Psychosocial Factors are Linked to Functional Gastrointestinal Disorders: A Population Based Nested Case-Control Study
Abstract
BACKGROUND: It is widely accepted based on volunteer studies that levels of psychological distress are similar in those with functional gastrointestinal (GI) disorders and health in the community, while increased psychological distress in outpatients is largely explained by health-care seeking. AIMS: To determine if psychological distress, life event stress, or social support is associated with functional GI disorders in a population-based study. METHODS: A nested case-control study was performed by first mailing a self-report bowel disease questionnaire to a random sample of Olmsted County, Minnesota, aged 20-50 yr. All persons who reported symptoms of nonulcer dyspepsia (NUD) or irritable bowel syndrome (IBS) (cases), or an absence of GI symptoms (controls), were invited to complete a series of validated questionnaires designed to measure psychological distress, life event stress, social support, current symptoms, and physician visits. RESULTS: 103 subjects with functional GI disorders and 119 controls participated (85% of eligible). Functional GI disorders were more likely to be reported by those with higher scores on each of the nine SCL-90-R scales used to measure psychological distress (except phobic anxiety), and those with more negative and total life event stress. In a multiple logistic regression model (including age and gender), somatization, interpersonal sensitivity, and total life event stress were independently associated with functional GI disorders. Findings were similar when subjects with the IBS and NUD were analyzed separately compared to controls. CONCLUSIONS: Contrary to current dogma, psychosocial factors were significantly associated with functional GI disorders in this community sample. This suggests that these factors may be involved in the etiopathogenesis rather than just driving health-care utilization.
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Earlier studies showed no systematic differences between participants and non-participants in age, gender, or SSC score.
“However, we have shown, after a careful review, that there were no systematic differences between individuals who participated and non-participants, including in terms of age, gender, or SSC score in our earlier studies (17,35,36).”
From Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule (2009) · cites this paper as [17]
Psychological and psychiatric comorbidity is common among patients with IBS.
“It is well known that psychological and psychiatric comorbidity is common among patients with IBS (17,20,40).”
From Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule (2009) · cites this paper as [17]
A recent population-based nested case-control study found that psychosocial distress measured by SCL-90-R was significantly associated with functional GI disorder and was not explained by health-care utilization.
“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.”
From Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule (2009) · cites this paper as [17]
There is considerable evidence supporting an association between psychological distress, environmental stress, and functional GI disorders, especially IBS.
“However, there is a considerable body of evidence supporting an association between psychological distress, environmental stress, and functional GI disorders, especially IBS (17–19).”
From Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule (2009) · cites this paper as [17]
Cites
Assessing social support: The Social Support Questionnaire.
Sarason, I. G., Levine, H. M., Basham, R. B., & Sarason, B. R. (1983) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.44.1.127 · Cited by 3,067 · see citing works
Assessing the impact of life changes: Development of the Life Experiences Survey.
Sarason, I. G., Johnson, J. H., & Siegel, J. M. (1978) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.46.5.932 · Cited by 2,788 · see citing works
The SCL-90 and the MMPI: A Step in the Validation of a New Self-Report Scale
Derogatis, L. R., Rickels, K., & Rock, A. F. (1976) · British Journal of Psychiatry · doi:10.1192/bjp.128.3.280 · Cited by 2,298 · see citing works
History of the Rochester Epidemiology Project
Melton, L. J. (1996) · Mayo Clinic Proceedings · doi:10.4065/71.3.266 · Cited by 1,443 · see citing works
Self-citationTowards positive diagnosis of the irritable bowel.
Manning, A. P., Thompson, W., Heaton, K. W., & Morris, A. F. (1978) · BMJ · doi:10.1136/bmj.2.6138.653 · Cited by 1,404 · see citing works
AGA technical review on irritable bowel syndrome.
Drossman, D. A., Camilleri, M., Mayer, E. A., & Whitehead, W. E. (2002) · Gastroenterology · doi:10.1053/gast.2002.37095 · Cited by 1,384 · see citing works
Brugha, T. S., Bebbington, P., Tennant, C., & Hurry, J. (1985) · Psychological Medicine · doi:10.1017/s003329170002105x · Cited by 1,108 · see citing works
Brugha, T. S., & Cragg, D. (1990) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1990.tb01360.x · Cited by 883 · see citing works
The Patient Record in Epidemiology
Kurland, L. T., & Molgaard, C. A. (1981) · Scientific American · doi:10.1038/scientificamerican1081-54 · Cited by 789 · see citing works
Psychosocial Factors in the Irritable Bowel Syndrome
Drossman, D. A., McKee, D. C., Sandler, R. S., Mitchell, C. M., Cramer, E. M., Lowman, B. C., & Burger, A. L. (1988) · Gastroenterology · doi:10.1016/s0016-5085(88)80017-9 · Cited by 757 · see citing works
Dyspepsia and dyspepsia subgroups: A population-based study
Talley, N. J., Zinsmeister, A. R., Schleck, C. D., & Melton, L. J. (1992) · Gastroenterology · doi:10.1016/0016-5085(92)90764-p · Cited by 663 · see citing works
Self-citationEpidemiology of colonic symptoms and the irritable bowel syndrome
Talley, N. J., Zinsmeister, A. R., van Dyke, C., & Melton, L. J. (1991) · Gastroenterology · doi:10.1016/0016-5085(91)90717-y · Cited by 648 · see citing works
Self-citationPrevalence of gastrointestinal symptoms in the elderly: A population-based study
Talley, N. J., O'Keefe, E. A., ZINSMEISTER, A. R., & Melton, L. J. (1992) · Gastroenterology · doi:10.1016/0016-5085(92)90175-x · Cited by 513 · see citing works
Self-citationSymptoms of Psychologic Distress Associated With Irritable Bowel Syndrome
Whitehead, W. E., Bosmajian, L., Zonderman, A. B., Costa Jr., P. T., & Schuster, M. M. (1988) · Gastroenterology · doi:10.1016/s0016-5085(88)80018-0 · Cited by 480 · see citing works
Onset and Disappearance of Gastrointestinal Symptoms and Functional Gastrointestinal Disorders
Talley, N. J., Weaver, A. L., Zinsmeister, A. R., & Melton, L. J. (1992) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116483 · Cited by 471 · see citing works
Self-citationFunctional dyspepsia : a classification with guidelines for diagnosis and management
Talley, N. (1991) · Medical Entomology and Zoology · Cited by 443 · see citing works
Self-citationLevel of chronic life stress predicts clinical outcome in irritable bowel syndrome
Bennett, E. J., Tennant, C. C., Piesse, C., Badcock, C.-A., & Kellow, J. E. (1998) · Gut · doi:10.1136/gut.43.2.256 · Cited by 405 · see citing works
Epidemiology and health care seeking in the functional GI disorders: a population-based study
Koloski, N. A., Talley, N. J., & Boyce, P. M. (2002) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2002.05783.x · Cited by 371 · see citing works
Self-citationAssessment of Functional Gastrointestinal Disease: The Bowel Disease Questionnaire
TALLEY, N. J., PHILLIPS, S. F., WILTGEN, C. M., ZINSMEISTER, A. R., & MELTON, L. J. (1990) · Mayo Clinic Proceedings · doi:10.1016/s0025-6196(12)62169-7 · Cited by 330 · see citing works
Self-citationTalley, N. J., Zinsmeister, A. R., & Melton, L. J. (1995) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a117548 · Cited by 327 · see citing works
Self-citationSymptom complaints and health care seeking behavior in subjects with bowel dysfunction
Sandler, R. S., Drossman, D. A., Nathan, H. P., & McKee, D. C. (1984) · Gastroenterology · doi:10.1016/0016-5085(84)90706-6 · Cited by 326 · see citing works
The Irritable Bowel Syndrome: Review and a Graduated Multicomponent Treatment Approach
Drossman, D. A., & Thompson, W. G. (1992) · Annals of Internal Medicine · doi:10.7326/0003-4819-116-12-1009 · Cited by 309 · see citing works
Lack of discriminant value of dyspepsia subgroups in patients referred for upper endoscopy
Talley, N. J., Weaver, A. L., Tesmer, D. L., & Zinsmeister, A. R. (1993) · Gastroenterology · doi:10.1016/0016-5085(93)90142-y · Cited by 302 · see citing works
Self-citationFunctional constipation and outlet delay: A population-based study
Talley, N. J., Weaver, A. L., Zinsmeister, A. R., & Melton, L. J. (1993) · Gastroenterology · doi:10.1016/0016-5085(93)90896-k · Cited by 297 · see citing works
Self-citationIrritable bowel-type symptoms in HMO examinees
Longstreth, G. F., & Wolde-Tsadik, G. (1993) · Digestive Diseases and Sciences · doi:10.1007/bf01303163 · Cited by 279 · see citing works
Psychiatric Illness and The Irritable Bowel Syndrome
Young, S. J., Alpers, D., Norland, C. C., & Woodruff, R. A. (1976) · Gastroenterology · doi:10.1016/s0016-5085(76)80002-9 · Cited by 275 · see citing works
Koloski, N. A., Talley, N. J., & Boyce, P. M. (2001) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2001.03789.x · Cited by 253 · see citing works
Self-citationPredictors of health care seeking for irritable bowel syndrome: a population based study
Talley, N. J., Boyce, P. M., & Jones, M. (1997) · Gut · doi:10.1136/gut.41.3.394 · Cited by 250 · cited 3× · see citing works
“Recent population-based studies from Australia (16, 17, 44) and Germany (18) support our contention from the present U.”
ResultSelf-citationAssociation of anxiety, neuroticism, and depression with dyspepsia of unknown cause
Talley, N. J., Fung, L. H., Gilligan, I. J., McNeil, D., & Piper, D. W. (1986) · Gastroenterology · doi:10.1016/0016-5085(86)90864-4 · Cited by 227 · see citing works
Self-citationWalker, E. A., Katon, W. J., Jemelka, R. P., & Roy-Byrne, P. P. (1992) · The American Journal of Medicine · doi:10.1016/0002-9343(92)90133-v · Cited by 195 · see citing works
Smith, R. C., Greenbaum, D. S., Vancouver, J. B., HENRY, R. C., Reinhart, M. A., Greenbaum, R. B., Dean, H. A., & Mayle, J. E. (1990) · Gastroenterology · doi:10.1016/0016-5085(90)90817-k · Cited by 171 · see citing works
Relation among personality and symptoms in nonulcer dyspepsia and the irritable bowel syndrome
Talley, N. J., Phillips, S. F., Bruce, B. K., Twomey, C. K., ZINSMEISTER, A. R., & Melton, L. J. (1990) · Gastroenterology · doi:10.1016/0016-5085(90)91012-u · Cited by 165 · see citing works
Self-citationTalley, N. J., Boyce, P. M., & Jones, M. (1998) · Gut · doi:10.1136/gut.42.1.47 · Cited by 154 · cited 3× · see citing works
“Recent population-based studies from Australia (16, 17, 44) and Germany (18) support our contention from the present U.”
ResultSelf-citationHerschbach, P., Henrich, G., & von Rad, M. (1999) · Psychosomatic Medicine · doi:10.1097/00006842-199903000-00005 · Cited by 110 · see citing works
Psychologic Considerations in the Irritable Bowel Syndrome
Whitehead, W. E., & Crowell, M. D. (1991) · Gastroenterology Clinics of North America · doi:10.1016/s0889-8553(21)00549-5 · Cited by 88 · see citing works
Martin, R., Davis, G. M., Baron, R. S., Suls, J. M., & al, E. (1994) · Health Psychology · doi:10.1037//0278-6133.13.5.432 · Cited by 84 · see citing works
Life stress and non-ulcer dyspepsia: A case-control study
Bennett, E., Beaurepaire, J., Langeluddecke, P., Kellow, J. E., & Tennant, C. (1991) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(91)90052-p · Cited by 81 · see citing works
Coping Style of Individuals With Functional Dyspepsia
Cheng, C., Hui, W., & Lam, S. (1999) · Psychosomatic Medicine · doi:10.1097/00006842-199911000-00011 · Cited by 81 · see citing works
Dyspepsia and Health Care Seeking in a Community (How Important Are Psychological Factors?)
Talley, N. J., Boyce, P. M., & Jones, M. (1998) · Digestive Diseases and Sciences · doi:10.1023/a:1018878717715 · Cited by 79 · see citing works
Self-citationMajor life event stress and dyspepsia of unknown cause: a case control study.
Talley, N. J., & Piper, D. W. (1986) · Gut · doi:10.1136/gut.27.2.127 · Cited by 79 · see citing works
Self-citationThe perception of life events and daily stress in nonulcer dyspepsia.
Hui, W. M., Shiu, L. P., & Lam, S. (1991) · PubMed · Cited by 65 · see citing works
Cheng, C. (2000) · Psychosomatic Medicine · doi:10.1097/00006842-200011000-00015 · Cited by 64 · see citing works
Harrell, F., Jr. (1996) · doi:10.1002/(sici)1097-0258(19960229)15:4
Flagged first, then by citations
Cited by
Sorted by citations
Guidelines on the irritable bowel syndrome: mechanisms and practical management
Spiller, R., Aziz, Q., Creed, F., Emmanuel, A., Houghton, L., Hungin, P., Jones, R., Kumar, D., Rubin, G., Trudgill, N., et al. (2007) · Gut · doi:10.1136/gut.2007.119446 · Cited by 818 · see citing works
Psychosocial Aspects of the Functional Gastrointestinal Disorders
Levy, R. L., Olden, K. W., Naliboff, B. D., Bradley, L. A., Francisconi, C., Drossman, D. A., & Creed, F. (2006) · Gastroenterology · doi:10.1053/j.gastro.2005.11.057 · Cited by 776 · see citing works
Management of functional somatic syndromes
Henningsen, P., Zipfel, S., & Herzog, W. (2007) · The Lancet · doi:10.1016/s0140-6736(07)60159-7 · Cited by 741 · see citing works
Immune Activation in Patients With Irritable Bowel Syndrome
Liebregts, T., Adam, B., Bredack, C., Röth, A., Heinzel, S., Lester, S., Downie–Doyle, S., Smith, E., Drew, P., Talley, N. J., et al. (2007) · Gastroenterology · doi:10.1053/j.gastro.2007.01.046 · Cited by 660 · see citing works
Self-citationKoloski, N. A., Jones, M., & Talley, N. J. (2016) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.13738 · Cited by 318 · see citing works
Self-citationIrritable bowel syndrome: A clinical review
Soares, R. L. (2014) · World Journal of Gastroenterology · doi:10.3748/wjg.v20.i34.12144 · Cited by 266 · see citing works
PTSD and stress sensitisation: A tale of brain and body
Stam, R. (2007) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2006.11.010 · Cited by 211 · see citing works
Physical and emotional health of mothers of youth with functional abdominal pain
Campo, J. V., Bridge, J., Lucas, A., Savorelli, S., Walker, L., Di Lorenzo, C., Iyengar, S., & Brent, D. A. (2007) · Archives of Pediatrics & Adolescent Medicine · doi:10.1001/archpedi.161.2.131 · Cited by 202 · see citing works
Labanski, A., Langhorst, J., Engler, H., & Elsenbruch, S. (2020) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2019.104501 · Cited by 200 · see citing works
Jerndal, P., Ringström, G., Agerforz, P., Karpefors, M., Akkermans, L. M., Bayati, A., & Simrén, M. (2010) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2010.01493.x · Cited by 192 · see citing works
New insights into the pathogenesis and pathophysiology of irritable bowel syndrome
Öhman, L., & Simrén, M. (2007) · Digestive and Liver Disease · doi:10.1016/j.dld.2006.10.014 · Cited by 155 · see citing works
Dyspepsia: Organic Versus Functional
Oustamanolakis, P., & Tack, J. (2012) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0b013e318241b335 · Cited by 146 · see citing works
Choung, R. S., Locke, G. R., Zinsmeister, A. R., Schleck, C. D., & Talley, N. J. (2009) · The American Journal of Gastroenterology · doi:10.1038/ajg.2009.239 · Cited by 129 · see citing works
Self-citationHasler, W. L., Parkman, H. P., Wilson, L. A., Pasricha, P. J., Koch, K. L., Abell, T. L., Snape, W. J., Farrugia, G., Lee, L., Tonascia, J., et al. (2010) · American Journal of Gastroenterology · doi:10.1038/ajg.2010.253 · Cited by 127 · see citing works
Kovács, Z., & Kovács, F. (2007) · The International Journal of Psychiatry in Medicine · doi:10.2190/pm.37.3.a · Cited by 87 · see citing works
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Creed, F. H., Tomenson, B., Chew-Graham, C., Macfarlane, G. J., Davies, I., Jackson, J., Littlewood, A., & McBeth, J. (2013) · International Journal of Behavioral Medicine · doi:10.1007/s12529-012-9257-y · Cited by 63 · see citing works
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Phillips, K., Wright, B. J., & Kent, S. (2013) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2013.08.002 · Cited by 61 · see citing works
Long-term impact of irritable bowel syndrome: a qualitative study
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Sayuk, G. S., Elwing, J. E., Lustman, P. J., & Clouse, R. E. (2007) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2006.11.024 · Cited by 26 · see citing works
Taranukha, T., Charan Suresh Kumar, V., Seamon, A., Sahr, N., Szabo, A., & Venkatesan, T. (2018) · Neurogastroenterology & Motility · doi:10.1111/nmo.13245 · Cited by 25 · see citing works
De Giorgi, F., Sarnelli, G., Cirillo, C., Savino, I. G., Turco, F., Nardone, G., Rocco, A., & Cuomo, R. (2013) · Neurogastroenterology & Motility · doi:10.1111/nmo.12004 · Cited by 21 · see citing works
- Authors
- Richard Locke, G., Weaver, A. L., Joseph Melton, L., & Talley, N. J.
- Affiliations
- Mayo Clinic (US)
- Venue
- American Journal of Gastroenterology
- Published
- 2004-02
- Volume
- 99
- Issue
- 2
- Pages
- 350-357
- ISSN
- 0002-9270 (ISSN-L)
- 1572-0241
- OpenAlex
- W2002912688
- Cited by
- 278
- References
- 43
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 1 · 2022: 8 · 2021: 5 · 2020: 7 · 2019: 5 · 2018: 6 · 2017: 10 · 2016: 7 · 2015: 17 · 2014: 18 · 2013: 13 · 2012: 21
- FWCI
- 15.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (AG 09440)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR030582, AR30582)
- National Center for Research Resources (M01-RR00 585, M01RR000585)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- functional gastrointestinal disorders, irritable bowel syndrome, functional dyspepsia, psychological distress, life events, social support, somatization, interpersonal sensitivity, psychosocial risk factors, etiopathogenesis, health care utilization
- MeSH terms
- Adult, Female, Gastrointestinal Diseases, Humans, Life Change Events, Male, Middle Aged, Social Support, Stress, Psychological, Case-Control Studies
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