Temporal Relationships Between Abdominal Pain, Psychological Distress and Coping in Patients With IBS – A Time Series Approach

Abstract

ObjectiveIrritable bowel syndrome (IBS) is a chronic disease leading to abdominal pain that is often related to psychological distress. The aim of the study was to investigate the temporal relationships between abdominal pain and psychological variables in patients with IBS.MethodsThis longitudinal diary study included eight patients from a waiting group, recruited in the frame of a pilot intervention study. During their waiting time of 3 months the patients answered questions daily regarding somatic and psychological variables using an online diary. All patients were considered and analyzed as single cases. The temporal dynamics between the time series of psycho-somatic variables were analyzed using a vector autoregressive (VAR) modeling approach.ResultsFor all patients, positive same-day correlations between somatic and psychological time series were observed. The highest same-day correlations were found between somatic symptoms and pain-related discomfort (r = 0.40 to r = 0.94). Altogether, n = 26 significant lagged relationships were identified; n = 17 (65%) indicated that somatic values were predictive of psychological complaints on the following days. N = 9 (35%) lagged relationships indicated an opposite relationship in that psychological complaints were predictive of somatic symptoms. Three patients showed a significant positive same-day correlation between abdominal pain and use of a positive coping strategy. However, significant lagged relationships in two patients showed that for these patients the use of positive thinking as a coping strategy was unhelpful in reducing pain on the following days.ConclusionsIn patients with IBS abdominal symptoms appear to be closely related to psychological symptoms. For some patients, somatic complaints predict psychological complaints, in other patients the directionality is opposite. The impact of coping strategies on somatic symptoms varies among patients, therefore their role for a possible reduction of pain should be further explored. The results suggest the need of characterizing patientsindividually for effective health interventions. Individual time series analyses provide helpful tools for finding reasonable person-level moderators.

Exploring Biopsychosocial Health Outcomes in Endometriosis and Endometriosis with Co-occurring Irritable Bowel Syndrome – A Prospective Cohort Study

“…Furthermore, a recent retrospective biobank cohort study (N = 65, 421) revealed that individuals living with both endometriosis and IBS are more likely to suffer from multiple co-occurring conditions and experience greater abdominal and pelvic pain compared to individuals with endometriosis or IBS alone [57]. In endometriosis and IBS, disease-related pain is signi cantly associated with increased symptoms of depression and anxiety, pain catastrophising and fatigue [35,37,40,[71][72][73], whilst disease severity may directly in uence how individuals with IBS adaptively cope with and respond to pain [74][75][76]. Accordingly, the presence of comorbid IBS-type symptoms in endometriosis potentially in uences individual responses to condition-related factors and may exacerbate adverse health outcomes, impairing overall HRQoL.…”

“…Conversely, trends for individuals with Endo+IBS were not stable, and after an initial decline in levels of pain catastrophising, results rebounded or diminished over time. These ndings suggest that the added burden of comorbid IBS-type symptoms may heighten catastrophic thinking about pain, or potentially increase individual sensitivity to cyclical changes or external and environmental stressors[71,84,85]. Given that health outcomes are directly affected by how individuals cope with and respond to pain, the development of personalised targeted interventions to address and support cognitive and emotional processes associated with pain catastrophising may help to optimise treatment success and improve overall QoL, for both individuals living with EndoOnly and individuals with Endo+IBS[79,85].…”

Turing and Van Gogh walk into a bar

“…Several mechanisms might explain this association. First, the association between digestives and suicide might reflect the increased prevalence of other health conditions among patients with psychiatric problems, including abdominal pain (e.g., Lexne et al [95]) and irritable bowel syndrome [56]. Similarly, psychiatric patients are more prone to poor lifestyle habits, increasing the likelihood of digestive problems in this group [84,124,137,151].…”