Irritable bowel syndrome: A single gastrointestinal disease or a general somatoform disorder?

Six-year follow-up of patients with functional bowel disorders, with and without previous psychotherapy

“…Such a change of diagnostic group had been noted before but for shorter follow-up periods [30], [31] and was attributed to an underlying common pathogenesis of FGD [32]. These authors did not record psychopathology in their sample and their symptom data therefore, cannot be correlated to psychopathology, as we did; but others have reported that psychopathology determines health care-seeking behaviour, symptom severity and duration, and psychological and somatic comorbidity [33], [34], [35].…”

“…As we have stated before [32], patients with functional gastrointestinal disorders are not a homogeneous group of patients even when they enter a specialised tertiary centre. Gender, motivation, psychological strain and severity of symptoms contribute to their health care seeking behaviour, but also to therapy outcome.…”

Multidimensionality of symptom complexes in irritable bowel syndrome and other functional gastrointestinal disorders

“…Patients with comorbidities appear to have a greater severity of symptoms [30,31], but such patients with severe IBS respond as well to psychotherapy or antidepressant therapy [31]. Enck et al [32] discuss whether IBS should be considered as part of a larger model of somatoform disorders involving all medical subspecialties. No answers are available at this time, but the fields of IBS, other chronic pain disorders, and somatoform disorders are beginning to converge and share data on the same patients.…”