A large proportion of individuals with functional GI disorders such as IBS report significant levels of psychological distress (50-90% of people with IBS in clinical samples in fact have diagnosable affective disorder – less in community samples), but it generally been unclear whether this elevation in psychological symptoms is a cause or amplifier of GI symptoms or the result of the bowel symptoms.
In contrast, individuals with bowel symptoms of more organic nature, like inflammatory bowel disease (IBD), tend to have lower levels of psychological distress than functional GI patients.
In a study presented as a poster today, Saturday May 16, Piacentino and colleagues in Rome, Italy, examined the relationship of psychological symptoms on the SCL-90_R with bowel symptom severity in 75 IBS patients and 69 patients with inflammatory bowel disease (35 of those had ulcerative colitis and 34 had Crohn’s Disease).
In line with prior studies, they found that on average the IBS patients had significantly higher scores on psychological distress than those with IBD.
However, both group scored significantly higher than population norms for psychological symptoms, and for both groups, and there was a clear increase in psychological symptom level with increasing severity of bowel symptoms.
This pattern of findings suggest that the elevated psychological distress of many GI patients is driven to substantial degree by the the gastrointestinal symptoms, regardless of whether the symptoms are organic or functional in nature – probably the result from the added stress and life interference that those gut troubles produce – although a bi-directional relationship between symptoms and psychological symptoms certainly is likely as well.
Daria Piacentino , Monica Cesarini , Enrico Corazziari. Gastrointestinal patients’ psychopathological level is associated with symptom severity irrespectively of inflammatory bowel disease or irritable bowel syndrome diagnosis. DDW 2015 Sa2009.