Psychiatric morbidity after surgery for inflammatory bowel disease: A systematic review

Table 2 Results regarding depression and anxiety

Ref.	Depression results	Anxiety results
Nahon et al[3], 2012	Multivariate analysis of predictive factors found no association between past history of surgery and depression (OR = 0.93, 95%CI: 0.50-1.72)	Multivariate analysis of predictive factors found past history of surgery to be significantly associated with decreased risk of anxiety (OR = 0.47, 95%CI: 0.31-0.71)
Panara et al[4], 2014	Multivariate analysis: history of surgery had a non-significant HR = 1.3 (95%CI: 0.92-1.76; P = 0.13).	-
Ananthakrishnan et al[16], 2013	Chi-square test: Higher 5 yr postoperative risk in IBD group (16%) compared with diverticulitis (9%) and inguinal hernia group (7%) (P < 0.05). Higher risk in CD surgery group compared with non-surgical group (OR = 1.34, 95%CI: 1.01-1.77). No significant increased risk in UC surgery group compared with non-surgical group (OR = 1.21, 95%CI: 0.93-1.58).	no significant increased OR in CD-surgery group compared with non-surgical group (OR = 1.20, 95%CI: 0.93-1.55) or UC-surgery group compared with non-surgical group (OR = 1.26, 95%CI: 0.96-1.65).
Keltingas-Jarvinen et al[17], 1983	Comparisons of means in Beck depression inventory – type of analysis not stated: UC < colorectal cancer	Comparisons of means in Rorschach content interpretation for anxiety – type of analysis not stated: UC > colorectal cancer
Tillinger et al[18], 1999	Wilcoxon test: significantly improved score three and six months postoperatively (P = 0.0038 and 0.0013 respectively). 24 mo postoperatively only improved scores for patients still in remission.	-
Nordin et al[19], 2002	Percentage of population divided on HADS depression subscales: 87% “non-cases”; 9% “doubtful cases”; 4% cases	Percentage of population divided on HADS anxiety subscale: 71% “non-cases”; 14% “doubtful cases”; 15% cases.
	Subgroup analysis of depression: unpaired t-test showed no difference between CD and UC patients with ileostomies and those without ileostomies.	Subgroup analysis of anxiety: unpaired t-test showed no difference between CD and UC patients with ileostomies and those without ileostomies.
Knowles et al[14], 2013	Percentage of population divided on HADS depression subscales: 84% normal; 6% mild; 10% moderate; 0% severe	Percentage of population divided on HADS anxiety subscale: 50% normal; 24% mild; 16% moderate; 10% severe.
Knowles et al[15], 2013	Percentage of population divided on HADS depression subscales: 58% normal; 26% mild; 16% moderate-severe	Percentage of population divided on HADS anxiety subscale: 51% normal; 39% mild; 10% moderate-severe
Häuser et al[20], 2005	Student’s t-test: no increased probable (HADS ≥ 11) mental disorder in UC with IPAA vs the general German population. Wilcoxon Mann-Whitney test: no difference in HADS depression subscales between UC patients with IPAA† compared to UC without IPAA.	Student’s t-test: no increased probable (HADS ≥ 11) mental disorder in UC with IPAA vs the general German population. Wilcoxon Mann-Whitney test: no difference on HADS anxiety subscale between UC patients with IPAA compared to UC without IPAA.
Schmidt et al[21], 2007	Kruskal-Wallis test showed no significant difference in HADS depression subscales between IPAA subgroups	Kruskal-Wallis test showed no significant difference on HADS anxiety subscale between IPAA† subgroups
Makkar et al[22], 2015	ANOVA: Significant difference between DASS among patients with irritable pouch syndrome (11.7 ± 9.7), pouch inflammation (8.1 ± 9.1) and normal pouch (4.4 ± 6.2), P =0.012.	ANOVA: no significant difference between DASS among patients with irritable pouch syndrome (8.1 ± 7.0), pouch inflammation (6.0 ± 6.8), and normal pouch (4.2 ± 4.9), P = 0.1
de Oca et al[23], 2003	-	Student’s t-test: CD < UC on anxiety values of the STAI ( P = 0.014)

OR: Odds ratio; ANOVA: Analyses of variance; HADS: Hospital Anxiety and Depression Scale; DASS: Depression, Anxiety and Stress Scale; STAI: State-Trait Anxiety Inventory; IPAA: Ileal Pouch-Anal Anastomosis; CD: Crohn’s disease; UC: Ulcerative colitis.