Systematic Reviews
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 28, 2017; 23(48): 8651-8659
Published online Dec 28, 2017. doi: 10.3748/wjg.v23.i48.8651
Psychiatric morbidity after surgery for inflammatory bowel disease: A systematic review
Marie Strøm Zangenberg, Alaa El-Hussuna
Marie Strøm Zangenberg, Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge 4600, Denmark
Alaa El-Hussuna, Department of Surgery, Aalborg University Hospital, Aalborg 9100, Denmark
Author contributions: Both authors contributed to conceiving and designing the study, collecting the data, analyzing and interpreting the data, writing the manuscript and approving the final version of the manuscript.
Conflict-of-interest statement: The authors have no conflict of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alaa El-Hussuna, MSc, Doctor, Consultant Surgeon, Department of Surgery, Aalborg University Hospital, Hobrovej 18-22, Aalborg 9100, Denmark. alaa@itu.dk
Telephone: +45-28944902 Fax: +45-97660000
Received: August 29, 2017
Peer-review started: August 30, 2017
First decision: September 13, 2017
Revised: September 14, 2017
Accepted: October 17, 2017
Article in press: October 17, 2017
Published online: December 28, 2017
Processing time: 119 Days and 21.1 Hours
ARTICLE HIGHLIGHTS
Research background

Previous research has shown a high incidence of psychiatric disorders among patients with inflammatory bowel disease (IBD), especially those with active disease this may lead to personal burden and prohibitive costs for the society.

Research motivation

In patients with IBD might have a higher risk for postoperative psychiatric disorders compared with other patients undergoing same type of surgery. This risk may simply reflect the difference between the disease groups and not the effect of surgery on the different diseases.

Research objectives

The aim of this review was to examine the evidence about psychiatric morbidity after IBD-related surgery.

Research methods

This is a systemic review which adheres to PRISMA guidelines. Research question and protocol were published at PROSPERO (CRD42016037600). Inclusion criteria were studies describing patients with inflammatory bowel disease undergoing surgery and their risk of developing psychiatric disorder. Studies describing psychiatric disorders prior to surgical intervention and studies exclusively reporting quality of life or single psychological symptoms as part of larger questionnaires not assessing psychiatric morbidity were excluded.

Research results

Patients with IBD have higher risk of depression after surgery compared with patients operated for diverticulitis or inguinal hernia but not cancer. Patients with ulcerative colitis (UC) might have higher risk of anxiety after surgery compared with patients with colorectal cancer. Compared with nonsurgical patients, patients operated for UC have higher risk of anxiety and patients operated for Crohn’s disease have higher risk of depression. Among patients with IBD, female gender and Charlson comorbidity score > 3 are risk factors for both anxiety and depression following surgery.

Research conclusions

Patients with IBD have higher postoperative risk for anxiety and/or depression.

Research perspectives

Large multi-center prospective studies are warranted to show and quantify the risk of postoperative psychiatric disorders in patients with IBD.