Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2015

Open Access 01-12-2015 | Research Article

Predictors of health-related quality of life in patients with irritable bowel syndrome. A cross-sectional study in Norway

Authors: Vilde Lehne Michalsen, Per Olav Vandvik, Per G. Farup

Published in: Health and Quality of Life Outcomes | Issue 1/2015

Login to get access

Abstract

Background

Reduced quality of life (QoL) is often the main problem for patients with irritable bowel syndrome (IBS). This study aimed at finding predictors of reduced physical and mental quality of life (QoL) accessible for intervention.

Methods

Consecutive patients with IBS (according to the Rome II criteria) visiting a general practitioner were included in a prospective cohort study and followed up for 6−9 months. At the last visit, information about sociodemographic characteristics, abdominal complaints, QoL and a range of physical and mental comorbidities were collected. Physical and mental QoL were measured with the generic QoL instrument Short Form-12 Physical Component Score (SF-12 PCS) and Short Form-12 Mental Component Score (SF-12 MCS) respectively. The normal scores are 50. This cross-sectional study used data from the last visit.

Results

Out of 208 patients included in the cohort study, 149 (female/male: 105/44) with a mean age of 52 years (SD 15.3) were available for the analyses. Physical and mental QoL were reduced, the mean SF-12 PCS and SF-12 MCS scores were 38.4 (SD 11.9) and 45.0 (SD 11.3) respectively. The main independent predictors of low SF-12 PCS and SF-12 MCS were subjective health complaints and organic diseases, and affective disorders respectively. The severity of IBS symptoms was of minor clinical importance.

Conclusions

To help patients with IBS and reduced QoL, treatment should focus on QoL and not on relief of IBS symptoms. The different causes of reduced physical and mental QoL make an individually directed treatment necessary.
Literature
1.
go back to reference Vandvik PO, Lydersen S, Farup PG. Prevalence, comorbidity and impact of irritable bowel syndrome in Norway. Scand J Gastroenterol. 2006;41:650–6.PubMedCrossRef Vandvik PO, Lydersen S, Farup PG. Prevalence, comorbidity and impact of irritable bowel syndrome in Norway. Scand J Gastroenterol. 2006;41:650–6.PubMedCrossRef
2.
go back to reference Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol. 2012;10:712–21.PubMedCrossRef Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol. 2012;10:712–21.PubMedCrossRef
3.
go back to reference Vandvik PO, Wilhelmsen I, Ihlebaek C, Farup PG. Comorbidity of irritable bowel syndrome in general practice: a striking feature with clinical implications. Aliment Pharmacol Ther. 2004;20:1195–203.PubMedCrossRef Vandvik PO, Wilhelmsen I, Ihlebaek C, Farup PG. Comorbidity of irritable bowel syndrome in general practice: a striking feature with clinical implications. Aliment Pharmacol Ther. 2004;20:1195–203.PubMedCrossRef
4.
go back to reference Lackner JM, Ma CX, Keefer L, Brenner DM, Gudleski GD, Satchidanand N, et al. Type, rather than number, of mental and physical comorbidities increases the severity of symptoms in patients with irritable bowel syndrome. Clin Gastroenterol Hepatol. 2013;11:1147–57.PubMedCentralPubMedCrossRef Lackner JM, Ma CX, Keefer L, Brenner DM, Gudleski GD, Satchidanand N, et al. Type, rather than number, of mental and physical comorbidities increases the severity of symptoms in patients with irritable bowel syndrome. Clin Gastroenterol Hepatol. 2013;11:1147–57.PubMedCentralPubMedCrossRef
5.
go back to reference Amouretti M, Le PC, Gaudin AF, Bommelaer G, Frexinos J, Ruszniewski P, et al. Impact of irritable bowel syndrome (IBS) on health-related quality of life (HRQOL). Gastroenterol Clin Biol. 2006;30:241–6.PubMedCrossRef Amouretti M, Le PC, Gaudin AF, Bommelaer G, Frexinos J, Ruszniewski P, et al. Impact of irritable bowel syndrome (IBS) on health-related quality of life (HRQOL). Gastroenterol Clin Biol. 2006;30:241–6.PubMedCrossRef
6.
go back to reference Brun-Strang C, Dapoigny M, Lafuma A, Wainsten JP, Fagnani F. Irritable bowel syndrome in France: quality of life, medical management, and costs: the Encoli study. Eur J Gastroenterol Hepatol. 2007;19:1097–103.PubMedCrossRef Brun-Strang C, Dapoigny M, Lafuma A, Wainsten JP, Fagnani F. Irritable bowel syndrome in France: quality of life, medical management, and costs: the Encoli study. Eur J Gastroenterol Hepatol. 2007;19:1097–103.PubMedCrossRef
7.
go back to reference Canavan C, West J, Card T. Review article: the economic impact of the irritable bowel syndrome. Aliment Pharmacol Ther. 2014;40:1023–34.PubMedCrossRef Canavan C, West J, Card T. Review article: the economic impact of the irritable bowel syndrome. Aliment Pharmacol Ther. 2014;40:1023–34.PubMedCrossRef
8.
go back to reference Johansson PA, Farup PG, Bracco A, Vandvik PO. How does comorbidity affect cost of health care in patients with irritable bowel syndrome? A cohort study in general practice. BMC Gastroenterol. 2010;10:31.PubMedCentralPubMedCrossRef Johansson PA, Farup PG, Bracco A, Vandvik PO. How does comorbidity affect cost of health care in patients with irritable bowel syndrome? A cohort study in general practice. BMC Gastroenterol. 2010;10:31.PubMedCentralPubMedCrossRef
9.
go back to reference Hahn BA, Kirchdoerfer LJ, Fullerton S, Mayer E. Patient-perceived severity of irritable bowel syndrome in relation to symptoms, health resource utilization and quality of life. Aliment Pharmacol Ther. 1997;11:553–9.PubMedCrossRef Hahn BA, Kirchdoerfer LJ, Fullerton S, Mayer E. Patient-perceived severity of irritable bowel syndrome in relation to symptoms, health resource utilization and quality of life. Aliment Pharmacol Ther. 1997;11:553–9.PubMedCrossRef
10.
go back to reference Coffin B, Dapoigny M, Cloarec D, Comet D, Dyard F. Relationship between severity of symptoms and quality of life in 858 patients with irritable bowel syndrome. Gastroenterol Clin Biol. 2004;28:11–5.PubMedCrossRef Coffin B, Dapoigny M, Cloarec D, Comet D, Dyard F. Relationship between severity of symptoms and quality of life in 858 patients with irritable bowel syndrome. Gastroenterol Clin Biol. 2004;28:11–5.PubMedCrossRef
11.
12.
go back to reference Hungin AP, Molloy-Bland M, Claes R, Heidelbaugh J, Cayley Jr WE, Muris J, et al. Systematic review: the perceptions, diagnosis and management of irritable bowel syndrome in primary care - A Rome Foundation Working Team Report. Aliment Pharmacol Ther. 2014;40:1133–45.PubMedCrossRef Hungin AP, Molloy-Bland M, Claes R, Heidelbaugh J, Cayley Jr WE, Muris J, et al. Systematic review: the perceptions, diagnosis and management of irritable bowel syndrome in primary care - A Rome Foundation Working Team Report. Aliment Pharmacol Ther. 2014;40:1133–45.PubMedCrossRef
13.
go back to reference Ford AC, Vandvik PO. Irritable bowel syndrome. Clin Evid (Online ). 2012;2012. Ford AC, Vandvik PO. Irritable bowel syndrome. Clin Evid (Online ). 2012;2012.
14.
go back to reference Rey E, Garcia-Alonso MO, Moreno-Ortega M, Alvarez-Sanchez A, Diaz-Rubio M. Determinants of quality of life in irritable bowel syndrome. J Clin Gastroenterol. 2008;42:1003–9.PubMedCrossRef Rey E, Garcia-Alonso MO, Moreno-Ortega M, Alvarez-Sanchez A, Diaz-Rubio M. Determinants of quality of life in irritable bowel syndrome. J Clin Gastroenterol. 2008;42:1003–9.PubMedCrossRef
15.
go back to reference Cho HS, Park JM, Lim CH, Cho YK, Lee IS, Kim SW, et al. Anxiety, depression and quality of life in patients with irritable bowel syndrome. Gut Liver. 2011;5:29–36.PubMedCentralPubMedCrossRef Cho HS, Park JM, Lim CH, Cho YK, Lee IS, Kim SW, et al. Anxiety, depression and quality of life in patients with irritable bowel syndrome. Gut Liver. 2011;5:29–36.PubMedCentralPubMedCrossRef
16.
go back to reference Spiegel BM, Gralnek IM, Bolus R, Chang L, Dulai GS, Mayer EA, et al. Clinical determinants of health-related quality of life in patients with irritable bowel syndrome. Arch Intern Med. 2004;164:1773–80.PubMedCrossRef Spiegel BM, Gralnek IM, Bolus R, Chang L, Dulai GS, Mayer EA, et al. Clinical determinants of health-related quality of life in patients with irritable bowel syndrome. Arch Intern Med. 2004;164:1773–80.PubMedCrossRef
17.
go back to reference Jamali R, Jamali A, Poorrahnama M, Omidi A, Jamali B, Moslemi N, et al. Evaluation of health related quality of life in irritable bowel syndrome patients. Health Qual Life Outcomes. 2012;10:12.PubMedCentralPubMedCrossRef Jamali R, Jamali A, Poorrahnama M, Omidi A, Jamali B, Moslemi N, et al. Evaluation of health related quality of life in irritable bowel syndrome patients. Health Qual Life Outcomes. 2012;10:12.PubMedCentralPubMedCrossRef
18.
go back to reference Vandvik PO, Kristensen P, Aabakken L, Farup PG. Abdominal complaints in general practice. Diagnoses and characteristics of patients. Scand J Prim Health Care. 2004;22:157–62.PubMedCrossRef Vandvik PO, Kristensen P, Aabakken L, Farup PG. Abdominal complaints in general practice. Diagnoses and characteristics of patients. Scand J Prim Health Care. 2004;22:157–62.PubMedCrossRef
19.
go back to reference Vandvik PO, Aabakken L, Farup PG. Diagnosing irritable bowel syndrome: poor agreement between general practitioners and the Rome II criteria. Scand J Gastroenterol. 2004;39:448–53.PubMedCrossRef Vandvik PO, Aabakken L, Farup PG. Diagnosing irritable bowel syndrome: poor agreement between general practitioners and the Rome II criteria. Scand J Gastroenterol. 2004;39:448–53.PubMedCrossRef
20.
go back to reference Farup PG, Vandvik PO, Aabakken L. How useful are the Rome II criteria for identification of upper gastrointestinal disorders in general practice? Scand J Gastroenterol. 2005;40:1284–9.PubMedCrossRef Farup PG, Vandvik PO, Aabakken L. How useful are the Rome II criteria for identification of upper gastrointestinal disorders in general practice? Scand J Gastroenterol. 2005;40:1284–9.PubMedCrossRef
21.
go back to reference Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE, et al. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol. 1998;51:1171–8.PubMedCrossRef Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE, et al. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol. 1998;51:1171–8.PubMedCrossRef
22.
go back to reference Ihlebaek C, Eriksen HR, Ursin H. Prevalence of subjective health complaints (SHC) in Norway. Scand J Public Health. 2002;30:20–9.PubMedCrossRef Ihlebaek C, Eriksen HR, Ursin H. Prevalence of subjective health complaints (SHC) in Norway. Scand J Public Health. 2002;30:20–9.PubMedCrossRef
23.
go back to reference Strand BH, Dalgard OS, Tambs K, Rognerud M. Measuring the mental health status of the Norwegian population: A comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36). Nord J Psychiatry. 2003;57:113–8.PubMedCrossRef Strand BH, Dalgard OS, Tambs K, Rognerud M. Measuring the mental health status of the Norwegian population: A comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36). Nord J Psychiatry. 2003;57:113–8.PubMedCrossRef
24.
go back to reference Speckens AE, Spinhoven P, Sloekers PP, Bolk JH, Van Hemert AM. A validation study of the whitely index, the illness attitude scales, and the somatosensory amplification scale in general medical and general practice patients. J Psychosom Res. 1996;40:95–104.PubMedCrossRef Speckens AE, Spinhoven P, Sloekers PP, Bolk JH, Van Hemert AM. A validation study of the whitely index, the illness attitude scales, and the somatosensory amplification scale in general medical and general practice patients. J Psychosom Res. 1996;40:95–104.PubMedCrossRef
25.
go back to reference Grayson DA. Latent trait analysis of the Eysenck personality questionnaire. J Psychiatr Res. 1986;20:217–35.PubMedCrossRef Grayson DA. Latent trait analysis of the Eysenck personality questionnaire. J Psychiatr Res. 1986;20:217–35.PubMedCrossRef
26.
go back to reference Sato T. The Eysenck personality questionnaire brief version: factor structure and reliability. J Psychol. 2005;139:545–52.PubMedCrossRef Sato T. The Eysenck personality questionnaire brief version: factor structure and reliability. J Psychol. 2005;139:545–52.PubMedCrossRef
27.
go back to reference van Buuren S. Felxible imputation of missing data. Chapman & Hall /CRC Press, Taylor & Francis Group, 6000 Broken Sound Parkway NW, Boca Raton, FL, USA. 2012;49. van Buuren S. Felxible imputation of missing data. Chapman & Hall /CRC Press, Taylor & Francis Group, 6000 Broken Sound Parkway NW, Boca Raton, FL, USA. 2012;49.
28.
go back to reference Hillila MT, Siivola MT, Farkkila MA. Comorbidity and use of health-care services among irritable bowel syndrome sufferers. Scand J Gastroenterol. 2007;42:799–806.PubMedCrossRef Hillila MT, Siivola MT, Farkkila MA. Comorbidity and use of health-care services among irritable bowel syndrome sufferers. Scand J Gastroenterol. 2007;42:799–806.PubMedCrossRef
29.
go back to reference Seres G, Kovacs Z, Kovacs A, Kerekgyarto O, Sardi K, Demeter P, et al. Different associations of health related quality of life with pain, psychological distress and coping strategies in patients with irritable bowel syndrome and inflammatory bowel disorder. J Clin Psychol Med Settings. 2008;15:287–95.PubMedCrossRef Seres G, Kovacs Z, Kovacs A, Kerekgyarto O, Sardi K, Demeter P, et al. Different associations of health related quality of life with pain, psychological distress and coping strategies in patients with irritable bowel syndrome and inflammatory bowel disorder. J Clin Psychol Med Settings. 2008;15:287–95.PubMedCrossRef
30.
go back to reference Lackner JM, Gudleski GD, Ma CX, Dewanwala A, Naliboff B. Fear of GI symptoms has an important impact on quality of life in patients with moderate-to-severe IBS. Am J Gastroenterol. 2014;109:1815–23.PubMedCrossRef Lackner JM, Gudleski GD, Ma CX, Dewanwala A, Naliboff B. Fear of GI symptoms has an important impact on quality of life in patients with moderate-to-severe IBS. Am J Gastroenterol. 2014;109:1815–23.PubMedCrossRef
31.
go back to reference Faresjo A, Grodzinsky E, Hallert C, Timpka T. Patients with irritable bowel syndrome are more burdened by co-morbidity and worry about serious diseases than healthy controls--eight years follow-up of IBS patients in primary care. BMC Public Health. 2013;13:832.PubMedCentralPubMedCrossRef Faresjo A, Grodzinsky E, Hallert C, Timpka T. Patients with irritable bowel syndrome are more burdened by co-morbidity and worry about serious diseases than healthy controls--eight years follow-up of IBS patients in primary care. BMC Public Health. 2013;13:832.PubMedCentralPubMedCrossRef
32.
go back to reference Minocha A, Johnson WD, Abell TL, Wigington WC. Prevalence, sociodemography, and quality of life of older versus younger patients with irritable bowel syndrome: a population-based study. Dig Dis Sci. 2006;51:446–53.PubMedCrossRef Minocha A, Johnson WD, Abell TL, Wigington WC. Prevalence, sociodemography, and quality of life of older versus younger patients with irritable bowel syndrome: a population-based study. Dig Dis Sci. 2006;51:446–53.PubMedCrossRef
33.
go back to reference Francis CY, Morris J, Whorwell PJ. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther. 1997;11:395–402.PubMedCrossRef Francis CY, Morris J, Whorwell PJ. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther. 1997;11:395–402.PubMedCrossRef
34.
go back to reference Sterne JA, White IR, Carlin JB, Spratt M, Royston P, Kenward MG, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:b2393.PubMedCentralPubMedCrossRef Sterne JA, White IR, Carlin JB, Spratt M, Royston P, Kenward MG, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:b2393.PubMedCentralPubMedCrossRef
Metadata
Title
Predictors of health-related quality of life in patients with irritable bowel syndrome. A cross-sectional study in Norway
Authors
Vilde Lehne Michalsen
Per Olav Vandvik
Per G. Farup
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2015
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-015-0311-8

Other articles of this Issue 1/2015

Health and Quality of Life Outcomes 1/2015 Go to the issue