Original article

Decoding the gut-brain axis in irritable bowel syndrome: a cross-sectional analysis of anxiety and depression symptoms in constipation and diarrhoea predominant subtypes

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Abstract

Aim: The gut–brain axis is pivotal in the pathophysiology of irritable bowel syndrome (IBS), with anxiety, depression and quality of life. IBS-C (constipation-predominant) and IBS-D (diarrhoea-predominant) are frequently linked with psychological comorbidities. Neither in Indonesia nor globally has research been conducted regarding the relationship between subtypes of IBS and depression and anxiety. This study aimed to identify the relationship between depression and anxiety and subtypes of IBS.

Methods: From January to December 2023, a cross-sectional study was conducted on 49 IBS patients at Dr Saiful Anwar General Hospital, Indonesia. Demographic data and colonoscopy reports were gathered. Psychological status was measured using the Hospital Anxiety and Depression Scale (HADS). The χ² test and Spearman's correlation analysis were performed to examine associations between demographic characteristics, IBS subtype, and psychological scores.

Results: There were no significant associations between sex, age, or IBS subtype and the presence of anxiety or depression symptoms. Anxiety and depression scores were modestly correlated overall (r = 0.503; p = 0.000). Subgroup analysis revealed a strong correlation in IBS-C (r = 0.613; p = 0.009) and a moderate correlation in IBS-D (r = 0.461; p = 0.008), indicating a notable interrelationship within these subtypes.

Conclusion: Moderate relationship between anxiety and depression was found in IBS patients, strongest in IBS-C and moderate in IBS-D. Neither demographics nor IBS subtype was significantly related to psychological symptoms independently. The findings warrant routine screening for mental health and multidisciplinary management in IBS patient.

Keywords: anxiety disorder, constipation, depressive disorder, diarrhea, irritable bowel syndrome