Psychiatric, Somatic and Other Functional Gastrointestinal Disorders in Patients With Irritable Bowel Syndrome at a Tertiary Care Center

Abstract

Background/AimsTo study the prevalence of somatic and psychiatric co-morbidities in the patients of irritable bowel syndrome (IBS) and to assess the quality of life (QOL) of these patients.MethodsOne hundred and eighty-four IBS patients and 198 controls were included. Diagnosis of IBS, its sub-classification and assessment of other functional gastrointestinal disorders (FGIDs) was made on basis of Rome III criteria. Severity of IBS was assessed using IBS severity scoring system. Psychiatric evaluation was done using Patient Heath Questionnaire. QOL was evaluated using WHO QOL-BREF.ResultsOne hundred and forty-seven (79.9%) and 158 (85.9%) patients with IBS had at least one other FGID or at least one somatic co-morbidity, respectively. Higher number of patients had at least one psychiatric co-morbidity compared to controls (79.9% vs 34.3%; P < 0.001). Major depressive syndrome (47.3% vs 5.1%; P < 0.001), somatoform disorder (50% vs 14.6%; P < 0.001) and panic syndrome (44% vs 11.6%; P < 0.001) were more common in IBS than controls. Only 14 (7.6%) patients were receiving drug treatment for their psychiatric illness. Severe IBS symptoms were present in significantly higher number of patients with constipation predominant IBS than diarrhea predominant IBS. Those with severe disease had higher prevalence of psychiatric (95.1%) and somatic (96.7%) co-morbidities compared with mild disease. QOL of IBS patients was significantly lower in all four domains compared to controls. Presence of at least one other FGID was significantly associated with presence of one or more psychiatric co-morbidity (P < 0.001).ConclusionsMajority of IBS patients presenting to a tertiary care center had associated psychiatric, somatic co-morbidities and reduced QOL. Very few of them received specific psychiatric treatment.

A cross-sectional study of irritable bowel syndrome in nurses in China: prevalence and associated psychological and lifestyle factors

“…Each item uses a 100-point scale and the final severity score is the sum of these scores (maximum up to 500). Patients were classified as having mild IBS (IBS severity score 75-175), moderately severe IBS (score 175-300), or severe IBS (score >300) (Francis et al, 1997;Singh et al, 2012).…”

Visceral and somatic hypersensitivity, autonomic cardiovascular dysfunction and low-grade inflammation in a subset of irritable bowel syndrome patients

“…Each item has a 100-point scale and the final score is the sum of scores from the five items. Patients were defined as having mild IBS with the score of 75-175, moderately severe IBS with the score 175-300, or severe IBS of the score >300 (Francis et al, 1997;Singh et al, 2012).…”

New and emerging therapies for the treatment of irritable bowel syndrome: an update for gastroenterologists

“…A greater percentage of patients with IBS received anxiolytics and antidepressants compared with healthy controls (p < 0.0001 for both comparisons); notably, 62% of patients received these agents prior to receiving a diagnosis of IBS [Ladabaum et al 2012]. Further, patients with IBS were more likely to have psychiatric conditions than individuals without IBS [Gulewitsch et al 2011;Singh et al 2012]. A significantly greater percentage of patients with severe IBS had at least one psychiatric disorder compared with patients with mild or moderate IBS (94.4% versus 35.7% and 76.1%, respectively; p = 0.003 and p = 0.02) .…”