Cited by 129Gastrointestinal motility and disordersPsychosomatic Disorders and Their TreatmentsFibromyalgia and Chronic Fatigue Syndrome Research

The DOI matches its Crossref record; 55 of the 55 references it cites were found in a registry or an index; none of the 47 sources its claims cite is checked for support yet.

Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule

Open access

Choung, Rok Seon, Locke, G Richard, Zinsmeister, Alan R, Schleck, Cathy D, Talley, Nicholas J·2009·The American Journal of Gastroenterology

DOI 10.1038/ajg.2009.239PMC PMC3772628

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Abstract

OBJECTIVES: Psychosocial factors may drive people with irritable bowel syndrome (IBS) to seek health care, but whether psychological factors are causally linked to IBS is controversial. One hypothesis is that IBS is a heterogeneous syndrome comprising two distinct conditions, one psychological and the other biological. However, it is unclear how many people with IBS in the community have little somatization and minimal psychosocial distress. The aim of our study was to estimate the proportion of people with IBS in a representative US community, who have low levels of somatic and psychological symptoms. METHODS: The cohort comprised subjects from three randomly selected population studies from Olmsted County, Minnesota. All of them filled out a validated gastrointestinal (GI) symptom questionnaire, the Symptom Checklist-90-R (SCL-90-R), and the Somatic Symptom Checklist (SSC) comprising 11 somatic complaint items. Logistic regression models were used to evaluate the associations between somatic symptoms/psychosocial factors and IBS, adjusting for age and gender. RESULTS: Of the 501 eligible subjects, 461 (92%) provided complete data (mean age=56 years, 49% female). IBS (Rome II criteria) was associated with both higher SSC and Global Severity Index (GSI of SCL-90-R) scores. Among subjects with high (75th percentile) SSC scores, 43% reported IBS vs. 10% of those with low (<25th percentile) SSC scores. Among those with high (60) GSI scores, 23% reported IBS vs. 6% with low (<40) GSI scores. Specifically, none of the IBS subjects had both low SSC and low GSI scores. CONCLUSIONS: Psychological factors and somatization are strongly associated with IBS in the community. However, IBS may not be related to low psychological distress and/or somatization.

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Crossref · 10.1038/ajg.2009.239

Cites

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Claims the paper makes

0 of 47 cited sources checked · 0 supported · 0 flagged

A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Specifically, none of the IBS subjects had both low SSC and low GSI scores.”
- Also stated in: § Psychological distress in subjects with and without IBS · plain
  “Specifically, none of the 106 IBS subject had both a low SSC score and a low GSI score as defined above.”
- Also stated in: § DISCUSSION · plain
  “Interestingly, we did not find any community subject with low psychological distress and somatic complaints scores to have IBS.”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > Abstract > RESULTS
Load-bearingStrength:plain· not yet calibratedn = 106
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes

Show all 23 claims

It may state two separate claims as one. 25
Probably not a substantial claim. 18

In the paper
“The Talley BDQ has been shown to be a reliable and valid measure of GI symptoms (31).”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > METHODS > Subjects
What the sources say
- Not checked yetcites [31] Talley NJ, 1990, Mayo Clin Proc source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“Fink et al. (49) showed that functional somatic symptoms could be grouped into three main symptom clusters, namely GI, CP (cardio-pulmonary), and MS (musculoskeletal). In addition, they found significantly inter-correlated correlation coefficients of 0.40–0.45 (Spearman’s rho) between a number of the symptoms from CP, GI, and MS symptom groups, and suggested that the three functional somatic synd”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > DISCUSSION
What the sources say
- Not checked yetcites [49] source
Load-bearingStrength:hedged· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“Furthermore, in the systemic review, Whitehead et al. (20) reported that between a quarter and a third of patients with IBS meet the criteria for somatization disorder, which is much higher than in the normal population.”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > INTRODUCTION
What the sources say
- Not checked yetcites [20] source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In a recent population-based nested case–control study (17), psychosocial distress as measured by the Symptom Checklist-90-R (SCL-90-R) was significantly associated with the presence of a functional GI disorder and was not explained by health-care utilization.”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > INTRODUCTION
What the sources say
- Not checked yetcites [17] source
Load-bearingStrength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Psychological factors and somatization are strongly associated with IBS in the community.”
- Also stated in: § DISCUSSION · boosted
  “We conclude from this population-based study that psychological factors are strongly associated with IBS in the community; notably, somatization is significantly associated with IBS independent of age, gender, education level, marital status, smoking, alcohol use, and BMI.”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > Abstract > CONCLUSIONS
Load-bearingStrength:boosted· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The definition of the normal range of SCL-90-R scores was based on commercially used cutoff definitions that are widely accepted (34,47).”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > DISCUSSION
What the sources say
- Not checked yetcites [34] source
- Not checked yetcites [47] source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
In the paper
“Whitehead et al. (40) reported that 48 of 51 symptom-based diagnoses were significantly more common in patients with IBS vs. that in controls, including headache, back pain, sleep disorder, muscle weakness, pelvic pain, and blurred vision.”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > DISCUSSION
What the sources say
- Not checked yetcites [40] source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In contrast, more recent population studies (42–45) have suggested that the earlier volunteer non-population-based studies may have been biased, but this view is still controversial (16).”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > DISCUSSION
What the sources say
- Not checked yetcites [42] source
- Not checked yetcites [43] source
- Not checked yetcites [44] Talley NJ, 1998, Gut source
- Not checked yetcites [45] Herschbach P, 1999, Psychosom Med source
- Not checked yetcites [16] source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Koloski et al. (19) reported that psychiatric diagnoses, neuroticism, more highly threatening life event stress, an external locus of control, and ineffectual coping styles were significantly associated with having a diagnosis of IBS and/or dyspepsia, and somatization was independently associated with IBS in a random population sample from Sydney, Australia.”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > DISCUSSION
What the sources say
- Not checked yetcites [19] source
Load-bearingStrength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“Sewitch et al. (47) studied the psychosocial distress in 200 patients with IBD from tertiary care settings. They showed that patients with IBD had higher levels of psychological distress than controls; the mean GSI score of patients with IBD was 57.1 (s.d. = 9.4).”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > DISCUSSION
What the sources say
- Not checked yetcites [47] source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedn = 200
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Other studies (21–23) have also observed an excess somatization tendency in outpatients with IBS.”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > INTRODUCTION
What the sources say
- Not checked yetcites [21] source
- Not checked yetcites [22] source
- Not checked yetcites [23] source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Sayuk et al. (46) reported that a higher burden of the current somatic symptoms was a strong predictor of a functional bowel disease in outpatients presenting with GI complaints.”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > DISCUSSION
What the sources say
- Not checked yetcites [46] source
Strength:boosted· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“We have applied this definition in earlier studies and shown that it provides data similar to that of a physician interview (27,39).”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > METHODS > Definition of IBS
What the sources say
- Not checked yetcites [27] Talley NJ, 1991, Gastroenterology source
- Not checked yetcites [39] Talley NJ, 1995, Am J Epidemiol source
Strength:boosted· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“The Olmsted County, Minnesota, population comprises ~120,000 individuals, of which 89% are white; sociodemographically, this community resembles the US white population.”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > METHODS > Subjects
What the sources say
- Not checked yetcites [24] source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The SCL-90-R is a measure of psychological state (34).”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > METHODS > Subjects
What the sources say
- Not checked yetcites [34] source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
In the paper
“The American Gastroenterological Association technical review on IBS (16) reported that the prevalence of a psychiatric disorder ranges from 40 to more than 90% among patients with IBS referred to tertiary care centers, but argued that these studies overestimated the true prevalence of psychosocial disturbance in patients with IBS because psychological factors influence whether patients consult ph”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > DISCUSSION
What the sources say
- Not checked yetcites [16] source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Although the cause of the disorder remains essentially unknown, IBS is currently conceptualized as a bio-psychosocial disorder with disturbances of motor function, heightened visceral sensitivity, and possibly central nervous system disturbances (4–6).”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > INTRODUCTION
What the sources say
- Not checked yetcites [4] source
- Not checked yetcites [5] Mayer EA, 2001, Am J Physiol Gastrointest Liver Physiol source
- Not checked yetcites [6] source
Strength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Early life experiences (e.g., abuse), adult stressors (e.g., divorce or bereavement), lack of social support, and other social learning experiences can affect both an individual’s physiological and psychological responses, and may precipitate abdominal distress, as well as psychiatric disorders (4,7–11).”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > INTRODUCTION
What the sources say
- Not checked yetcites [4] source
- Not checked yetcites [7] Talley NJ, 1995, Am J Gastroenterol
- Not checked yetcites [8] Delvaux M, 1997, Eur J Gastroenterol Hepatol source
- Not checked yetcites [9] Ali A, 2000, Psychosom Med source
- Not checked yetcites [10] source
- Not checked yetcites [11] Bennett EJ, 1998, Gut source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Several studies carried out in volunteers (12,13,41) reported that persons with IBS, who do not see physicians, are psychologically similar to those without bowel complaints.”
§ Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule > DISCUSSION
What the sources say
- Not checked yetcites [12] Drossman DA, 1988, Gastroenterology source
- Not checked yetcites [13] Whitehead WE, 1988, Gastroenterology source
- Not checked yetcites [41] Sandler RS, 1984, Gastroenterology source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.

34 of 34

The paper relies on this without support.
There is little community data on the relationship between IBS and somatization or psychosocial distress.
“In addition, few data regarding the association between IBS and somatization and/or psychosocial distress exist in the community.”
The paper relies on this without support.
The extent of psychological distress among community IBS sufferers is unclear because prior studies have not documented how many are entirely free of psychological comorbidity.
“However, the burden of psychological distress in IBS remains unclear in the community, as studies have failed to document how many IBS sufferers are totally free of psychological comorbidity.”

2 of 2

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

IBS proportion in high SSC group differs across sections
Major
The abstract reports 43% IBS prevalence among subjects with high SSC scores, while the Results section later reports 40% for the same high SSC comparison. These are different values for the same subgroup comparison and are not explained as due to a different denominator or rounding.
IBS proportion in high GSI group differs across sections
Major
The abstract reports 23% IBS among subjects with high GSI scores, while the later Results section reports 33% for the same high-GSI comparison. These values conflict and cannot both describe the same subgroup result.
Female proportion differs between abstract and results
Minor
For the same 461 subjects, the abstract reports 49% female and the Results section reports 48%.
Number of associated somatic complaints changes from seven to eight
Minor
The Predictors of IBS section says seven complaints were associated with IBS, while the Discussion says eight were. The predictors statement also names only three exceptions among 11 complaints, leaving eight rather than seven.

4 of 4

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Forno, D. D., Compare, A., Cipollaro, I., Luca, P. D., Iorio, A., & Grossi, E. (2012) · Springer eBooks · doi:10.1007/978-88-470-2080-1_1
Inaugural Rome Foundation Research into the Epidemiology of All Disorders of Gut–Brain Interaction: The 1993 U.S. Householder Survey in Digestive Diseases and Sciences, a High-Cite Classic
Talley, N. J. (2026) · Digestive Diseases and Sciences · doi:10.1007/s10620-026-10143-0
Self-citation

Authors: Choung, R. S., Locke, G. R., Zinsmeister, A. R., Schleck, C. D., & Talley, N. J.
Affiliations: Mayo Clinic (US)
Corresponding author: Talley, Nicholas J
ORCID: Choung, Rok Seon
Schleck, Cathy D
Talley, Nicholas J
Venue: The American Journal of Gastroenterology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2009-06-02
Volume: 104
Issue: 7
Pages: 1772-1779
ISSN: 0002-9270 (ISSN-L)
1572-0241
DOI: 10.1038/ajg.2009.239
PMC: PMC3772628
OpenAlex: W2084613607
Semantic Scholar: 6d7a40f1028191d0e3d61e87054f6ff37ff6baaa
Cited by: 129
References: 55
Citations by year: 2026: 1 · 2025: 2 · 2024: 4 · 2022: 4 · 2021: 7 · 2020: 4 · 2019: 8 · 2018: 3 · 2017: 8 · 2016: 12 · 2015: 12 · 2014: 12 · 2013: 14 · 2012: 10
FWCI: 13.45
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: www.springer.com/tdm (unspecified)
Locations: The American Journal of Gastroenterology (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR030582, R01AR30582)
Topics: Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Keywords: irritable bowel syndrome, psychosocial distress, somatic symptoms, somatization, psychological factors, community population, SCL-90-R, Rome II criteria, gastrointestinal symptoms
MeSH terms: Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Life Change Events, Male, Middle Aged, Probability, Psychiatric Status Rating Scales, Psychology, Surveys and Questionnaires, Reference Values, Severity of Illness Index, Somatoform Disorders, Stress, Psychological, Incidence, Case-Control Studies, Age Distribution, Sex Distribution, Sickness Impact Profile, Risk Assessment, Irritable Bowel Syndrome

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Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule

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