Depression, Anxiety and Quality of Life in Adults and Older Adults with Irritable Bowel Syndrome (IBS): Observational Analysis of MEPS National Database

Monira Alwhaibi,* Saja H Almazrou* Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia*These authors contributed equally to this workCorrespondence: Monira Alwhaibi, Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, 11149, Saudi Arabia, Email [email protected]: Irritable bowel syndrome (IBS) is associated with impaired health-related quality of life (HRQoL) and a high burden of comorbid mental health conditions, However, limited population-level evidence exists. Therefore, this study examined the relationship between anxiety, depression, and HRQoL among adult and elderly populations with IBS in the United States.Methods: A cross-sectional observational analysis was conducted. Data were drawn from the 2017– 2022 Medical Expenditure Panel Survey (MEPS). Adults aged ≥ 18 years with a diagnosis of IBS were included. HRQoL was assessed using the Veterans RAND 12-Item Health Survey, generating Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. Adjusted multivariable linear regression models provides weighted national estimates for the associations between IBS groups (IBS only, IBS with anxiety, IBS with depression, and IBS with both) and HRQoL. Depression and anxiety were identified from MEPS using the ICD-10-CM codes. Subgroup analyses compared adults (18– 64 years) and older adults (≥ 65 years).Results: Among 595 adults with IBS, most were women (78%) and aged > 65 years (39%). IBS with comorbid depression and/or anxiety was strongly associated with lower HRQoL. Participants with both depression and anxiety reported the poorest HRQoL (PCS mean = 38.84; MCS mean = 39.20). Regression analyses showed significant reductions in both PCS and MCS for individuals with comorbid psychiatric disorders compared with IBS only (all p< 0.001). In age-stratified analyses, depression and anxiety were primarily associated with larger declines in mental HRQoL among younger adults, whereas in older adults these comorbidities were associated with reductions in both physical and mental HRQoL, with greater overall impairment in the presence of chronic comorbid conditions. Protective factors included employment, higher income, physical activity, and good self-rated health.Conclusion: Comorbid depression and anxiety substantially reduce both physical and mental HRQoL among individuals with IBS, with distinct age-specific patterns. Younger adults are primarily affected in mental domains, whereas older adults experience broader impairment in in physical and mental domains. These findings suggest the need for integrated clinical approaches that address both IBS and mental health to improve overall HRQoL in IBS patients.Plain Language Summary: People with irritable bowel syndrome (IBS) who also have depression or anxiety experience much poorer quality of life, especially those who have both conditions together.Younger adults with IBS are affected mainly in their mental well-being, while older adults experience declines in both physical and mental health, partly due to other chronic health problems.Regular physical activity, good overall health, higher income, and employment are linked to better quality of life, highlighting the importance of integrated care that supports both mental and physical health in IBS.Keywords: mental health, irritable bowel syndrome, depression, quality of life