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Cited by 102Psychosomatic Disorders and Their TreatmentsGastrointestinal motility and disordersFibromyalgia and Chronic Fatigue Syndrome Research

The presentation of irritable bowel syndrome in the context of somatization disorder

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North, Carol S., Downs, Dana, Clouse, Ray E., Alrakawi, Aydamir, Dokucu, Mehmet E., Cox, Jann, Spitznagel, Edward L., Alpers, David H.·2004·Clinical Gastroenterology and Hepatology
DOI 10.1016/s1542-3565(04)00350-7
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Abstract

Background and aims Somatization disorder, a female predominant disorder, has been found with higher than expected prevalence in previous studies of irritable bowel syndrome (IBS) and might be responsible for some of the comorbidity and excessive health care resource use associated with IBS. The study's aim was to determine within a female IBS population the degree of segregation of psychiatric illness, functional disorders, and health care utilization with somatization disorder. Methods In a prospective, 6-month follow-up study, psychiatric disorders were assessed with the Diagnostic Interview Schedule, gastrointestinal and other symptoms with self-report questionnaires, and medically unexplained complaints by thorough chart review. The setting was a university gastroenterology clinic. The participants were a convenience sample of female clinic attendees with IBS (N = 56). Results Somatization disorder was diagnosed in 25% of patients and highly probable in another 5%. Somatization disorder was associated with significantly greater numbers of gastrointestinal and other symptoms, psychiatric disorders, physicians consulted, telephone calls to physicians, urgent care visits, medication changes, and missed work days and with benzodiazepine use. On follow-up, somatization disorder was associated with psychiatric and IBS symptoms, medication changes, and treatment dissatisfaction. Both somatization disorder and other psychiatric illnesses were associated with other functional gastrointestinal disorders; only somatization disorder remained predictive in a regression model that controlled for the presence of other psychiatric illness. Conclusions Among female IBS patients attending a university gastroenterology clinic, many aspects of comorbidity and health care behaviors previously associated with IBS segregated with the diagnosis of somatization disorder. Recognition and appreciation of somatization disorder in IBS have important ramifications for the conduct of research and clinical practice.

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  • The various functional disorders have important characteristics in common, including epidemiology (female predominance), pathophysiology, diagnosis (symptom-based), the central role of the patient-physician relationship in therapy, and common therapeutic modalities.

    “The various functional disorders have important characteristics in common, including epidemiology (female predominance), pathophysiology (inflammation, hypersensitivity, impaired central processing of afferent sensory information, role of serotonin, psychological distress and somatization, and the role of stress and life events), diagnosis (symptom-based), the central role of the patient-physician”

    From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [8]

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  • Somatization disorder is a potentially important link between the various functional disorders.

    “Still, as discussed above, SD is a potentially important link between the various functional disorders.”

    From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [8]

  • SD was much more important than depression or anxiety, which are often considered as psychiatric associates of IBS.

    “In fact SD was much more important that depression or anxiety, which are often considered as psychiatric associates of IBS.”

    From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [8]

  • Many aspects of co-morbidity and health care behaviors were more associated with the diagnosis of SD than with the diagnosis of IBS.

    “They reported that many aspects of co-morbidity and health care behaviors were more associated with the diagnosis of SD than with the diagnosis of IBS.”

    From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [8]

  • North et al. reported a very high rate of non-gastrointestinal functional disorders in IBS patients, but significantly more so among those with somatization disorder (SD).

    “North et al.8 reported a very high rate of non-gastrointestinal functional disorders in IBS patients, but significantly more so among those with SD.”

    From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [8]

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Cites

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2 of the 51 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. MacDonald AJ, Bouchier IAD. Nonorganic gastrointestinal illness: a medical and psychiatric study. Br J Psychiatry 1980;136: 276 -283.
  2. Miller A, North CS, Clouse RE, Alpers DH, Wetzel RD. Irritable bowel syndrome, psychiatric illness, personality, and abuse: is somatization disorder the missing link? Ann Clin Psychiatry 2001;13:25-30.

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Authors
North, C. S., Downs, D., Clouse, R. E., Alrakawi, A., Dokucu, M. E., Cox, J., Spitznagel, E. L., & Alpers, D. H.
Affiliations
Washington University in St. Louis (US)
Corresponding author
North, Carol S.
ORCID
Venue
Clinical Gastroenterology and Hepatology
Publisher
Elsevier BV
Published
2004-09
Volume
2
Issue
9
Pages
787-795
ISSN
1542-3565 (ISSN-L)
DOI
10.1016/s1542-3565(04)00350-7
OpenAlex
W2172216861
Cited by
102
References
51
Citations by year
2026: 1 · 2025: 2 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 6 · 2020: 2 · 2019: 2 · 2018: 1 · 2017: 4 · 2016: 1 · 2015: 5 · 2014: 7 · 2013: 8 · 2012: 8
FWCI
5.64
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Gastroenterology and Hepatology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Keywords
irritable bowel syndrome, somatization disorder, psychiatric comorbidity, functional gastrointestinal disorders, health care utilization, medically unexplained symptoms, benzodiazepine use, lost workdays, treatment dissatisfaction, women
MeSH terms
Adolescent, Adult, Aged, Female, Health Services, Humans, Middle Aged, Surveys and Questionnaires, Somatoform Disorders, Comorbidity, Prevalence, Irritable Bowel Syndrome

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