The relationship of current psychiatric disorder to functional disability and distress in patients with inflammatory bowel disease
Abstract
Although prior theories about psychiatric disorders causing inflammatory bowel disease (IBD) have largely been discredited, these same disorders have at times been associated with functional gastrointestinal symptoms such as those found in irritable bowel syndrome. Since functional gastrointestinal symptoms can also occur in patients with organic pathology, we hypothesized that a current psychiatric disorder might amplify or produce additional gastrointestinal symptoms in patients with organic gastrointestinal diseases such as IBD, leading to additive functional disability and decreased quality of life. This pilot study evaluated a sequential sample of 40 IBD patients using the NIMH Diagnostic Interview Schedule, structured interviews for functional gastrointestinal symptoms, and prior episodes of emotional, physical, and sexual abuse as well as self-report measures of personality and disability. We compared IBD patients with and without a current psychiatric disorder while controlling for disease severity. Eight patients with major depression were treated with antidepressants. Patients with a current psychiatric disorder had significantly higher 1) mean number of lifetime psychiatric diagnoses, 2) prevalence rates of prior sexual and physical victimization, and, 3) mean numbers of both gastrointestinal and other medically unexplained symptoms despite no differences in severity of IBD. Significant and trend level differences were apparent on several measures of functional disability. A regression analysis showed that number of psychiatric diagnoses, number of functional gastrointestinal symptoms, and dissociation scale scores significantly discriminated the groups. Treatment of current major depression decreased functional disability despite no objective changes in gastrointestinal disease severity. It was concluded that the presence of a current psychiatric disorder appears to alter the perception of disease severity in patients with IBD. Nonrecognition of the psychiatric disorder may lead to unnecessary and aggressive interventions for IBD patients such as medication changes, invasive testing, or surgery. The presence of a current psychiatric illness also appears to be associated with increased functional disability. Psychiatric evaluation and treatment, therefore, have an important role in the ongoing management of IBD patients with distressing gastrointestinal symptoms not directly attributable to their IBD.
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Cites
Development, reliability, and validity of a dissociation scale
BERNSTEIN, E. M., & PUTNAM, F. W. (1986) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-198612000-00004 · Cited by 3,793 · see citing works
The MOS Short-form General Health Survey: Reliability and Validity in a Patient Population
Stewart, A. L., Hays, R. D., & Ware, J. E. (1988) · Medical Care · doi:10.1097/00005650-198807000-00007 · Cited by 3,339 · see citing works
Drossman, D. A., Li, Z., Andruzzi, E., Temple, R. D., Talley, N. J., Grant Thompson, W., Whitehead, W. E., Janssens, J., Funch-Jensen, P., Corazziari, E., et al. (1993) · Digestive Diseases and Sciences · doi:10.1007/bf01303162 · Cited by 2,198 · see citing works
Sexual and physical abuse in women with functional or organic gastrointestinal disorders
Drossman, D. A., Leserman, J., Nachman, G., Li, Z., Gluck, H., Toomey, T. C., & Mitchell, C. M. (1990) · Annals of Internal Medicine · doi:10.7326/0003-4819-113-11-828 · Cited by 898 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Depression and Diabetes: Impact of Depressive Symptoms on Adherence, Function, and Costs
Ciechanowski, P. S., Katon, W. J., & Russo, J. E. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.21.3278 · Cited by 1,465 · see citing works
Self-citationBrain–Gut Interactions in Inflammatory Bowel Disease
Bonaz, B. L., & Bernstein, C. N. (2013) · Gastroenterology · doi:10.1053/j.gastro.2012.10.003 · Cited by 667 · see citing works
Impact of major depression on chronic medical illness
Katon, W., & Ciechanowski, P. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00313-6 · Cited by 485 · see citing works
Self-citationWalker, J. R., Ediger, J. P., Graff, L. A., Greenfeld, J. M., Clara, I., Lix, L., Rawsthorne, P., Miller, N., Rogala, L., McPhail, C. M., et al. (2008) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2008.01980.x · Cited by 437 · see citing works
LYTE, M., LI, W., OPITZ, N., GAYKEMA, R., & GOEHLER, L. (2006) · Physiology & Behavior · doi:10.1016/j.physbeh.2006.06.019 · Cited by 334 · see citing works
Pain and inflammatory bowel disease.
Bielefeldt, K., Davis, B., & Binion, D. G. (2009) · Inflammatory Bowel Diseases · doi:10.1002/ibd.20848 · Cited by 304 · see citing works
Guthrie, E., Jackson, J., Shaffer, J., Thompson, D., Tomenson, B., & Creed, F. (2002) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2002.05842.x · Cited by 306 · see citing works
Self-citationFuller-Thomson, E., & Sulman, J. (2006) · Inflammatory Bowel Diseases · doi:10.1097/00054725-200608000-00005 · Cited by 292 · see citing works
Romberg-Camps, M. J. L., Bol, Y., Dagnelie, P. C., Hesselink-van de Kruijs, M. A. M., Kester, A. D. M., Engels, L. G. J. B., van Deursen, C., Hameeteman, W. H. A., Pierik, M., Wolters, F., et al. (2010) · Inflammatory Bowel Diseases · doi:10.1002/ibd.21285 · Cited by 240 · see citing works
PERSOONS, P., VERMEIRE, S., DEMYTTENAERE, K., FISCHLER, B., VANDENBERGHE, J., VAN OUDENHOVE, L., PIERIK, M., HLAVATY, T., VAN ASSCHE, G., NOMAN, M., et al. (2005) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2005.02535.x · Cited by 253 · see citing works
Pace, F., Molteni, P., Bollani, S., Sarzi‐Puttini, P., Stockbrügger, R., Porro, G. B., & Drossman, D. A. (2003) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365520310004524 · Cited by 157 · see citing works
Knowles, S. R., Wilson, J. L., Connell, W. R., & Kamm, M. A. (2011) · Inflammatory Bowel Diseases · doi:10.1002/ibd.21650 · Cited by 113 · see citing works
Pain management in patients with inflammatory bowel disease: insights for the clinician
Srinath, A. I., Walter, C., Newara, M. C., & Szigethy, E. M. (2012) · Therapeutic Advances in Gastroenterology · doi:10.1177/1756283x12446158 · Cited by 111 · see citing works
Antidepressants in Inflammatory Bowel Disease: A Systematic Review
Macer, B. J. D., Prady, S. L., & Mikocka-Walus, A. (2017) · Inflammatory Bowel Diseases · doi:10.1097/mib.0000000000001059 · Cited by 92 · see citing works
SZIGETHY, E., WHITTON, S. W., LEVY-WARREN, A., DeMaso, D. R., WEISZ, J., & BEARDSLEE, W. R. (2004) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000142284.10574.1f · Cited by 92 · see citing works
Clinical trial guidelines for pharmacological treatment of irritable bowel syndrome
Corazziari, E., Bytzer, P., Delvaux, M., Holtmann, G., Malagelada, J. R., Morris, J., Muller‐Lissner, S., Spiller, R. C., Tack, J., & Whorwell, P. J. (2003) · Alimentary Pharmacology & Therapeutics · doi:10.1046/j.1365-2036.2003.01709.x · Cited by 80 · see citing works
Gray, W. N., Denson, L. A., Baldassano, R. N., & Hommel, K. A. (2011) · Inflammatory Bowel Diseases · doi:10.1002/ibd.21520 · Cited by 86 · see citing works
Sainsbury, K., Mullan, B., & Sharpe, L. (2013) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2013.05.011 · Cited by 83 · see citing works
Yanartas, Ö., Kani, H. T., Bicakci, E., Kilic, I., Banzragch, M., Acikel, C., Atug, O., Kuscu, K., Imeryuz, N., & Akin, H. (2016) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s106039 · Cited by 69 · see citing works
Tarricone, I., Regazzi, M. G., Bonucci, G., Rizzello, F., Carini, G., Muratori, R., Poggioli, G., & Campieri, M. (2017) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2017.07.001 · Cited by 53 · see citing works
Anxiety symptoms and disease severity in children and adolescents with Crohn disease
Reigada, L. C., Hoogendoorn, C. J., Walsh, L. C., Lai, J., Szigethy, E., Cohen, B. H., Bao, R., Isola, K., & Benkov, K. J. (2015) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000000552 · Cited by 50 · see citing works
Reigada, L. C., Benkov, K. J., Bruzzese, J., Hoogendoorn, C., Szigethy, E., Briggie, A., Walder, D. J., & Warner, C. M. (2013) · Journal for Specialists in Pediatric Nursing · doi:10.1111/jspn.12019 · Cited by 34 · see citing works
Eindor- Abarbanel, A., Naftali, T., Ruhimovich, N., Bar-Gil Shitrit, A., Sklerovsky-Benjaminov, F., Konikoff, F., Matalon, S., Shirin, H., Milgrom, Y., Ziv-Baran, T., et al. (2021) · Frontline Gastroenterology · doi:10.1136/flgastro-2020-101412 · Cited by 28 · see citing works
- Authors
- Walker, E. A., Gelfand, M. D., Gelfand, A. N., Creed, F., & Katon, W. J.
- Affiliations
- University of Washington (US)
- Virginia Mason Medical Center (US)
- Manchester Royal Infirmary (GB)
- Corresponding author
- Walker, Edward A.
- ORCID
- Creed, Francis
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 1996-07
- Volume
- 18
- Issue
- 4
- Pages
- 220-229
- ISSN
- 0163-8343 (ISSN-L)
- OpenAlex
- W2114187469
- Cited by
- 144
- References
- 4
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 4 · 2019: 4 · 2018: 3 · 2017: 2 · 2016: 5 · 2015: 8 · 2014: 8 · 2013: 7 · 2012: 6
- FWCI
- 1.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- inflammatory bowel disease, psychiatric comorbidity, functional disability, gastrointestinal symptoms, irritable bowel syndrome, major depressive disorder, antidepressant treatment, dissociation, medically unexplained symptoms, quality of life, disease severity perception
- MeSH terms
- Activities of Daily Living, Adult, Antidepressive Agents, Anxiety Disorders, Depressive Disorder, Female, Disabled Persons, Persons with Disabilities, Humans, Interview, Psychological, Male, Middle Aged, Pilot Projects, Severity of Illness Index, Stress, Psychological, Inflammatory Bowel Diseases, Logistic Models, Case-Control Studies
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