Irritable Bowel Symptoms and the Development of Common Mental Disorders and Functional Somatic Syndromes Identified in Secondary Care - a Long-term, Population-based Study

Overview

Journal Clin Epidemiol

Publisher Dove Medical Press

Specialty Public Health

Date 2017 Aug 18

PMID 28814899

Citations 5

Authors

Chalotte Heinsvig Poulsen

Lene Falgaard Eplov

Carsten Hjorthoj

Marie Eliasen

Sine Skovbjerg

Thomas Meinertz Dantoft

Andreas Schroder

Torben Jorgensen

Affiliations

Soon will be listed here.

Abstract

Objective: Irritable bowel syndrome (IBS) is associated with mental vulnerability, and half of patients report comorbid somatic and mental symptoms. We aimed to investigate the relationship between an IBS symptom continuum and the subsequent development of common mental disorders (CMDs) and functional somatic syndromes (FSSs).

Methods And Study Design: A longitudinal population-based study comprising two 5-year follow-up studies, Dan-MONICA 1 (1982-1987) and Inter99 (1999-2004), recruited from the western part of Copenhagen County. The total study population (n = 7,278) was divided into symptom groups according to the degree of IBS definition fulfillment at baseline and/or follow-up and was followed until December 2013 in Danish central registries. Cox regression was used for the analyses, adjusting for age, sex, length of education and cohort membership. In a subsequent analysis, we adjusted for mental vulnerability as a risk factor for both CMDs and FSSs, including IBS.

Results: Over a 5-year period, 51% patients had no IBS symptoms, 17% patients had IBS symptoms without abdominal pain, 22% patients had IBS symptoms including abdominal pain and 10% patients fulfilled the IBS definition. IBS and IBS symptoms including abdominal pain were significantly associated with the development of CMDs and other FSSs identified in secondary care. When adjusting for mental vulnerability, IBS and IBS symptoms including abdominal pain were no longer associated with CMDs, but the significant relationship to other FSSs remained.

Conclusion: In a clinical setting, the perspective should be broadened to individuals not fulfilling the symptom cluster of IBS but who report frequent abdominal pain. Additionally, it is important to combine symptom-based criteria of IBS with psychosocial markers such as mental vulnerability, because it could guide clinicians in decisions regarding prognosis and treatment.

Citing Articles

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Irritable bowel syndrome in women: Association between decreased insular subregion volumes and gastrointestinal symptoms.

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Extraintestinal manifestations in irritable bowel syndrome: A systematic review.

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Leveraging 16S rRNA Microbiome Sequencing Data to Identify Bacterial Signatures for Irritable Bowel Syndrome.

Liu Y, Li W, Yang H, Zhang X, Wang W, Jia S Front Cell Infect Microbiol. 2021; 11:645951.

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The impact of mental vulnerability on the relationship between cardiovascular disease and depression.

Jorgensen T, Wium-Andersen M, Jorgensen M, Osler M Eur Psychiatry. 2020; 63(1):e16.

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