Self-schema in irritable bowel syndrome and depression.

Abstract

Some investigators have suggested that irritable bowel syndrome (IBS) represents a physiologic expression of an affective disorder. This study investigated whether IBS patients differed in their self-schema from depressed patients. Self-schema refers to a cognitive framework of the individual's beliefs, attitudes, and self-perceptions which is stored in memory and which influences incoming information. The sample consisted of 21 IBS patients, 21 psychiatric outpatients with major depression (MD), and 19 normal controls. All groups were age matched. Subjects completed a structured psychiatric interview (Diagnostic Interview Schedule (DIS) and a Beck Depression Inventory (BDI), in addition to a test of self-schema, which involved rating and recall of a variety of "depressed" and "nondepressed" content adjectives. Consistent with previous work on self-schema, the MD group recalled significantly more depressed adjectives rated under the self-referent task than the Control group (p less than 0.05) and, also, the IBS group (p less than 0.05). Most striking was the finding that a subgroup of IBS patients who met criteria for MD (43% of the sample) recalled significantly more self-referent nondepressed words (and less self-referent depressed words) than the MD group (p less than 0.05). In other words, IBS patients with MD do not view themselves as depressed. These findings suggest that while some IBS and depressed psychiatric outpatients may share depressive symptoms, these groups can be differentiated by their self-schema.

Hypervigilance in irritable bowel syndrome compared with organic gastrointestinal disease

“…In line with one previous study [20], the IBS patients in our study did not selectively recall negative affects, and there was no difference compared with organic GI patients. Gomborone et al [19] previously reported that IBS patients, similar to patients with depression, also selectively recognise emotionally negative words when compared with both healthy controls and patients with IBD.…”

“…Two studies used different types of memory tests to assess selective processing of negatively charged information and came to opposite conclusions [19,20]. A similar method was also used by Gibbs-Gallagher et al [21] to prove the presence of selective attention for words representing gastrointestinal (GI) sensations in IBS patients compared to healthy controls and patients with asthma.…”

Acute tryptophan depletion affects brain-gut responses in irritable bowel syndrome patients and controls

“…45 The presence of a depression-like memory bias in IBS is however not fully established. 46 47 Whitehead and Palsson suggested that psychological response bias resulting in increased attention and hypervigilance to gastrointestinal sensations is present in IBS and influences visceral perception. 48 In our study, ATD induced a depression-like affective memory bias.…”

A History of Abuse in Community Subjects with Irritable Bowel Syndrome and Functional Dyspepsia: The Role of Other Psychosocial Variables

“…There is other evidence to suggest that people with IBS tend to present themselves in a favorable light [37], which may result in a lower rate of reported abuse. Leserman et al [27], however, did find good overall agreement of 80% between the two types of assessment.…”