Global Prevalence of Anxiety in Gastroenterology and Hepatology Outpatients: A Systematic Review and Meta-Analysis

Many patients with chronic health conditions experience anxiety, which can have significant implications on physical health outcomes and quality of life. This systematic review and meta-analysis aimed to examine the prevalence of anxiety in gastroenterology and hepatology outpatients, across factors such as physical health condition, type of anxiety, and patient demographics, with the intention to support clinicians in providing effective patient care.

Several recent systematic reviews have been published investigating rates of anxiety in different outpatient settings, and have found consistently high rates across the dermatology, endocrinology, cardiology and respiratory/sleep medicine fields, ranging between 25.1% and 30.3%. Whilst there are established links between gastroenterology and hepatology conditions with anxiety, there has yet to be a study estimating the overall global prevalence of anxiety in this outpatient setting. PubMed, Embase, Cochrane and PsycINFO databases were searched from database inception to January 2023 for studies reporting anxiety in gastroenterology and hepatology outpatients ≥ 16 years of age. Prevalence was extracted from self-report questionnaires, diagnostic interviews, and records. The final meta-analysis included 81 studies, with 28,334 participants. Pooled prevalence of anxiety was 31.2% (95% CI 28.2%-34.4%). Subgroup analyses identified significant differences in prevalence across anxiety type, with health anxiety showing the highest prevalence at 23.7%, followed by generalised anxiety 14.5%, specific phobia 12.5%, panic disorder/agoraphobia 12.2%, social anxiety 11.3%, post-traumatic stress disorder 4.9%, and obsessive-compulsive disorder 4.2%. No other significant differences were found. Anxiety is thus common amongst gastroenterology and hepatology outpatients, and so it is important that careful consideration be given to the identification and management of anxiety in these settings.