Non-Organic Gastrointestinal Illness: A Medical and Psychiatric Study

Abstract

One hundred consecutive referrals to a general medical out-patient clinic were evaluated psychiatrically under blind conditions in order to investigate the nature and occurrence of non-organic disease presenting as gastrointestinal illness. Twenty-eight patients had marked psychiatric illness with or without physical illness, and there was an association between psychiatric illness and the absence of organic disease, as determined by outcome at follow-up of 4-11 months. Patients with obsessional traits were more at risk of non-organic illness. Historical items indicating a likelihood of non-organic gastrointestinal illness included "nerves", "depression", unhappy childhood, early parental loss and early separations from parents during childhood. Psychiatric illness often persisted after treatment for physical symptoms. Some of the techniques used in this study to identify psychiatric illness could be usefully employed in everyday practice.

Inflammatory bowel disease versus irritable bowel syndrome: a hospital‐based, case‐control study of disease impact on quality of life

“…However, their study differed from ours in many aspects: the diagnosis of IBS was not standardized, all the patients were new 'entries', and the diagnosis of organic disease was not explicit. The question then arises as to whether the similar severity of psychological symptoms found in our study among the two patient groups was due to the particularly high psychiatric comorbidity of IBS patients seen in the setting of tertiary care, which ranges from 42% to 100% (13,(35)(36)(37)(38)(39)(40)(41), or to the psychological burden of the disease itself.…”

Significant psychological morbidity occurs in irritable bowel syndrome: a case‐control study using a pharmacy reimbursement database

“…12 A number of studies have examined the prevalence of depression and anxiety in IBS. [13][14][15][16][17][18][19][20][21][22] Limitations of these studies include selection bias, disparate diagnostic criteria for IBS, depression and anxiety and assessing psychological traits as opposed to psychiatric diagnosis. Using a validated, well-characterized pharmacy reimbursement database and drug prescribing as a surrogate marker for psychological and IBS diagnosis, we examined the co-existence of psychological comorbidity in IBS in the community and evaluated the persistence of psychological co-morbidity over time.…”

Psychophysiology of visceral pain in IBS and health

“…Patients with IBS tend to report crises in their lives and in this context experience a worsening of their symptoms [19]. Therefore, a meaningful question might be whether patients with IBS, like patients with affective disorders, tend to remember negative events, especially since functional intestinal disorders and depression or anxiety disorders are frequently associated [50]. Indeed, Gomborone et al [51] showed that in a verbal memory test in which patients with IBS, patients with depression, patients with organic disorders of gastrointestinal function, and healthy participants were compared, patients with IBS preferred emotionally negatively charged words, similar to patients with depression.…”