The prevalence of anxiety and depression in patients with ostomy: A systematic review and meta‐analysis

Abstract

Aim:The prevalence of anxiety and depression in patients with ostomy is reported differently. The aim of this systematic review and meta-analysis is to estimate the global prevalence of anxiety and depression in patients with ostomy. Method:A systematic search of Embase, Proquest, Scopus, PubMed and Web of Science (ISI) databases was conducted from January 1990 up to 5 May 2021. A total of 3392 records were retrieved and 18 studies were ultimately included. Two reviewers independently assessed full-text of articles according to predefined criteria.A random-effects model was used to estimate the prevalence of anxiety and depression and I 2 index was used to assess the heterogeneity of the studies. Subgroup analysis and mea-regression were conducted to explore potential sources of heterogeneity. The review protocol is registered in PROSPERO and is available online. Data analysis was performed using R software version 4.3.1. Results:In this study, the pooled prevalence of anxiety was 47.60% (95% CI, 29.94-65.26) and the pooled prevalence of depression was 38.86% (95% CI,.The subgroup analysis showed the prevalence of anxiety and depression in different regions was not significantly different (p = 0.854, p = 0.143 respectively). Nevertheless, the highest and lowest prevalence of anxiety were in Asia and the America 51.79% and 32.69%, respectively and the highest and lowest prevalence depression were in Asia with 49.80% and Europe with 26.77%, respectively. Conclusion:The finding of this study showed the global prevalence of anxiety and depression in patients with ostomy is high. Therefore, all health care providers who deal with these patients should use appropriate psychological strategies, techniques and interventions to reduce anxiety and depression in these patients.

Comparison of adjustment to a temporary or permanent ostomy using the OAI‐23

“…Several studies confirm a high prevalence of anxiety among people with an ostomy, ranging from 47.6% to 56.6% [12, 18–20]. High levels of anxiety have been reported in both the short term <1 year [18] and long term (mean 5.5 years) [20].…”

“…Anxiety and the diminished inclination to socialize are driven by the fear of 'being different', loss of self-confidence, uncertainty, frustration, helplessness [23], stigma or greater requirements for assistance with self-care [24,25]. Furthermore, body image disturbance [18,21,26,27] and the physical problems associated with an ostomy, including, flatus noise, pouch leakage, bleeding, peristomal skin complications and odour, all contribute to anxiety, social withdrawal and isolation [18,26,27]. Sleep disturbance and lack of energy have been identified as factors [26] contributing to a decreased willingness to engage in intimacy, social interactions, travel and the performance of employment responsibilities [18].…”

“…Furthermore, body image disturbance [18,21,26,27] and the physical problems associated with an ostomy, including, flatus noise, pouch leakage, bleeding, peristomal skin complications and odour, all contribute to anxiety, social withdrawal and isolation [18,26,27]. Sleep disturbance and lack of energy have been identified as factors [26] contributing to a decreased willingness to engage in intimacy, social interactions, travel and the performance of employment responsibilities [18]. As in our study, participants living with an ostomy for a greater length of time reported lower levels of social engagement [28] and were significantly more afraid of meeting new people [12].…”

Is it “all in the bag?” Multidisciplinary perspectives on ostomy surgery in pediatric IBD across the ImproveCareNow network

“…Pediatric inflammatory bowel disease (IBD) is a chronic, immune‐mediated illness that has a growing armamentarium of treatment options, including ostomies 1–3 . The extant literature on ostomies in pediatric IBD, while somewhat limited, continues to highlight the psychosocial considerations of this complex surgical decision, limited knowledge amongst patients with pediatric IBD about ostomies, variability in multidisciplinary care for these patients, and the persistent ostomy‐related stigma that can impact patients, families, and healthcare professionals (HCPs) in nuanced ways 4–12 . For example, ostomy‐related stigma for a patient may engender worries that an adolescent may not be able to play competitive sports and contribute to a strong preference to not pursue surgery.…”

“…[1][2][3] The extant literature on ostomies in pediatric IBD, while somewhat limited, continues to highlight the psychosocial considerations of this complex surgical decision, limited knowledge amongst patients with pediatric IBD about ostomies, variability in multidisciplinary care for these patients, and the persistent ostomy-related stigma that can impact patients, families, and healthcare professionals (HCPs) in nuanced ways. [4][5][6][7][8][9][10][11][12] For example, ostomy-related stigma for a patient may engender worries that an adolescent may not be able to play competitive sports and contribute to a strong preference to not pursue surgery. Multidisciplinary care remains the gold standard in caring for pediatric patients living with IBD, 13,14 with ongoing exploration of different models of multidisciplinary care in daily practice, 14 if multidisciplinary care is equitable and accessible to this population, [15][16][17] and how surgical decisions may impact the make-up, coordination, and collaboration amongst a multidisciplinary team.…”