Do psychological factors predict symptom severity in patients with subjective food hypersensitivity?

Lind, Ragna; Lied, Gülen Arslan; Lillestøl, Kristine; Valeur, Jørgen; Berstad, Arnold

doi:10.3109/00365521003797213

Cited by 20 publications

(30 citation statements)

References 145 publications

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“…Only the NCGS patients responded to gluten challenge by an increase in subjective health complaints, suggesting the presence of more nongastrointestinal symptoms in NCGS than CD (Table I; Figure 2). The level of subjective health complaints was somewhat lower for CD and NCGS patients, than in patients reporting food hypersensitivity [38].…”

Section: Discussionmentioning

confidence: 99%

Absence of somatization in non-coeliac gluten sensitivity

Brottveit

Vandvik

Wojniusz

et al. 2012

Scandinavian Journal of Gastroenterology

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Section: Discussionmentioning

confidence: 99%

Absence of somatization in non-coeliac gluten sensitivity

Brottveit

Vandvik

Wojniusz

et al. 2012

Scandinavian Journal of Gastroenterology

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“…On the other hand, patients working part time (44%) reported significantly more subjective health complaints, but not more job stress, than those working full time, supporting the assumption that the patients' complaints are largely unrelated to job stress and work situation. Furthermore, psychological factors such as symptom-specific and general anxiety, and depression could explain only approximately 10% of the variance in the patients' symptom severity; hence, 90% of the variance remained unexplained [50]. Nevertheless, many patients still experience that their bowel disorders are considered a psychosomatic disorder [51].…”

Section: Studies On Psychosocial Aspectsmentioning

confidence: 98%

Perceived food hypersensitivity: A review of 10 years of interdisciplinary research at a reference center

Lied

Lillestøl

Lind

et al. 2011

Scandinavian Journal of Gastroenterology

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Perceived food hypersensitivity is a prevalent, but poorly understood condition. In this review article, we summarize narratively recent literature including results of our 10 years' interdisciplinary research program dealing with such patients. The patients (more than 400) included in our studies were all adults referred to a university hospital because of gastrointestinal complaints self-attributed to food hypersensitivity. Despite extensive examinations, food allergy was seldom diagnosed. The majority of the patients fulfilled the diagnostic criteria for irritable bowel syndrome. In addition, most suffered from several extra-intestinal health complaints and had considerably impaired quality of life. However, psychological factors could explain only approximately 10% of the variance in the patients' symptom severity and 90% of the variance thus remained unexplained. Intolerance to low-digestible carbohydrates was a common problem and abdominal symptoms were replicated by carbohydrate ingestion. A considerable number of patients showed evidence of immune activation by analyses of B-cell activating factor, dendritic cells and "IgE-armed" mast cells. Multiple factors such as immune activation, disturbed intestinal fermentation, enteric dysmotility, post-infectious changes and "local" allergy in the gut as well as psychological disturbances may play a role in the pathophysiology of perceived food hypersensitivity. Hence, our results support the view that management of these patients should be interdisciplinary.

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“…Most of the patients were diagnosed with IBS, but none with food allergy 14. One cannot exclude the possibility that the results are due to a general tendency to amplify bodily sensations in the patient group.…”

Section: Discussionmentioning

confidence: 94%

“…In 2008/2009, 38 consecutive adult patients (older than 18 years) with unexplained self-reported food hypersensitivity were examined at Haukeland University Hospital, Bergen, Norway, by an interdisciplinary team, including allergologists, gastroenterologists, psychiatrists, and dieticians, as previously described 14. In addition, the patients answered the following questionnaires: the FIS,19 the quality of life Short-Form Nepean Dyspepsia Index (SF-NDI),13 the Subjective Health Complaints Inventory (SHC),23 and two questionnaires concerning IBS, Severity of IBS Symptoms24 and Rome III criteria 25…”

Section: Methodsmentioning

confidence: 99%

“…Previous studies in patients with unexplained self-reported food hypersensitivity have shown that the majority suffer from IBS with abdominal pain/discomfort, bloating, and disturbed bowel habits 13,14. In addition they had a high prevalence of subjective health complaints, including musculoskeletal pain,15 and considerably impaired quality of life 13.…”

Section: Introductionmentioning

confidence: 99%

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Chronic fatigue in patients with unexplained self-reported food hypersensitivity and irritable bowel syndrome: validation of a Norwegian translation of the Fatigue Impact Scale

Lind

Berstad²,

Hatlebakk³

et al. 2013

CEG

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BackgroundPatients with unexplained self-reported food hypersensitivity and irritable bowel syndrome (IBS) suffer from several health complaints, including fatigue. The aim of the present study was to validate a Norwegian translation of the Fatigue Impact Scale (FIS), and to assess the impact of fatigue in patients with self-reported food hypersensitivity and IBS, as compared with healthy controls.MethodsThirty-eight patients with unexplained self-reported food hypersensitivity and IBS, who participated in the validation of the FIS completed the following additional questionnaires: the Short Form of Nepean Dyspepsia Index for assessment of quality of life, the Subjective Health Complaint Inventory, and questionnaires for diagnosis and severity of IBS. Impact of fatigue was studied in 43 patients with unexplained self-reported food hypersensitivity, 70% diagnosed with IBS, and 42 healthy controls.ResultsCronbach’s α for the FIS was 0.98, indicating excellent agreement between individual items. Scores on the FIS correlated with scores on the Short Form of Nepean Dyspepsia Index (r = 0.50, P = 0.001), indicating good convergent validity, and were higher in patients (median 85.0, interquartile range 36.8–105.3) than in controls (median 14.0, interquartile range 3.0–29.0, P ≤ 0.0001).ConclusionThe Norwegian translation of the FIS performed excellently in patients with unexplained self-reported food hypersensitivity and IBS, with patients reporting significantly more impact of chronic fatigue than healthy controls.

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Do psychological factors predict symptom severity in patients with subjective food hypersensitivity?

Abstract: Psychological factors were not major predictors of symptom severity in patients with subjective food hypersensitivity. The Norwegian version of VSI had satisfactory validity.

Cited by 20 publications

References 145 publications

Absence of somatization in non-coeliac gluten sensitivity

Absence of somatization in non-coeliac gluten sensitivity

Perceived food hypersensitivity: A review of 10 years of interdisciplinary research at a reference center

Chronic fatigue in patients with unexplained self-reported food hypersensitivity and irritable bowel syndrome: validation of a Norwegian translation of the Fatigue Impact Scale

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