Which psychological factors exacerbate irritable bowel syndrome? Development of a comprehensive model (original) (raw)
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Depression, Anxiety, Stress, Anger in IBS Patients
Journal of Pure and Applied Microbiology
Irritable Bowel Syndrome (IBS) is one of the most common gastrointestinal (GI) disorders seen by primary care physician and gastroenterologist. Gender-specific prevalence rates for IBS are approximately two female to one male in most studies, and all population based. It is commonly accepted that IBS seems to be influenced by psychosocial stressors and affective factors, whose role may contribute to the predisposition, precipitation and perpetuation of IBS symptoms, affecting also the clinical outcome. Forty-five patients with irritable bowel syndrome (5males, 40 females) and 50 healthy volunteers from the community (7males, 43females) matched for age, level of education and social-status were enrolled. After an examination by a gastroenterologist and a total colonoscopy, all IBS subjects evaluated with clinical interview conducted by psychiatrist. All the subjects were administered the STAXI-2 and DASS 21 tests. Participants included 45(47%) IBS patients (40% GAD, 24% depression, 18% OCD, 13% panic and 5% somatization disorder) with mean and standard deviation age of 38.44 (10.57) and 50 (53%) control with mean and standard deviation age of 35.42 (9.37). The results show significant differences in trait anger and Anger expression-out between IBS patients and the controls. From the present study it seems that IBS patients, compared with control subjects, were more psychologically distressed with higher degrees of depression, anxiety and anger. We suppose that psychological management are very important for reducing IBS symptoms, and it is clinically important to assess the psychological factors contributing to inducing IBS.
Pain, 2008
Irritable bowel syndrome (IBS) affects up to 22% of the general population. Its aetiology remains unclear. Previously reported cross-sectional associations with psychological distress and depression are not fully understood. We hypothesised that psychosocial factors, particularly those associated with somatisation, would act as risk markers for the onset of IBS. We conducted a community-based prospective study of subjects, aged 25-65 years, randomly selected from the registers of three primary care practices. Responses to a detailed questionnaire allowed subjects' IBS status to be classified using a modified version of the Rome II criteria. The questionnaire also included validated psychosocial instruments. Subjects free of IBS at baseline and eligible for follow-up 15 months later formed the cohort for this analysis (n = 3732). An adjusted participation rate of 71% (n = 2456) was achieved at follow-up. 3.5% (n = 86) of subjects developed IBS. After adjustment for age, gender and baseline abdominal pain status, high levels of illness behaviour (odds ratio (OR) = 5.2; 95% confidence interval (95% CI) 2.5-11.0), anxiety (OR = 2.0; 95% CI 0.98-4.1), sleep problems (OR = 1.6; 95% CI 0.8-3.2), and somatic symptoms (OR = 1.6; 95% CI 0.8-2.9) were found to be independent predictors of IBS onset. This study has demonstrated that psychosocial factors indicative of the process of somatisation are independent risk markers for the development of IBS in a group of subjects previously free of IBS. Similar relationships are observed in other "functional" disorders, further supporting the hypothesis that they have similar aetiologies.
Bmc Gastroenterology, 2010
Background: Irritable bowel syndrome (IBS) is commonly regarded as a functional disorder, and is hypothesized to be associated with anxiety and depression. This evidence mainly rests on population-based studies utilising selfreport screening instruments for psychopathology. Other studies applying structured clinical interviews are generally based on small clinical samples, which are vulnerable to biases. The extant evidence base for an association between IBS and psychopathology is hence not conclusive. The aim of this study was therefore to re-examine the hypothesis using population-based data and psychiatric morbidity established with a structured clinical interview. Methods: Data were derived from a population-based epidemiological study (n = 1077). Anxiety and mood disorders were established using the Structured Clinical Interview for DSM-IV-TR (SCID-I/NP) and the General Health Questionnaire (GHQ-12). Current and lifetime IBS was self-reported. Hypertension and diabetes were employed as comparison groups as they are expected to be unrelated to mental health. Results: Current IBS (n = 69, 6.4%) was associated with an increased likelihood of current mood and/or anxiety disorders (OR = 2.62, 95%CI 1.49 -4.60). Half the population reporting a lifetime IBS diagnosis also had a lifetime mood or anxiety disorder. Exploratory analyses demonstrated an increased prevalence of IBS across most common anxiety and mood disorders, the exception being bipolar disorder. The association with IBS and symptoms load (GHQ-12) followed a curved dose response pattern. In contrast, hypertension and diabetes were consistently unrelated to psychiatric morbidity. Conclusions: IBS is significantly associated with anxiety and mood disorders. This study provides indicative evidence for IBS as a disorder with a psychosomatic aspect.
Advanced Biomedical Research, 2016
Background: Psychiatric disorders are common in irritable bowel syndrome (IBS). We conducted this study to investigate the relationship of IBS and their subtypes with some of psychological factors. Materials and Methods: A cross-sectional study was performed among 4763 staff of Isfahan University of Medical Sciences in 2011. Modified ROME III questionnaire and Talley Bowel Disease Questionnaire were used to evaluate IBS symptoms. Hospital Anxiety and Depression Scale and 12-item General Health Questionnaire were utilized to assess anxiety, depression and psychological distress. Logistic regression analysis was used to determine the association of psychological states and IBS in the total subject and both genders. Results: About, 4763 participants with mean age 36/58 ± 8/09 were included the 2106 males and 2657 females. Three thousand and seven hundred and seventy-six (81.2%) and 2650 (57.2%) participants were married and graduated respectively. Subtype analysis of IBS and its relationship with anxiety, depression and distress comparing the two genders can be observed that: IBS and clinically-significant IBS have higher anxiety, depression symptoms, and distress than the subject without IBS (P < 0.001). Women with IBS, have higher scores than men (P < 0.001). Compared to other subtypes, mixed IBS subtype has a higher anxiety, depression, and distress score. Conclusion: A high prevalence of anxiety, depression symptoms and distress in our subjects emphasize the importance of the psychological evaluation of the patients with IBS, in order to better management of the patients and may also help to reduce the burden of health care costs.
Irritable bowel syndrome and psychological stress
Health SA Gesondheid, 1999
The purpose of this study was twofold. The first aim was to clarify the relationship between psychological stress and lrritable Bowel Syndrome (IBS) by establishing whether individuals suffering from IBS experience minor stress differently from healthy individuals in terms of its frequency or intensity. The second aim was more general and concerns theory building in a field filled with ambiguity and confusion. Two groups, one comprising IBS sufferers and the other healthy controls, completed the Daily Stress lnventory and the Occupational Stress lnventoryquestionnaires designed to measure minor daily and occupational stress respectively. The findings indicate that IBS sufferers do not experience more stress than healthy individuals, but they experience the stressors with greater intensity. ABSTRAK Die doel van die studie was tweeledig. Eerstens is daar gepoog om duidelikheid te kry oor die verband tussen sielkundige stres en Prikkelbare Dermsindroom (PDS), deur te bepaal of individue wat aan PDS ly geringe stres anders ervaar as gesonde individue in terme van gereeldheid of intensiteit. Die tweede doelwit was meer algemeen en spreek die kwessie van teorie ontwikkeling aan in 'n veld gevul met dubbelsinningheid en verwarring. Twee groepe, een bestaande uit PDS lyers en die ander 'n gesonde kontrolegroep, het die "Daily Stress Inventory'' en die "Occupational Stress Inventory" voltooi. Die vraelyste is ontwerp om onderskeidelik daaglikse stres en werkstres te meet. Die resultate dui daarop dat PDS lyers nie meer stres ervaar as die gesonde individue nie, maar dat hulle we1 die stressors ervaar met groter intensiteit.
word count 250) Background. Adult attachment is an important psychological concept, rooted in childhood relationship experience. It includes four attachment styles: secure, anxiouspreoccupied, dismissing-avoidant and fearful-avoidant. Anxious and avoidant attachment have significant effects on health status but have never been studied in irritable bowel syndrome (IBS). Catastrophizing and negative pain beliefs were also measured since they may be affected by attachment. Aims: To determine: 1) whether attachment style differs between IBS patients and healthy controls, 2) how attachment, catastrophizing and negative pain beliefs correlate with IBS symptom severity (IBS-SSS), 3) whether geographic location is relevant. Method: 463 IBS patients with moderate to severe symptoms and 192 healthy controls completed validated questionnaires about attachment as well as catastrophizing, negative pain beliefs and IBS-SSS in 9 locations, U.