Gastrointestinal and Psychological Mediators of Health-Related Quality of Life in IBS and IBD: A Structural Equation Modeling Analysis

Abstract

Objective Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are chronic gastrointestinal (GI) syndromes in which both GI and psychological symptoms have been shown to negatively impact health-related quality of life (HRQOL). The objective of this study was to use structural equation modeling (SEM) to characterize the interrelationships among HRQOL, GI, and psychological symptoms to improve our understanding of the illness processes in both conditions. Methods Study participants included 564 Rome positive IBS patients and 126 IBD patients diagnosed via endoscopic and / or tissue confirmation. All patients completed questionnaires to assess bowel symptoms, psychological symptoms (SCL-90R), and HRQOL (SF-36). SEM with its two components of confirmatory analyses and structural modeling were applied to determine the relationships between GI and psychological symptoms and HRQOL within the IBS and IBD groups. Results For both IBD and IBS, psychological distress was found to have a stronger direct effect on HRQOL(−0.51 and −0.48 for IBS and IBD, respectively) than GI symptoms (−0.25 and −0.28). The impact of GI symptoms on psychological distress was stronger in IBD compared with IBS (0.43 vs. 0.22; P <0.05). The indirect effect of GI symptoms on HRQOL operating through psychological distress was significantly higher in IBD than IBS (−0.21 vs. −0.11; P <0.05). Conclusions Psychological distress is less dependent on GI symptom severity in IBS compared with IBD even though the degree that psychological distress impacts HRQOL is similar. The findings emphasize the importance of addressing psychological symptoms in both syndromes.

Female gender and gastrointestinal symptoms, not brain‐derived neurotrophic factor, are associated with depression and anxiety in cirrhosis

“…Significantly higher depression scores were detected in patients who suffered from abdominal bloating (11 [6.25, 15.75] vs. 7.5 [4, 12.75], P = 0.002), belching (10 [6, 18] vs. 8 [4,13], P = 0.011), anorexia (13 [8,20] vs. 7 [4,11], P < 0.001), abdominal pain (12 [6.75, 20] vs. 8 [4,12], P < 0.001), nausea/vomiting (16 [10.5, 30] vs. 8 [4,13], P < 0.001), and constipation (13 [8.5, 19.75] vs. 8 [4,14], P = 0.004). Similarly, anxiety scores were significantly higher in patients with abdominal bloating (7 [3,9] vs. 4 [2,7], P = 0.003), belching (7 [3,10] vs. 4 [2,8], P = 0.008), anorexia (7 [4,11] vs. 4 [2,7], P < 0.001), abdominal pain (7 [3.75, 12.25] Patients who were classified as being cases of depression showed significantly more frequent symptoms of anorexia (55.88% vs. 29.88%, P = 0.003), abdominal pain (58.82% vs. 26.43%, P < 0.001), and nausea/vomiting (44.12% vs. 10.34%, P < 0.001) than non-depressed patients. In patients with anxiety, abdominal pain (68.18% vs. 27.42%, P < 0.001), nausea/vomiting (59.09% vs. 10.75%, P < 0.001), and constipation (27.30% vs. 10.75%, P = 0.027) were significantly more frequent ( Multiple linear regression analysis was used to identify the possible covariates related to depression and anxiety.…”

“…Many investigations have confirmed that GI symptoms are strongly associated with the psychological distress in patients with GI disorders as well as in patients with diabetes mellitus. [6][7][8] Only very few studies have shown the association between GI symptomatology and psychological dysfunction in cirrhosis. 9,10 Brain-derived neurotrophic factor belongs to the neurotrophin family of growth factors, playing an essential role in the survival, differentiation, and outgrowth of peripheral and central neurons.…”

Inflammatory Bowel Disease and Sexual Function in Male and Female Patients: An Update on Evidence in the Past Ten Years

“…2,3,4 Almost 40 years ago Gazzard et al reported a decreased sexual activity among patients with IBD. 5 Worryingly, nowadays this remains an issue, since a significant proportion of patients report lack of intimate relationships due to IBD and sexual problems seem to be common [20.6%].…”

Pharmacotherapy for irritable bowel syndrome in the context of evidence-based medicine

“…: +7(499)187-1097; e-mail: svch555362@yandex.ru номическими затратами на лечение, но и влиянием на качество жизни (КЖ) больных СРК, которое значительно ниже теоретически нормального уровня по всем оценива-емым критериям [4]. Более того, оно сопоставимо с тако-вым при хронической сердечной недостаточности, воспа-лительных заболеваниях кишечника и сахарном диабете, а у больных СРК и запором снижение КЖ сопоставимо с КЖ пациентов, страдающих ревматоидным и псориати-ческим артритом [5][6][7].…”