Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
Department of Paediatric Gastroenterology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
Aliment Pharmacol Ther. 2018 Sep;48(5):496-506. doi: 10.1111/apt.14865. Epub 2018 Jul 8.
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.
To systematically evaluate available data on the prevalence of anxiety and depressive symptoms and disorders in paediatric IBD (aged 6-18 years).
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.
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.
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.
心理问题与儿科炎症性肠病（IBD）共存的现象越来越受到关注。大多数研究调查了焦虑和抑郁的患病率，其范围从 0%到 50%不等。有必要进行系统评价，以清楚地了解儿科 IBD 中焦虑和抑郁的患病率。
系统评估儿科 IBD（6-18 岁）患儿焦虑和抑郁症状及障碍的患病率。
对 1994 年至 2017 年间发表的研究进行了 Embase、Medline Ovid、Web of Science、Cochrane、PubMed、PsychInfo Ovid 和 Google scholar 的全面检索。使用逆方差异质性模型计算合并患病率。采用元回归分析来研究疾病类型、疾病活动度和性别是否影响患病率。
共纳入 28 项研究（N=8107，平均年龄 14.3 岁）。焦虑症状的合并患病率估计值为 16.4%（95%可信区间 6.8%-27.3%），焦虑障碍的合并患病率估计值为 4.2%（95%可信区间 3.6%-4.8%）。抑郁症状的合并患病率估计值为 15.0%（95%可信区间 6.4%-24.8%），抑郁障碍的合并患病率估计值为 3.4%（95%可信区间 0%-9.3%）。元回归分析表明，疾病类型或性别对这些患病率无影响，但疾病活动度较高的研究其抑郁症状的患病率更高。
描述的焦虑和抑郁症状的合并患病率低于成人 IBD。然而，由于用于测量症状的工具/临界值不同，且研究抑郁障碍的研究较少，因此结果应谨慎解释。需要跨文化使用相同的工具，以更好地了解患病率。
