Efficacy of antidepressants and psychological therapies in irritable bowel syndrome: systematic review and meta-analysis.

Hdl Handle:
http://hdl.handle.net/10147/201247
Title:
Efficacy of antidepressants and psychological therapies in irritable bowel syndrome: systematic review and meta-analysis.
Authors:
Ford, A C; Talley, N J; Schoenfeld, P S; Quigley, E M M; Moayyedi, P
Affiliation:
Gastroenterology Division, McMaster University Medical Centre, 1200 Main Street West, Hamilton, Ontario, L8N 3Z5, Canada. alexf12399@yahoo.com
Citation:
Efficacy of antidepressants and psychological therapies in irritable bowel syndrome: systematic review and meta-analysis. 2009, 58 (3):367-78 Gut
Journal:
Gut
Issue Date:
Mar-2009
URI:
http://hdl.handle.net/10147/201247
DOI:
10.1136/gut.2008.163162
PubMed ID:
19001059
Abstract:
Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder. Evidence for treatment of the condition with antidepressants and psychological therapies is conflicting.; Systematic review and meta-analysis of randomised controlled trials (RCTs). MEDLINE, EMBASE and the Cochrane Controlled Trials Register were searched (up to May 2008).; RCTs based in primary, secondary and tertiary care.; Adults with IBS.; Antidepressants versus placebo, and psychological therapies versus control therapy or "usual management".; Dichotomous symptom data were pooled to obtain a relative risk (RR) of remaining symptomatic after therapy, with a 95% confidence interval (CI). The number needed to treat (NNT) was calculated from the reciprocal of the risk difference.; The search strategy identified 571 citations. Thirty-two RCTs were eligible for inclusion: 19 compared psychological therapies with control therapy or "usual management", 12 compared antidepressants with placebo, and one compared both psychological therapy and antidepressants with placebo. Study quality was generally good for antidepressant but poor for psychological therapy trials. The RR of IBS symptoms persisting with antidepressants versus placebo was 0.66 (95% CI, 0.57 to 0.78), with similar treatment effects for both tricyclic antidepressants and selective serotonin reuptake inhibitors. The RR of symptoms persisting with psychological therapies was 0.67 (95% CI, 0.57 to 0.79). The NNT was 4 for both interventions.; Antidepressants are effective in the treatment of IBS. There is less high-quality evidence for routine use of psychological therapies in IBS, but available data suggest these may be of comparable efficacy.
Item Type:
Article
Language:
en
Description:
OBJECTIVE: Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder. Evidence for treatment of the condition with antidepressants and psychological therapies is conflicting. DESIGN: Systematic review and meta-analysis of randomised controlled trials (RCTs). MEDLINE, EMBASE and the Cochrane Controlled Trials Register were searched (up to May 2008). SETTING: RCTs based in primary, secondary and tertiary care. PATIENTS: Adults with IBS. INTERVENTIONS: Antidepressants versus placebo, and psychological therapies versus control therapy or "usual management". MAIN OUTCOME MEASURES: Dichotomous symptom data were pooled to obtain a relative risk (RR) of remaining symptomatic after therapy, with a 95% confidence interval (CI). The number needed to treat (NNT) was calculated from the reciprocal of the risk difference. RESULTS: The search strategy identified 571 citations. Thirty-two RCTs were eligible for inclusion: 19 compared psychological therapies with control therapy or "usual management", 12 compared antidepressants with placebo, and one compared both psychological therapy and antidepressants with placebo. Study quality was generally good for antidepressant but poor for psychological therapy trials. The RR of IBS symptoms persisting with antidepressants versus placebo was 0.66 (95% CI, 0.57 to 0.78), with similar treatment effects for both tricyclic antidepressants and selective serotonin reuptake inhibitors. The RR of symptoms persisting with psychological therapies was 0.67 (95% CI, 0.57 to 0.79). The NNT was 4 for both interventions. CONCLUSIONS: Antidepressants are effective in the treatment of IBS. There is less high-quality evidence for routine use of psychological therapies in IBS, but available data suggest these may be of comparable efficacy.
MeSH:
Adult; Antidepressive Agents; Cognitive Therapy; Combined Modality Therapy; Female; Humans; Irritable Bowel Syndrome; Male; Placebos; Practice Guidelines as Topic; Randomized Controlled Trials as Topic; Treatment Outcome
ISSN:
1468-3288

Full metadata record

DC FieldValue Language
dc.contributor.authorFord, A Cen
dc.contributor.authorTalley, N Jen
dc.contributor.authorSchoenfeld, P Sen
dc.contributor.authorQuigley, E M Men
dc.contributor.authorMoayyedi, Pen
dc.date.accessioned2012-01-10T12:35:19Z-
dc.date.available2012-01-10T12:35:19Z-
dc.date.issued2009-03-
dc.identifier.citationEfficacy of antidepressants and psychological therapies in irritable bowel syndrome: systematic review and meta-analysis. 2009, 58 (3):367-78 Guten
dc.identifier.issn1468-3288-
dc.identifier.pmid19001059-
dc.identifier.doi10.1136/gut.2008.163162-
dc.identifier.urihttp://hdl.handle.net/10147/201247-
dc.descriptionOBJECTIVE: Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder. Evidence for treatment of the condition with antidepressants and psychological therapies is conflicting. DESIGN: Systematic review and meta-analysis of randomised controlled trials (RCTs). MEDLINE, EMBASE and the Cochrane Controlled Trials Register were searched (up to May 2008). SETTING: RCTs based in primary, secondary and tertiary care. PATIENTS: Adults with IBS. INTERVENTIONS: Antidepressants versus placebo, and psychological therapies versus control therapy or "usual management". MAIN OUTCOME MEASURES: Dichotomous symptom data were pooled to obtain a relative risk (RR) of remaining symptomatic after therapy, with a 95% confidence interval (CI). The number needed to treat (NNT) was calculated from the reciprocal of the risk difference. RESULTS: The search strategy identified 571 citations. Thirty-two RCTs were eligible for inclusion: 19 compared psychological therapies with control therapy or "usual management", 12 compared antidepressants with placebo, and one compared both psychological therapy and antidepressants with placebo. Study quality was generally good for antidepressant but poor for psychological therapy trials. The RR of IBS symptoms persisting with antidepressants versus placebo was 0.66 (95% CI, 0.57 to 0.78), with similar treatment effects for both tricyclic antidepressants and selective serotonin reuptake inhibitors. The RR of symptoms persisting with psychological therapies was 0.67 (95% CI, 0.57 to 0.79). The NNT was 4 for both interventions. CONCLUSIONS: Antidepressants are effective in the treatment of IBS. There is less high-quality evidence for routine use of psychological therapies in IBS, but available data suggest these may be of comparable efficacy.en
dc.description.abstractIrritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder. Evidence for treatment of the condition with antidepressants and psychological therapies is conflicting.-
dc.description.abstractSystematic review and meta-analysis of randomised controlled trials (RCTs). MEDLINE, EMBASE and the Cochrane Controlled Trials Register were searched (up to May 2008).-
dc.description.abstractRCTs based in primary, secondary and tertiary care.-
dc.description.abstractAdults with IBS.-
dc.description.abstractAntidepressants versus placebo, and psychological therapies versus control therapy or "usual management".-
dc.description.abstractDichotomous symptom data were pooled to obtain a relative risk (RR) of remaining symptomatic after therapy, with a 95% confidence interval (CI). The number needed to treat (NNT) was calculated from the reciprocal of the risk difference.-
dc.description.abstractThe search strategy identified 571 citations. Thirty-two RCTs were eligible for inclusion: 19 compared psychological therapies with control therapy or "usual management", 12 compared antidepressants with placebo, and one compared both psychological therapy and antidepressants with placebo. Study quality was generally good for antidepressant but poor for psychological therapy trials. The RR of IBS symptoms persisting with antidepressants versus placebo was 0.66 (95% CI, 0.57 to 0.78), with similar treatment effects for both tricyclic antidepressants and selective serotonin reuptake inhibitors. The RR of symptoms persisting with psychological therapies was 0.67 (95% CI, 0.57 to 0.79). The NNT was 4 for both interventions.-
dc.description.abstractAntidepressants are effective in the treatment of IBS. There is less high-quality evidence for routine use of psychological therapies in IBS, but available data suggest these may be of comparable efficacy.-
dc.language.isoenen
dc.subject.meshAdult-
dc.subject.meshAntidepressive Agents-
dc.subject.meshCognitive Therapy-
dc.subject.meshCombined Modality Therapy-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshIrritable Bowel Syndrome-
dc.subject.meshMale-
dc.subject.meshPlacebos-
dc.subject.meshPractice Guidelines as Topic-
dc.subject.meshRandomized Controlled Trials as Topic-
dc.subject.meshTreatment Outcome-
dc.titleEfficacy of antidepressants and psychological therapies in irritable bowel syndrome: systematic review and meta-analysis.en
dc.typeArticleen
dc.contributor.departmentGastroenterology Division, McMaster University Medical Centre, 1200 Main Street West, Hamilton, Ontario, L8N 3Z5, Canada. alexf12399@yahoo.comen
dc.identifier.journalGuten
dc.description.provinceMunster-

Related articles on PubMed

All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.