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Query: UMLS:C0022104 (irritable bowel syndrome)
 8,033 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The study of the psychologic profile of patients with the irritable bowel syndrome (IBS) has shown that psychologic aggression, personality abnormalities, psychiatric diagnostics and pathologic behaviour patterns are more frequently encountered than in normal subjects or those with other disease. Moreover, patients with IBS often relate psychological events experienced in infancy such as a lost child, divorce of parents, or sexual abuse which can affect their future and particularly their manner of seeking medical advice. As it is known that only between 23 and 38 per cent of patients with IBS seek medical advice, it is also important to know whether these psychologic characteristics are true for all subjects with these symptoms or if they are found in a particular subgroup of patients who seek medical advice because, in fact, they are really ill. Multivariate analysis was used to evaluate the medical and psychologic status of 72 patients with IBS, 82 patients with symptoms suggestive of IBS but who did not seek medical advice, and 84 normal subjects. With regard to semeiologic differences according to whether patients sought medical advice or not, there were more subjects in the first group who complained of diarrhea and pain. Moreover, there were more patients with personality abnormalities, pathologic behaviour patterns, and a lower sensitivity to stress in subjects with IBS seeking medical advice than in those with symptoms who did not seek advice (p less than 0.001) or normal subjects (p less than 0.001). There were no significant differences between the subjects with symptoms but who do not seek medical advice and the normal subjects (p = 0.21).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Personality and psychological factors in the irritable bowel syndrome]. 221 Jan 85

Patients with chronic pelvic pain attending a tertiary referral centre show certain social, developmental and psychological characteristics. Specifically, they appear to have fewer children and to report more paternal overprotection, and a trend towards low maternal care compared to normals. They also show more depression, free-floating anxiety and somatic anxiety than such populations. The levels are similar to those found in other outpatient populations presenting with migraine or irritable bowel syndrome. Hostility levels are greater than those in normal subjects. Overall the present patient population reports the same degree of childhood sexual abuse as do many other female clinic and community sample populations. Sexual abuse is unlikely to be a specific aetiological factor in the development of chronic pelvic pain though it may yet be found to be important in subsets of the population.
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PMID:Psychosocial aspects of chronic pelvic pain, with special reference to sexual abuse. A study of 164 women. 841 46

We compared 71 patients with irritable bowel syndrome (IBS) and 40 patients with inflammatory bowel disease (IBD) using structured interviews for psychiatric, gastrointestinal and sexual/physical victimization histories, as well as self-reported measures of personality, functional disability and dissociation. IBS patients had significantly higher lifetime prevalence rates of major depression, current panic disorder, and childhood sexual abuse. Despite the absence of organic pathology, IBS patients had significantly higher numbers of medically unexplained physical symptoms and disability ratings equal to, or greater than, those of patients with severe organic gastrointestinal disease.
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PMID:Psychiatric diagnoses, sexual and physical victimization, and disability in patients with irritable bowel syndrome or inflammatory bowel disease. 863 55

Although prior theories about psychiatric disorders causing inflammatory bowel disease (IBD) have largely been discredited, these same disorders have at times been associated with functional gastrointestinal symptoms such as those found in irritable bowel syndrome. Since functional gastrointestinal symptoms can also occur in patients with organic pathology, we hypothesized that a current psychiatric disorder might amplify or produce additional gastrointestinal symptoms in patients with organic gastrointestinal diseases such as IBD, leading to additive functional disability and decreased quality of life. This pilot study evaluated a sequential sample of 40 IBD patients using the NIMH Diagnostic Interview Schedule, structured interviews for functional gastrointestinal symptoms, and prior episodes of emotional, physical, and sexual abuse as well as self-report measures of personality and disability. We compared IBD patients with and without a current psychiatric disorder while controlling for disease severity. Eight patients with major depression were treated with antidepressants. Patients with a current psychiatric disorder had significantly higher 1) mean number of lifetime psychiatric diagnoses, 2) prevalence rates of prior sexual and physical victimization, and, 3) mean numbers of both gastrointestinal and other medically unexplained symptoms despite no differences in severity of IBD. Significant and trend level differences were apparent on several measures of functional disability. A regression analysis showed that number of psychiatric diagnoses, number of functional gastrointestinal symptoms, and dissociation scale scores significantly discriminated the groups. Treatment of current major depression decreased functional disability despite no objective changes in gastrointestinal disease severity. It was concluded that the presence of a current psychiatric disorder appears to alter the perception of disease severity in patients with IBD. Nonrecognition of the psychiatric disorder may lead to unnecessary and aggressive interventions for IBD patients such as medication changes, invasive testing, or surgery. The presence of a current psychiatric illness also appears to be associated with increased functional disability. Psychiatric evaluation and treatment, therefore, have an important role in the ongoing management of IBD patients with distressing gastrointestinal symptoms not directly attributable to their IBD.
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PMID:The relationship of current psychiatric disorder to functional disability and distress in patients with inflammatory bowel disease. 883 53

Chronic pelvic pain and irritable bowel syndrome are common disorders, yet very little is known about their comorbidity. As part of an epidemiological study of patients with irritable bowel syndrome or irritable bowel disease we inquired about a history of chronic pelvic pain and related gynecological problems, and hypothesized that distress associated with either of these conditions was additive in women with both syndromes. A medically trained interviewer evaluated a sequential sample of 60 women with irritable bowel syndrome and 26 women with inflammatory bowel disease in an urban gastroenterology clinic using the National Institute of Mental Health Diagnostic Interview Schedule, the Briere Child Maltreatment Interview (emotional, physical and sexual abuse), and a structured interview to elicit a lifetime history of chronic pelvic pain that was distinct from the history of bowel distress. Chronic pelvic pain was reported in 21 (35.0%) of the irritable bowel syndrome patients vs. 4 (13.8%) of the inflammatory bowel disease group (p < 0.05). Compared to women with irritable bowel syndrome alone, those with both irritable bowel syndrome and chronic pelvic pain were significantly more likely to have a lifetime history of dysthymic disorder, current and lifetime panic disorder, somatization disorder, childhood sexual abuse and hysterectomy. Logistic regression showed that mean number of somatization symptoms was the best predictor of a history of both irritable bowel syndrome and chronic pelvic pain compared either to inflammatory bowel disease or irritable bowel syndrome alone. Many women with irritable bowel syndrome may have a history of chronic pelvic pain as well. The high rates of psychopathology associated with irritable bowel syndrome and chronic pelvic pain independently are even higher in women with both syndromes, and women who present with either irritable bowel syndrome or chronic pelvic pain should probably be evaluated for both disorders.
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PMID:Chronic pelvic pain and gynecological symptoms in women with irritable bowel syndrome. 886 Aug 85

The aims of this study were to determine whether increased pain sensitivity in patients with irritable bowel is due to physiological differences in perceptual sensitivity or psychological influences on perception, and whether prior sexual abuse accounts for increased pain sensitivity. Seventeen sexually abused and 15 nonabused women with irritable bowel were compared to 13 sexually abused and 14 nonabused women without irritable bowel. Among the nonabused subjects, the volume of rectal distension that produced moderate pain was lower in IBS patients than in controls, replicating earlier studies, but these thresholds were correlated with psychological measures of anxiety and somatization. The ability to discriminate between painful distensions (perceptual sensitivity) was not different between groups. Sexual abuse was not associated with lower pain thresholds. Thus, differences in pain sensitivity appear to be due to psychological influences on perception, but a history of sexual abuse does not contribute significantly to this pain sensitivity.
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PMID:Pain from rectal distension in women with irritable bowel syndrome: relationship to sexual abuse. 912 52

This study was designed to determine the percentage of patients in a solo gastroenterology practice with both irritable bowel syndrome and histories of sexual abuse. Sixty-five patients participated in the study. These patients had an incidence of sexual abuse greater than the general population. Implications are drawn for nurses in gastroenterology practice.
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PMID:Abuse, threat, and irritable bowel syndrome: what is the connection? 946 Mar 53

Molested women who completed a series of 16 weekly group psychotherapy sessions conducted by social workers improved substantially regarding various aspects of psychological functioning, including self-image, coping techniques, relationship issues, and mothering. In addition, there was significant improvement in all psychological symptom scales and all global indices of symptomatic distress measured by the SCL-90-R. Furthermore, the improvement was present immediately after therapy and, with the exception of the hostility score, persisted 1 year later. Although the somatization score was reduced, the number of visits for physical symptoms did not change. The patients studied manifested characteristics typical of previously surveyed women with a history of childhood abuse, including a frequent history of major surgery (Drossman et al., 1996; Longstreth & Wolde-Tsadik, 1993; Springs & Friedrich, 1992) and, in some, a previous problem with alcohol (Springs & Friedrich, 1992; Walker et al., 1995) or drugs (Longstreth & Wolde-Tsadik, 1993; Miller & McCluskey-Fawcett, 1993; Springs & Friedrich, 1992). Also, nearly one half of the subjects had irritable bowel syndrome, the prototypical functional bowel disorder (Drossman et al., 1995; Longstreth & Wolde-Tsadik, 1993; Scarinci et al., 1994; Walker et al., 1995). Most of their baseline SCL-90-R scores were > 1 SD above the nonpatient norms. A problem inherent in assessing the long-term benefit of this study and other group psychotherapy studies is the tendency for some patients to continue similar or different forms of therapy after completing the group sessions. More than one half of patients received subsequent therapy that could have influenced their status at 1-year follow-up. However, most of the symptom dimensions and all global indices were similar 1 year posttherapy in the women who did not receive more treatment as compared to results in the women who did. Patients who received additional therapy had higher somatization scores before, immediately after, and 1 year posttherapy; scores in the other group increased 1 year posttherapy. Although the indications for subsequent therapy were not surveyed, there was an association between additional psychological care seeking and somatization. Furthermore, improvement in psychological status reflected by the phobic-anxiety score immediately posttherapy may have contributed to the decision of some patients to seek subsequent therapy. In the group without additional treatment, the loss of some of the initial somatization improvement at 1 year may have contributed to the lack of reduction in medical care visits in the combined groups. We speculate that provision of additional therapy to more patients might have had a long-term effect on somatization and reduced medical visits. We obtained complete psychological data and nearly complete medical-visit data on our patients, and our survey included 1-year follow-up. Our survey did not meet rigorous methodological standards for an outcome study, however. We surveyed only a small number of patients and did not collect similar data on an untreated control group. It was not possible to distinguish health care visits for organic versus functional disorders, but such a distinction may be artificial, because psychological factors may influence health care seeking for "organic" illness. Because our measurements came from a subset of our patients who were willing to complete the survey questionnaires, we do not know how generalizable the findings are. There is increasing awareness among health care professionals that childhood sexual abuse is common and that it may have serious and long-term psychological and medical sequelae. Our data suggest that group psychotherapy by social workers for women victims may have long-lasting psychological and somatic symptom benefits. Reduction in health care usage was not found, and this outcome may require the identification and treatment of patients who need additi
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PMID:Group psychotherapy for women molested in childhood: psychological and somatic symptoms and medical visits. 976 93

The causes of functional dyspepsia remain unclear. Research has linked other functional gastrointestinal disorders, particularly irritable bowel syndrome, to a history of physical or sexual abuse, psychosocial distress and certain psychiatric disorders. In functional dyspepsia, there is a possibility of certain psychiatric disorders, particularly alcohol abuse and eating disorders, indirectly influencing the development of functional dyspepsia-like symptoms. However, the literature on possible psychosocial correlates in functional dyspepsia is not as mature as the literature on irritable bowel syndrome. This paper critically reviews the psychosocial dimensions and implications for the psychotherapeutic treatment of functional dyspepsia.
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PMID:Are psychosocial factors of aetiological importance in functional dyspepsia? 989 88

Psychological difficulties in patients with irritable bowel syndrome (IBS) are strongly related to symptom severity and patient status. This has important implications for clinical practice, and the design and conduct of clinical trials. Psychosocial factors (personality, psychiatric diagnosis illness behavior, life stress, psychological distress) distinguish patients with IBS from patients with no IBS. Psychosocial difficulties (e.g., history of physical or sexual abuse, maladaptive coping, or "catastrophizing") predict poorer health outcome (greater pain scores, psychologic distress and poorer daily function, more days spent in bed, and more frequent physician visits and surgeries). When using the standardized Functional Bowel Disorder Severity Index, patients classified as severe are distinguished from moderates by several psychosocial difficulties and health-care use variables. In addition, whereas patients with severe illness report more pain, there is no difference from patients with moderate illness in terms of visceral sensation threshold. Given these data, it is important to consider psychosocial factors as predictive of symptom severity and clinical outcome, and this should be considered in clinical care and the design of clinical trials.
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PMID:Do psychosocial factors define symptom severity and patient status in irritable bowel syndrome? 1058 72


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