total of 30 cross-sectional studies from Asia were selected for systematic review and meta-analysis. The data collected shows that anxiety increases 1.53 times and depression 1.29 times with the risk of IBS while poor sleep quality increases the risk of IBS by 1.80 times. This data is considered statistically significant. The results showed that Anxiety (aOR=1.53; 95% CI=1.23 to 1.90; p=0.001), Depression (aOR=1.29; 95% CI=1.05 to 1.59; p=0.02), Poor sleep quality (aOR=1.80; 95% CI=1.48 to 2.19; p<0.001).
Conclusion: The relationship between anxiety-depression mental disorder and poor sleep quality is felt to be statistically significant in causing irritable bowel syndrome.
Keywords: irritable bowel syndrome, risk factors, anxiety, depression, sleep quality
Correspondence:
Cendekia Airedeta Mulianda. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: c.airedeta@gmail.com. Mobile: +6282336712311.
References
Abdallah AM, Sharafeddin MA (2021). Subjective sleep quality among patients with irritable bowel syndrome attending outpatient clinic in zagazig university hospital. J adv med. 39 (1):23-31. doi:10.21608/EJCM.20 21.144069.
Abdelsalam IRS, Ahmad MAM (2018). The prevalence of irritable bowel syndrome (ibs) in a private university in Malaysia, and its associated factors including stress, depression and anxiety. Asian J Med Health 13(2): 1-12. doi: 10.9734/AJMAH/2018/45604
Albutaysh OF, AlQurain AA, Almukhaitah AA, Alahmdi YM, Alharbi FS (2020). Epidemiology of irritable bowel syndrome and its associated factors in Saudi undergraduate students. Saudi J Gastroenterol, 26(2): 8993. doi: 10.4103/sjg.SJG_459_19.
Alqahtani NH, Mahfouz MEM (2022). The Prevalence and Risk Factors of Irritable Bowel Syndrome in Saudi Arabia in 2019. Int J Prev Med 13(13). doi: 10.4103/ijpvm.IJPVM_486_20.
Alvand S, Mohammadi Z, Rashidian L, Cheraghian B, Rahimi Z, Danehchin L, Paridar, et al. (2020). Irritable bowel syndrome: psychological disorder or poverty? Results of a large cross-sectional study in Iran. Arch Iran Med. 23(12):821-826. doi: 10.34172/aim.2020.109.
Banerjee A, Sarkhel S, Sarkar R, Dhali GK (2017). Anxiety and Depression in Irritable Bowel Syndrome. Indian J Psychol Med. 39(6): 741–745. doi: 10.4103/IJPSYM.IJPSYM_46_17.
Bellini M, Gemignani A, Gambaccini D, Toti S, Menicucci D, Stasi C, Costa F, et al. (2011). Evaluation of latent links between irritable bowel syndrome and sleep quality. World J Gastro enterol. 17:5089–96. doi: 10.3748/wjg.v17.i46.5089
Chen HD, Bair MJ, Chang WC, Hsu CS, Wong MW, Hung JS, Liu TT, et al. (2020). Similarities and differences between IBS-C and FC with regards to symptomatology, sleep quality and psychological attributes. J Formos Med Assoc, 119(11):75-80. doi: 10.1016/j.jfma.2019.02.017.
Drossman DA, Hasler WL (2016). Rome IV Functional GI disorders: Disorders of gut-brain interaction, Am J Gastroenterol. 150(6) 1257–1261. doi : 10.1053j.gastro.2016.03.035
Elhosseiny D, Mahmoud NE, Manzour AF (2019). Factors associated with irritable bowel syndrome among medical students at Ain Shams University. J Egypt Public Health Assoc. 94(1):23. doi: 10.1186/s42506-019-0023-8.
Ford AC, Lacy BE, M.D, Talley NJ (2017) Irritable Bowel Syndrome. N Engl J Med. 376(26) 2566–2578. doi: 10.1056/NEJMra1607547
Hye IK, Jung SA, Choi JY, Kim SE, Jung HK, Shim KN, Yoo K (2013). Impact of shiftwork on irritable bowel syndrome and functional dyspepsia. J Korean Med Sci 28:431-437. doi: 10.3346/jkms.2013.28.3.431.
Ibrahim NH, Bloushy RIA, Sait SH, Azhary HWA, Albar NH, Mirdad GA (2016). Irritable bowel syndrome among nurses working in King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Libyan J Med, 30(11):30866. doi: 10.3402/ljm.v11.308 66.
Ibrahim NK, Jamhoor SMA, Ashor NW, Alsulami AA, Bukhari DA, Blosh AMA, Fathi TT (2018). Irritable Bowel Syndrome among Paramedical Students, King Abdulaziz University, Jeddah, Saudi Arabia. J adv med. 25 (6):1-9. doi: 10.9734/JAMMR/2018/39233.
Jadallah KA, Khatatbeh MM, Sarsak EW, Sweidan AN, Alzubi BF (2022). Irritable bowel syndrome and its associated factors among Jordanian medical students: A cross-sectional study. Medicine (Baltimore), 101(33). doi: 10.1097/MD.0000000000030134.
Jiang C, Xu Y, Sharma S, Zhang L, Wang H, Song J, Qian W, et al. (2019). Psychosocial factors associated with irritable bowel syndrome development in Chinese College Freshmen. J Neurogastroenterol Motil, 25(2):233-240. doi: 10.5056/jnm18028.
Kim SY, Choung RS, Lee SK, Choe JW, Jung SW, Hyun JJ, Koo JS (2018). Self-reported Sleep Impairment in Functional Dyspepsia and Irritable Bowel Syndrome. J Neurogastroenterol Motil. 24:280-288. doi: 10.5056/jnm17098.
Koh SJ, Kim M, Oh DY, Kim BG, Lee KL, Kim JW (2014). Psychosocial stress in nurses with shift work schedule is associated with functional gastrointestinal disorders. J Neurogastro-enterol Motil. 20(4):16-22. doi: 10.5056/jnm-14034
Lim SK, Yoo SJ, Koo DL, Park CA, Ryu HJ, Jung YJ, Jeong JB, et al. (2017). Stress and sleep quality in doctors working on-call shifts are associated with functional gastrointestinal disorders. World J Gastroenterol. 23(18): 3330-3337. doi: 10.3748/wjg.v23.i18.3330.
Maghsoudi S, Amra B, Teimouri A (2022). The assessment of the correlation between sleep quality and irritable bowel syndrome among medical students. Immunopathol Persa. 8(1):e07. doi: 10.34172/ipp.2022.07.
Nanda S, Sungono V (2020). Relationship between psychological distress and Irritable Bowel Syndrome (IBS) in medical students of Pelita Harapan University. Indones J Gastroenterol Hepatol Dig Endosc. 21(3): 199-206. doi: 10.24871/2132020199206.
Oksoo K, Cha C, Jeong H, Cho M, Kim B (2021). Influence of irritable bowel syndrome on stress and depressive symptoms in nurses: the korea nurses' health study. Int J Environ Res Public Health. 18(23):12324. doi: 10.3390/ijerph182312324.
Park JH, Mi JY, Jin LH, Young SJ (2018). Prevalence and factors related to irritable bowel syndrome in university students. J Korean Acad Fundam Nurs. 25(4):282-292. doi: 10.7739/jkafn.2018.25.4.282.
Patel A, Hasak S, Cassell B, Ciorba MA, Vivio EE, Kumar M, Gyawali P (2016). Effects of disturbed sleep on gastrointestinal and somatic pain symptoms in IBS. Aliment Pharmacol Ther. 44 (3): 246–258. doi: 10.1111/apt.13677.
Roohafza H, Bidaki EZ, Keshteli AH, Daghaghzade H, Afshar H, Adibi P (2016). Anxiety, depression and dis-tress among irritable bowel syndrome and their subtypes: An epidemiological population based study. Adv Bio-med Res. 28(5):183. doi: 10.4103/22-77-9175.190938.
Sarkar S, Choudhury S, Balasundaram S, Balasubramanian SMP (2020). Depression and anxiety associated with functional bowel disorders and its impact on quality of life: A cross-secti-onal study. Ind Psychiatry J. 29(1): 68–75. doi: 10.4103/ipj.ipj_59_18
Seger S, Nasharuddin NNB, Fernandez SL, Rahmah ABMD, Shun NTM, Agarwal P, Burud I (2020). Prevalence and factors associated with irritable bowel syndrome among medical students in a Malaysian private university: a cross sectional study. Pan Afr Med J. 13 (37). doi: 10.11604/pamj.2020.37.151.21716.
Selim A, Salem SS, Albasher N, Bakrmom G, Alanzi S, Jradi H (2022). Irritable bowel syndrome and coping strategies: a cross-sectional study for identifying psychological alarms and factors related to coping in riyadh, saudi arabia. Clin Nurs Res. 31(1):144-154. doi: 10.1177/10547738211020437.
Sharawy SME, Amer IF, Alkadeem MZ (2022). Irritable bowel syndrome in Egyptian medical students, prevalence and associated factors: a cross-sectio-nal study. Pan Afr Med J. 41(18):311. doi: 10.11604/pamj
Son YJ, Jun EY, Park JH (2009). Prevalence and risk factors of irritable bowel syndrome in Korean adolescent girls: A school-based study. Int J Nurs Stud. 46(1):76-84. doi: 10.1016/j.ijnurstu.2008.07.006.
Song KH, Jung HK, Kim HJ, Koo HS, Kwon YH, Shin HD, Lim HC, et al. (2018). Clinical practice guidelines for irritable bowel syndrome in korea, 2017 revised edition. J Neurogastroenterol Motil. 24(2): 197–215. doi: 10.5056/jnm17145.
Sperber AD, Bangdiwala SI, Drossman DA, Ghoshal UC, Simren M, Tack J, Whitehead WE, et al. (2021). Worldwide prevalence and burden of functional gastrointestinal disorders, results of rome foundation global study. Gastro-enterology. 160(1):99-114.e3. doi: 10.1053/j.gastro.2020.04.014.
Vork L (2021). MEASuRing symptoms in irritable bowel syndrome: towards an individualized and daily life approach. Doctoral Thesis, Maastricht University. doi: 10.26481/dis.20210409lv.
Wang Y, Jin F, Chi B, Duan S, Zhang Q, Liu Y, Hao W, et al. (2016). Gender differences in irritable bowel syndrome among medical students at Inner Mongolia Medical University, China: a cross-sectional study. Psychol Health Med. 74(8):964. doi: 10.1080/13548-506.2016.1144890.
Wang YT, Lim HY, Tai D, Krishnamoorthy TL, Tan T, Barbier S, Thumboo J (2012). The impact of irritable bowel syndrome on health-related quality of life: a Singapore perspective. BMC Gastroenterol. 12(9): 104. doi: 10.1186/1471-230X-12-104.
Yamamoto R, Kaneita Y, Osaki Y, Kanda H, Suzuki K, Higuchi S, Ikeda M, et al. (2015). Irritable bowel syndrome among Japanese adolescents: A nationally representative survey. J Gas-troenterol Hepatol. 30(9): 1354-60. doi: 10.1111/jgh.12974.
Yousef S, Jadallah K, Kheirallah KA, Nsour MA, Batieha A (2021). Irritable bowel syndrome among medical students in jordan: a cross-sectional study. Res Sq. 1-22. doi: 10.21203/rs.3.rs333610/v1.
Zamani M, Tabari SA, Zamani V (2019). Systematic review with meta-analysis: the prevalence of anxiety and depression in patients with irritable bowel syndrome. Aliment Pharmacol Ther. 50(2): 132-143. doi: 10.1111/apt.15325.
Zargar A, Gooraji SA, Keshavarzi B, Aghamohammadi AAH (2019). Effect of irritable bowel syndrome on sleep quality and quality of life of inflamematory bowel disease in clinical remission. Int J Prev Med. 10:10. doi: 10.4103/ijpvm.IJPVM_364_17.
