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20-10-2011 | Psychology | Article

Psychopathology exacerbated in IBS patients with functional dyspepsia


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MedWire News: Functional dyspepsia (FP) points to the presence of more severe psychopathology in patients with irritable bowel syndrome (IBS), indicates research published in the journal BMC Gastroenterology.

"These findings suggest that a substantial subset of patients… presenting both IBS and FD symptoms may benefit from psychological assessment and treatment," report Enrico Corazziari and co-authors, from Sapienza University in Rome, Italy.

"Appropriate assessment and treatment are likely to have a positive impact on patients' well-being and healthcare utilization."

Noting that many patients have overlapping symptoms of IBS and FD, and that both conditions are associated with psychologic factors and psychiatric illness, the team hypothesized that IBS patients with FD may have more severe psychopathology than those without dyspeptic symptoms.

To investigate, the team asked 82 patients, aged an average of 42 years, with Rome III criteria IBS to complete the Symptom Checklist 90 Revised (SCL-90-R) assessment for psychologic status.

The majority (68.3%) of patients had symptoms only of IBS. The 31.7% of patients with both conditions were assessed for Rome III-defined FD subtype; 17 had postprandial distress syndrome and nine had epigastric pain syndrome.

Overall, patients with IBS and FD had significantly higher median scores on the global severity index of the SCL-90-R than those with IBS alone, at 1.00 versus 0.48. Scoring ranges from 0 (no distress) to 4.0 (extremely distressing); a score of 0.58 or above indicates somatic and psychologic suffering and a high likelihood of psychiatric illness.

Patients with IBS and FD also scored significantly higher than those with IBS alone on eight of the nine SCL-90-R subscales - obsessive-compulsive, interpersonal sensitivity, depression, anxiety, anger-hostility, phobic anxiety, paranoid ideation, and psychoticism. The groups did not significantly differ for the somatization subscale.

SCL-90-R global and subscale results did not significantly differ by FD subtype among patients with IBS and FD. However, the researchers note this finding should be considered "provisional" due to the small numbers of patients examined.

Corazziari et al conclude: "In clinical practice the higher levels of psychopathology observed in IBS patients with FD in comparison to those without FD may result in an increased medical consultation and in a greater impairment of health-related quality of life, with significant socio-economic implications."

By Lynda Williams

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