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Published in: BMC Gastroenterology 1/2011

Open Access 01-12-2011 | Research article

Psychopathological features of irritable bowel syndrome patients with and without functional dyspepsia: a cross sectional study

Authors: Daria Piacentino, Rosanna Cantarini, Marianna Alfonsi, Danilo Badiali, Nadia Pallotta, Massimo Biondi, Enrico S Corazziari

Published in: BMC Gastroenterology | Issue 1/2011

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Abstract

Background

Irritable bowel syndrome (IBS) and functional dyspepsia (FD) show considerable overlap and are both associated with psychiatric comorbidity. The present study aimed to investigate whether IBS patients with FD show higher levels of psychopathology than those without FD. As a preliminary analysis, it also evaluated the psychopathological differences, if any, between IBS patients featuring the two Rome III-defined FD subtypes, i.e. postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS).

Methods

Consecutive outpatients (n = 82, F = 67, mean age 41.6 ± 12.7 years) referred to our third level gastroenterological centre, matching the Rome III criteria for IBS and, if present, for concurrent FD, were recruited. They were asked to complete a 90-item self-rating questionnaire, the Symptom Checklist 90 Revised (SCL-90-R), in order to assess the psychological status. Comparisons between groups were carried out using the non-parametric Mann-Whitney U test.

Results

Patients with IBS only were 56 (68.3%, F = 43, mean age 41.6 ± 13.3 years) and patients with both IBS and FD were 26 (31.7%, F = 24, mean age 41.8 ± 11.5 years), 17 of whom had PDS and 9 EPS. Patients with both IBS and FD scored significantly higher on the SCL-90-R GSI and on eight out of the nine subscales than patients with IBS only (P ranging from 0.000 to 0.03). No difference was found between IBS patients with PDS and IBS patients with EPS (P ranging from 0.07 to 0.97), but this result has to be considered provisional, given the small sample size of the two subgroups.

Conclusions

IBS-FD overlap is associated with an increased severity of psychopathological features. This finding suggests that a substantial subset of patients of a third level gastroenterological centre with both IBS and FD may benefit from psychological assessment and treatment.
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Literature
1.
go back to reference Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC: Functional bowel disorders. Gastroenterology. 2006, 130: 1480-1491. 10.1053/j.gastro.2005.11.061.CrossRefPubMed Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC: Functional bowel disorders. Gastroenterology. 2006, 130: 1480-1491. 10.1053/j.gastro.2005.11.061.CrossRefPubMed
2.
go back to reference Tack J, Talley NJ, Camilleri M, Holtmann G, Hu P, Malagelada JR, Stanghellini V: Functional gastroduodenal disorders. Gastroenterology. 2006, 130: 1466-1479. 10.1053/j.gastro.2005.11.059.CrossRefPubMed Tack J, Talley NJ, Camilleri M, Holtmann G, Hu P, Malagelada JR, Stanghellini V: Functional gastroduodenal disorders. Gastroenterology. 2006, 130: 1466-1479. 10.1053/j.gastro.2005.11.059.CrossRefPubMed
3.
go back to reference Agréus L, Svardsudd K, Nyren O, Tibblin G: Irritable bowel syndrome and dyspepsia in the general population: overlap and lack of stability over time. Gastroenterology. 1995, 109: 671-680. 10.1016/0016-5085(95)90373-9.CrossRefPubMed Agréus L, Svardsudd K, Nyren O, Tibblin G: Irritable bowel syndrome and dyspepsia in the general population: overlap and lack of stability over time. Gastroenterology. 1995, 109: 671-680. 10.1016/0016-5085(95)90373-9.CrossRefPubMed
4.
go back to reference Outlaw WM, Koch KL: Dyspepsia and its overlap with irritable bowel syndrome. Curr Gastroenterol Rep. 2006, 8: 266-272. 10.1007/s11894-006-0046-0.CrossRefPubMed Outlaw WM, Koch KL: Dyspepsia and its overlap with irritable bowel syndrome. Curr Gastroenterol Rep. 2006, 8: 266-272. 10.1007/s11894-006-0046-0.CrossRefPubMed
5.
go back to reference Wang A, Liao X, Xiong L, Peng S, Xiao Y, Liu S, Hu P, Chen M: The clinical overlap between functional dyspepsia and irritable bowel syndrome based on Rome III criteria. BMC Gastroenterol. 2008, 8: 43-50. 10.1186/1471-230X-8-43.CrossRefPubMedPubMedCentral Wang A, Liao X, Xiong L, Peng S, Xiao Y, Liu S, Hu P, Chen M: The clinical overlap between functional dyspepsia and irritable bowel syndrome based on Rome III criteria. BMC Gastroenterol. 2008, 8: 43-50. 10.1186/1471-230X-8-43.CrossRefPubMedPubMedCentral
6.
go back to reference Cremonini F, Talley NJ: Review article: the overlap between functional dyspepsia and irritable bowel syndrome -- a tale of one or two disorders?. Aliment Pharmacol Ther. 2004, 20: 40-49.CrossRefPubMed Cremonini F, Talley NJ: Review article: the overlap between functional dyspepsia and irritable bowel syndrome -- a tale of one or two disorders?. Aliment Pharmacol Ther. 2004, 20: 40-49.CrossRefPubMed
7.
go back to reference Levy RL, Olden KW, Naliboff BD, Bradley LA, Francisconi C, Drossman DA, Creed F: Psychosocial aspects of the functional gastrointestinal disorders. Gastroenterology. 2006, 130: 1447-1458. 10.1053/j.gastro.2005.11.057.CrossRefPubMed Levy RL, Olden KW, Naliboff BD, Bradley LA, Francisconi C, Drossman DA, Creed F: Psychosocial aspects of the functional gastrointestinal disorders. Gastroenterology. 2006, 130: 1447-1458. 10.1053/j.gastro.2005.11.057.CrossRefPubMed
8.
go back to reference Talley NJ, Dennis EH, Schettler-Duncan VA, Lacy BE, Olden KW, Crowell MD: Overlapping upper and lower gastrointestinal symptoms in irritable bowel syndrome patients with constipation or diarrhea. Am J Gastroenterol. 2003, 98: 2454-2459. 10.1111/j.1572-0241.2003.07699.x.CrossRefPubMed Talley NJ, Dennis EH, Schettler-Duncan VA, Lacy BE, Olden KW, Crowell MD: Overlapping upper and lower gastrointestinal symptoms in irritable bowel syndrome patients with constipation or diarrhea. Am J Gastroenterol. 2003, 98: 2454-2459. 10.1111/j.1572-0241.2003.07699.x.CrossRefPubMed
9.
go back to reference Balboa A, Mearin F, Badia X, Benavent J, Caballero AM, Domínguez-Muñoz JE, Garrigues V, Piqué JM, Roset M, Cucala M, Figueras M: Impact of upper digestive symptoms in patients with irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2006, 18: 1271-1277. 10.1097/01.meg.0000243870.41207.2f.CrossRefPubMed Balboa A, Mearin F, Badia X, Benavent J, Caballero AM, Domínguez-Muñoz JE, Garrigues V, Piqué JM, Roset M, Cucala M, Figueras M: Impact of upper digestive symptoms in patients with irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2006, 18: 1271-1277. 10.1097/01.meg.0000243870.41207.2f.CrossRefPubMed
10.
go back to reference Mikocka-Walus A, Turnbull D, Moulding N, Wilson I, Andrews JM, Holtmann G: Psychological comorbidity and complexity of gastrointestinal symptoms in clinically diagnosed irritable bowel syndrome patients. J Gastroenterol Hepatol. 2008, 23: 1137-1143. 10.1111/j.1440-1746.2007.05245.x.CrossRefPubMed Mikocka-Walus A, Turnbull D, Moulding N, Wilson I, Andrews JM, Holtmann G: Psychological comorbidity and complexity of gastrointestinal symptoms in clinically diagnosed irritable bowel syndrome patients. J Gastroenterol Hepatol. 2008, 23: 1137-1143. 10.1111/j.1440-1746.2007.05245.x.CrossRefPubMed
11.
go back to reference Koloski NA, Talley NJ, Boyce PM: Predictors of health care seeking for irritable bowel syndrome and non-ulcer dyspepsia: a critical review of the literature on symptom and psychosocial factors. Am J Gastroenterol. 2001, 96: 1340-1349. 10.1111/j.1572-0241.2001.03789.x.CrossRefPubMed Koloski NA, Talley NJ, Boyce PM: Predictors of health care seeking for irritable bowel syndrome and non-ulcer dyspepsia: a critical review of the literature on symptom and psychosocial factors. Am J Gastroenterol. 2001, 96: 1340-1349. 10.1111/j.1572-0241.2001.03789.x.CrossRefPubMed
12.
go back to reference Buzás GM: Functional dyspepsia: the past, the present and the Rome III classification. Orv Hetil. 2007, 148: 1573-1579. 10.1556/OH.2007.28131.CrossRefPubMed Buzás GM: Functional dyspepsia: the past, the present and the Rome III classification. Orv Hetil. 2007, 148: 1573-1579. 10.1556/OH.2007.28131.CrossRefPubMed
13.
go back to reference Drossman DA, Talley NJ, Whitehead WE, Thompson WG, Corazziari E: The Rome II Modular Questionnaire: investigator and respondent forms. Rome II The Functional Gastrointestinal Disorders. Edited by: Drossman DA, Corazziari E, Talley NJ, Thompson WG, Whitehead WE. 2000, Degnon Associates: McLean, VA, USA, 669-678. 2 Drossman DA, Talley NJ, Whitehead WE, Thompson WG, Corazziari E: The Rome II Modular Questionnaire: investigator and respondent forms. Rome II The Functional Gastrointestinal Disorders. Edited by: Drossman DA, Corazziari E, Talley NJ, Thompson WG, Whitehead WE. 2000, Degnon Associates: McLean, VA, USA, 669-678. 2
14.
go back to reference Derogatis LR: The SCL-90-R Administration, scoring, and procedures manual II. 1983, Clinical Psychometric Research: Towson, MD, USA Derogatis LR: The SCL-90-R Administration, scoring, and procedures manual II. 1983, Clinical Psychometric Research: Towson, MD, USA
15.
go back to reference Cassano GB, Conti L, Levine J: SCL-90. Repertorio delle scale di valutazione in psichiatria. Edited by: Conti L. 1999, SEE: Firenze, 325-332. Cassano GB, Conti L, Levine J: SCL-90. Repertorio delle scale di valutazione in psichiatria. Edited by: Conti L. 1999, SEE: Firenze, 325-332.
16.
go back to reference Schauenburg H, Strack M: Die Symptom-Checklist-90-R zur darstellung von statistischen und klinisch signifikanten psychotherapie-ergebnissen. Psychother Psychosom Med Psychol. 1998, 48: 257-264.PubMed Schauenburg H, Strack M: Die Symptom-Checklist-90-R zur darstellung von statistischen und klinisch signifikanten psychotherapie-ergebnissen. Psychother Psychosom Med Psychol. 1998, 48: 257-264.PubMed
17.
go back to reference Schauenburg H, Strack M: Measuring psychotherapeutic change with the symptom checklist SCL-90-R. Psychother Psychosom. 1999, 68: 199-206. 10.1159/000012333.CrossRefPubMed Schauenburg H, Strack M: Measuring psychotherapeutic change with the symptom checklist SCL-90-R. Psychother Psychosom. 1999, 68: 199-206. 10.1159/000012333.CrossRefPubMed
18.
go back to reference SPSS for Windows: Release 13.0. 2004, SPSS Inc: Chicago, IL, USA SPSS for Windows: Release 13.0. 2004, SPSS Inc: Chicago, IL, USA
19.
go back to reference Talley NJ, Boyce P, Jones M: Identification of distinct upper and lower gastrointestinal symptom groupings in an urban population. Gut. 1998, 42: 690-695. 10.1136/gut.42.5.690.CrossRefPubMedPubMedCentral Talley NJ, Boyce P, Jones M: Identification of distinct upper and lower gastrointestinal symptom groupings in an urban population. Gut. 1998, 42: 690-695. 10.1136/gut.42.5.690.CrossRefPubMedPubMedCentral
20.
go back to reference Svedlund J, Sjodin I, Gillberg L: Upper gastrointestinal and mental symptoms in the irritable bowel syndrome. Scand J Gastroenterol. 1985, 20: 595-601. 10.3109/00365528509089702.CrossRefPubMed Svedlund J, Sjodin I, Gillberg L: Upper gastrointestinal and mental symptoms in the irritable bowel syndrome. Scand J Gastroenterol. 1985, 20: 595-601. 10.3109/00365528509089702.CrossRefPubMed
21.
go back to reference Stanghellini V, Tosetti C, Barbara G, De Giorgio R, Cogliandro L, Cogliandro R, Corinaldesi R: Dyspeptic symptoms and gastric emptying in the irritable bowel syndrome. Am J Gastroenterol. 2002, 97: 2738-2743. 10.1111/j.1572-0241.2002.07062.x.CrossRefPubMed Stanghellini V, Tosetti C, Barbara G, De Giorgio R, Cogliandro L, Cogliandro R, Corinaldesi R: Dyspeptic symptoms and gastric emptying in the irritable bowel syndrome. Am J Gastroenterol. 2002, 97: 2738-2743. 10.1111/j.1572-0241.2002.07062.x.CrossRefPubMed
22.
go back to reference Talley NJ, Zinsmeister AR, Schleck CD, Melton LJ III: Dyspepsia and dyspepsia subgroups: a population-based study. Gastroenterology. 1992, 102: 1259-1268.CrossRefPubMed Talley NJ, Zinsmeister AR, Schleck CD, Melton LJ III: Dyspepsia and dyspepsia subgroups: a population-based study. Gastroenterology. 1992, 102: 1259-1268.CrossRefPubMed
23.
go back to reference Shah SS, Bhatia SJ, Mistry FP: Epidemiology of dyspepsia in the general population in Mumbai. Indian J Gastroenterol. 2001, 20: 103-106.PubMed Shah SS, Bhatia SJ, Mistry FP: Epidemiology of dyspepsia in the general population in Mumbai. Indian J Gastroenterol. 2001, 20: 103-106.PubMed
24.
go back to reference Crean GP, Holden RJ, Knill-Jones RP, Beattie AD, James WB, Marjoribanks FM, Spiegelhalter DJ: A database on dyspepsia. Gut. 1994, 35: 191-202. 10.1136/gut.35.2.191.CrossRefPubMedPubMedCentral Crean GP, Holden RJ, Knill-Jones RP, Beattie AD, James WB, Marjoribanks FM, Spiegelhalter DJ: A database on dyspepsia. Gut. 1994, 35: 191-202. 10.1136/gut.35.2.191.CrossRefPubMedPubMedCentral
25.
go back to reference Corsetti M, Caenepeel P, Fischler B, Janssens J, Tack J: Impact of coexisting irritable bowel syndrome on symptoms and pathophysiological mechanisms in functional dyspepsia. Am J Gastroenterol. 2004, 99: 1152-1159. 10.1111/j.1572-0241.2004.30040.x.CrossRefPubMed Corsetti M, Caenepeel P, Fischler B, Janssens J, Tack J: Impact of coexisting irritable bowel syndrome on symptoms and pathophysiological mechanisms in functional dyspepsia. Am J Gastroenterol. 2004, 99: 1152-1159. 10.1111/j.1572-0241.2004.30040.x.CrossRefPubMed
26.
go back to reference Whitehead WE, Gibbs NA, Li Z, Drossman DA: Is functional dyspepsia just a subset of the irritable bowel syndrome?. Bailliere's Clin Gastroenterol. 1998, 12: 443-461. 10.1016/S0950-3528(98)90017-3.CrossRef Whitehead WE, Gibbs NA, Li Z, Drossman DA: Is functional dyspepsia just a subset of the irritable bowel syndrome?. Bailliere's Clin Gastroenterol. 1998, 12: 443-461. 10.1016/S0950-3528(98)90017-3.CrossRef
27.
go back to reference Whitehead WE, Palsson O, Jones KR: Systematic review of the comorbidity of irritable bowel syndrome with other disorders: what are the causes and implications?. Gastroenterology. 2002, 122: 1140-1156. 10.1053/gast.2002.32392.CrossRefPubMed Whitehead WE, Palsson O, Jones KR: Systematic review of the comorbidity of irritable bowel syndrome with other disorders: what are the causes and implications?. Gastroenterology. 2002, 122: 1140-1156. 10.1053/gast.2002.32392.CrossRefPubMed
28.
go back to reference Schwarz SP, Blanchard EB, Berreman CF, Scharff L, Taylor AE, Greene BR, Suls JM, Malamood HS: Psychological aspects of irritable bowel syndrome: comparisons with inflammatory bowel disease and nonpatient controls. Behav Res Ther. 1993, 31: 297-304. 10.1016/0005-7967(93)90028-S.CrossRefPubMed Schwarz SP, Blanchard EB, Berreman CF, Scharff L, Taylor AE, Greene BR, Suls JM, Malamood HS: Psychological aspects of irritable bowel syndrome: comparisons with inflammatory bowel disease and nonpatient controls. Behav Res Ther. 1993, 31: 297-304. 10.1016/0005-7967(93)90028-S.CrossRefPubMed
29.
go back to reference Talley NJ, Fung LH, Gilligan IJ, McNeil D, Piper DW: Association of anxiety, neuroticism, and depression with dyspepsia of unknown cause. A case-control study. Gastroenterology. 1986, 90: 886-892.CrossRefPubMed Talley NJ, Fung LH, Gilligan IJ, McNeil D, Piper DW: Association of anxiety, neuroticism, and depression with dyspepsia of unknown cause. A case-control study. Gastroenterology. 1986, 90: 886-892.CrossRefPubMed
30.
go back to reference Lee S, Park M, Choi S: A study of anger, alexithymia, and depression in the functional dyspepsia. J Psychosom Res. 2003, 55: 149-150.CrossRef Lee S, Park M, Choi S: A study of anger, alexithymia, and depression in the functional dyspepsia. J Psychosom Res. 2003, 55: 149-150.CrossRef
31.
go back to reference Jones MP, Sharp LK, Crowell MD: Psychosocial correlates of symptoms in functional dyspepsia. Clin Gastroenterol Hepatol. 2005, 3: 521-528. 10.1016/S1542-3565(05)00245-4.CrossRefPubMed Jones MP, Sharp LK, Crowell MD: Psychosocial correlates of symptoms in functional dyspepsia. Clin Gastroenterol Hepatol. 2005, 3: 521-528. 10.1016/S1542-3565(05)00245-4.CrossRefPubMed
32.
go back to reference Haug TT, Svebak S, Wilhelmsen I, Berstad A, Ursin H: Psychological factors and somatic symptoms in functional dyspepsia. A comparison with duodenal ulcer and healthy controls. J Psychosom Res. 1994, 38: 281-291. 10.1016/0022-3999(94)90033-7.CrossRefPubMed Haug TT, Svebak S, Wilhelmsen I, Berstad A, Ursin H: Psychological factors and somatic symptoms in functional dyspepsia. A comparison with duodenal ulcer and healthy controls. J Psychosom Res. 1994, 38: 281-291. 10.1016/0022-3999(94)90033-7.CrossRefPubMed
33.
go back to reference Magni G, di Mario F, Bemasconi G, Mastropaolo G: DSM-III diagnoses associated with dyspepsia of unknown cause. Am J Psychiatry. 1987, 144: 1222-1223.CrossRefPubMed Magni G, di Mario F, Bemasconi G, Mastropaolo G: DSM-III diagnoses associated with dyspepsia of unknown cause. Am J Psychiatry. 1987, 144: 1222-1223.CrossRefPubMed
34.
go back to reference Aro P, Talley NJ, Ronkainen J, Storskrubb T, Vieth M, Johansson SE, Bolling-Sternevald E, Agréus L: Anxiety Is associated with uninvestigated and functional dyspepsia (Rome III criteria) in a Swedish population-based study. Gastroenterology. 2009, 137: 94-100. 10.1053/j.gastro.2009.03.039.CrossRefPubMed Aro P, Talley NJ, Ronkainen J, Storskrubb T, Vieth M, Johansson SE, Bolling-Sternevald E, Agréus L: Anxiety Is associated with uninvestigated and functional dyspepsia (Rome III criteria) in a Swedish population-based study. Gastroenterology. 2009, 137: 94-100. 10.1053/j.gastro.2009.03.039.CrossRefPubMed
35.
go back to reference Sjödin I, Svedlund J: Psychological aspects of non-ulcer dyspepsia: a psychosomatic view focusing on a comparison between the irritable bowel syndrome and peptic ulcer disease. Scand J Gastroenterol. 1985, 20: 51-58.CrossRef Sjödin I, Svedlund J: Psychological aspects of non-ulcer dyspepsia: a psychosomatic view focusing on a comparison between the irritable bowel syndrome and peptic ulcer disease. Scand J Gastroenterol. 1985, 20: 51-58.CrossRef
36.
go back to reference Drossman DA: Presidential address: gastrointestinal illness and biopsychosocial model. Psychosom Med. 1998, 60: 258-267.CrossRefPubMed Drossman DA: Presidential address: gastrointestinal illness and biopsychosocial model. Psychosom Med. 1998, 60: 258-267.CrossRefPubMed
37.
go back to reference Drossman DA: The role of psychosocial factors in gastrointestinal illness. Scand J Gastroenterol. 1996, 221: 1-4.CrossRef Drossman DA: The role of psychosocial factors in gastrointestinal illness. Scand J Gastroenterol. 1996, 221: 1-4.CrossRef
38.
go back to reference Hu WHC, Lam SK, Lam CLK, Wong WM, Lam KF, Lai KC, Wong YH, Wong BCY, Chan AOO, Chan CK, Leung GM, Hui WM: Anxiety but not depression determines health care-seeking behavior in Chinese patients with dyspepsia and irritable bowel syndrome: a population-based study. Aliment Pharmacol Ther. 2002, 16: 2081-2088. 10.1046/j.1365-2036.2002.01377.x.CrossRefPubMed Hu WHC, Lam SK, Lam CLK, Wong WM, Lam KF, Lai KC, Wong YH, Wong BCY, Chan AOO, Chan CK, Leung GM, Hui WM: Anxiety but not depression determines health care-seeking behavior in Chinese patients with dyspepsia and irritable bowel syndrome: a population-based study. Aliment Pharmacol Ther. 2002, 16: 2081-2088. 10.1046/j.1365-2036.2002.01377.x.CrossRefPubMed
Metadata
Title
Psychopathological features of irritable bowel syndrome patients with and without functional dyspepsia: a cross sectional study
Authors
Daria Piacentino
Rosanna Cantarini
Marianna Alfonsi
Danilo Badiali
Nadia Pallotta
Massimo Biondi
Enrico S Corazziari
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2011
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/1471-230X-11-94

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