Psychiatric illness and irritable bowel syndrome: a comparison with inflammatory bowel disease

Walker, Edward A.; Roy‐Byrne, Peter; Katon, Wayne; Li, Lawrence; Amos, D. B.; Jiranek, Geoffrey C.

doi:10.1176/ajp.147.12.1656

Cited by 195 publications

(13 citation statements)

References 34 publications

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“…Functional somatic syndromes are characterized by medically unexplained symptoms and suffering [26,28]. The symptoms reported by individuals with functional somatic syndromes are prevalent in healthy populations [29,30] and characterized by diffuse and non-specific symptoms emerging from different organs and body parts [26,28,30-32]. Furthermore, the symptoms of functional somatic syndromes are very similar to somatization disorder, and the two conditions are thought to be closely related [26,33,34].…”

Section: Introductionmentioning

confidence: 99%

Somatic symptoms beyond those generally associated with a whiplash injury are increased in self-reported chronic whiplash. A population-based cross sectional study: the Hordaland Health Study (HUSK)

et al. 2012

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BackgroundChronic whiplash leads to considerable patient suffering and substantial societal costs. There are two competing hypothesis on the etiology of chronic whiplash. The traditional organic hypothesis considers chronic whiplash and related symptoms a result of a specific injury. In opposition is the hypothesis that chronic whiplash is a functional somatic syndrome, and related symptoms a result of society-induced expectations and amplification of symptoms. According to both hypotheses, patients reporting chronic whiplash are expected to have more neck pain, headache and symptoms of anxiety and depression than the general population. Increased prevalence of somatic symptoms beyond those directly related to a whiplash neck injury is less investigated. The aim of this study was to test an implication derived from the functional hypothesis: Is the prevalence of somatic symptoms as seen in somatization disorder, beyond symptoms related to a whiplash neck injury, increased in individuals self-reporting chronic whiplash? We further aimed to explore recall bias by comparing the symptom profile displayed by individuals self-reporting chronic whiplash to that among those self-reporting a non-functional injury: fractures of the hand or wrist. We explored symptom load, etiologic origin could not be investigated in this study.MethodsData from the Norwegian population-based “Hordaland Health Study” (HUSK, 1997–99); N = 13,986 was employed. Chronic whiplash was self-reported by 403 individuals and fractures by 1,746. Somatization tendency was measured using a list of 17 somatic symptoms arising from different body parts and organ systems, derived from the research criteria for somatization disorder (ICD-10, F45).ResultsChronic whiplash was associated with an increased level of all 17 somatic symptoms investigated (p<0.05). The association was moderately strong (group difference of 0.60 standard deviation), only partly accounted for by confounding. For self-reported fractures symptoms were only slightly elevated. Recent whiplash was more commonly reported than whiplash-injury a long time ago, and the association of interest weakly increased with time since whiplash (r = 0.016, p = 0.032).ConclusionsThe increased prevalence of somatic symptoms beyond symptoms expected according to the organic injury model for chronic whiplash, challenges the standard injury model for whiplash, and is indicative evidence of chronic whiplash being a functional somatic syndrome.

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Section: Introductionmentioning

confidence: 99%

Somatic symptoms beyond those generally associated with a whiplash injury are increased in self-reported chronic whiplash. A population-based cross sectional study: the Hordaland Health Study (HUSK)

et al. 2012

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“…Nonetheless, the majority of patients with FGIDs have high prevalence rates of current and lifetime psychiatric disorders [18, 22], especially somatization disorder and anxiety and mood disorders, suggesting a general disturbance in affect regulation. In comparison studies with IBD patients, patients with irritable bowel syndrome have shown significantly higher rates of current or lifetime panic disorder, higher numbers of medically unexplained somatic symptoms and higher lifetime prevalence rates of major depression and somatization disorder [22, 26]. …”

Section: Introductionmentioning

confidence: 99%

Alexithymia and Functional Gastrointestinal Disorders

Porcelli

Taylor

Bagby

et al. 1999

Psychother Psychosom

106

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Background: Although the alexithymia construct was derived from observations of patients with classical psychosomatic diseases, empirical studies have found only a moderate association between alexithymia and inflammatory bowel disease (IBD). Indeed, there is some evidence that alexithymia may be associated more strongly with functional somatic symptoms than with the psychosomatic diseases. The present study examined the relationship between alexithymia and functional gastrointestinal disorders (FGIDs) in a group of 121 FGID patients, and compared the results with findings from a group of 116 IBD patients and a group of 112 healthy subjects. Method: The subjects completed the 20-item Toronto Alexithymia Scale and the Hospital Anxiety and Depression Scale. Results: The FGID group was significantly more alexithymic than the IBD group, and the two gastrointestinal groups were more alexithymic than the normal healthy group. These differences remained even after controlling for the influence of education, gender, anxiety, depression and gastrointestinal symptoms. Conclusions: The finding of a high rate of alexithymia (66%) in the group of FGID patients is consistent with the propensity of these patients to somatization and to high levels of poorly differentiated psychological distress.

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“…[10] The disorders that were encountered frequently included depression, anxiety, somatization disorder, and substance use disorder, which is in agreement with the previous literature. [9101213] The present study finds that the rates of psychiatric diagnosis were higher than patients with NUD, even after controlling for other variables. Two previous studies, however, did not find differences in psychiatric morbidity between patients with IBS and peptic ulcer disease.…”

Section: Discussionmentioning

confidence: 41%

“…[89] It has been seen that up to 90% of patients with IBS may have associated psychiatric disorders. [1011] The disorders commonly encountered in patients with IBS include depression,[910] generalized anxiety,[910] panic disorder,[910] somatization disorder,[912] and substance use disorders. [13] Anxiety and depression have been noticed to be important concomitants of IBS and adversely affect patient outcomes.…”

mentioning

confidence: 99%

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Comparison of psychiatric morbidity in patients with irritable bowel syndrome and non-ulcer dyspepsia

et al. 2016

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Background and Aims:The present study aimed to find psychiatric morbidity, stress, anxiety, and depression in patients with irritable bowel syndrome (IBS) and compare it with patients having non-ulcer dyspepsia (NUD).Methods:This case NUD study compared 50 patients each with IBS and NUD. The two groups were compared on demographic data, psychiatric diagnosis using the Structured Clinical Interview for DSM-IV Axis 1 disorders, anxiety levels using the Hamilton Anxiety Rating Scale (HAM-A), and depression using the Hamilton Depression Rating Scale (HAM-D). The Presumptive Stressful Life Events Scale (PSLES) was used to measure stress.Results:The cases of IBS were more likely to be of female gender (P = 0.012), married (P = 0.009), and employed (P < 0.001). Psychiatric diagnoses were more common in the cases of IBS than NUDs (88% vs. 30%, P < 0.001), the most common being major depression and somatization disorder. Symptoms of anxiety and depression were more common in patients with IBS (P < 0.001 for HAM-A and HAM-D). Logistic regression revealed that having IBS and increased age were independent predictors of having a psychiatric diagnosis.Conclusions:IBS is associated with the considerable degree of psychiatric morbidity. Adequate attention should be paid toward comorbid psychiatric illnesses, and prompt treatment should be instituted.

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Psychiatric illness and irritable bowel syndrome: a comparison with inflammatory bowel disease

Cited by 195 publications

References 34 publications

Somatic symptoms beyond those generally associated with a whiplash injury are increased in self-reported chronic whiplash. A population-based cross sectional study: the Hordaland Health Study (HUSK)

Somatic symptoms beyond those generally associated with a whiplash injury are increased in self-reported chronic whiplash. A population-based cross sectional study: the Hordaland Health Study (HUSK)

Alexithymia and Functional Gastrointestinal Disorders

Comparison of psychiatric morbidity in patients with irritable bowel syndrome and non-ulcer dyspepsia

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