Predictors of health care seeking for irritable bowel syndrome: a population based study
Open accessAbstract
Background —It has been suggested that psychological factors rather than symptoms drive subjects with irritable bowel syndrome (IBS) to seek medical care, but this issue has not been tackled in a population based study. Aim —To identify whether psychological factors or abuse explain health care seeking for IBS. Methods —A sample of residents of Penrith (a Sydney suburb representative of the Australian population) selected randomly from the electoral rolls (that by law include the entire population ⩾18 years) was mailed a validated self-report questionnaire. Measured were gastrointestinal symptoms including the Manning (and Rome) criteria for IBS, health care seeking, neuroticism (Eysenck Personality Questionnaire), psychological morbidity (General Health Questionnaire: GHQ) and sexual, physical and emotional abuse (including the standardised Drossman questions). Results —Among 730 subjects, 96 (13%, 95% confidence interval (CI) 11–16%) had IBS by the Manning criteria. Of those with IBS, 73% (95% CI 63–81%) had sought medical care for abdominal pain or discomfort. Only increasing pain severity (odds ratio (OR) = 2.10, 95% CI 1.11–3.95) and duration of pain (OR=1.53, 95% CI 1.10–2.13) were independently associated with seeking health care for IBS. Pain severity was also predictive of recent care seeking (OR=1.74, 95% CI 1.12–1.96). Neuroticism, psychological morbidity and abuse history were not significant predictors. Conclusion —Psychological factors do not seem to explain health care seeking among community subjects with IBS.
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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 [18]
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Boyce, P. M., Talley, N. J., Burke, C. A., & Koloski, N. A. (2005) · Internal Medicine Journal · doi:10.1111/j.1445-5994.2006.01006.x · Cited by 103 · see citing works
Self-citationAcupuncture for treatment of irritable bowel syndrome
Lim, B., Manheimer, E. W., Lao, L., Ziea, E. T. C., Wisniewski, J., Liu, J., & Berman, B. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005111.pub2 · Cited by 104 · see citing works
Impact of Rome IV irritable bowel syndrome on work and activities of daily living
Goodoory, V. C., Ng, C. E., Black, C. J., & Ford, A. C. (2022) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.17132 · Cited by 102 · see citing works
Comorbid clinical conditions in chronic fatigue
Aaron, L. A., Herrell, R. K., Ashton, S., Belcourt, M., Schmaling, K. B., Goldberg, J. H., & Buchwald, D. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.03419.x · Cited by 101 · see citing works
Pathways in gut-brain communication: Evidence for distinct gut-to-brain and brain-to-gut syndromes
Keightley, P., Koloski, N. A., & Talley, N. J. (2015) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867415569801 · Cited by 97 · see citing works
“Talley’s postal survey of 730 random Sydney community subjects (13% of whom had IBS) revealed that they often did have high levels of psychological distress, and while severity of symptoms explained some of the increased presenting, psychosocial factors did not (Talley et al., 1997).”
BackgroundSelf-citationEpidemiology of Irritable Bowel Syndrome in Chinese
Lau, E. M. C., Chan, F. K. L., Ziea, E. T.-C., Chan, C., Wu, J. C. Y., & Sung, J. J. �. (2002) · Digestive Diseases and Sciences · doi:10.1023/a:1020549118299 · Cited by 91 · see citing works
Utility of the Rome I and Rome II criteria for irritable bowel syndrome in U.S. women
Chey, W. D., Olden, K. W., Carter, E., Boyle, J. M., Drossman, D. A., & Chang, L. (2002) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2002.07026.x · Cited by 93 · see citing works
Prevalence of irritable bowel syndrome (IBS) and variability of diagnostic criteria
Bommelaer, G., Poynard, T., Pen, C. L., Gaudin, A.-F., Maurel, F., Priol, G., Amouretti, M., Frexinos, J., Ruszniewski, P. B., & Hasnaoui, A. E. (2004) · Gastroentérologie Clinique et Biologique · doi:10.1016/s0399-8320(04)95011-7 · Cited by 86 · see citing works
“In contrast, our estimate of prevalence may seem much lower than those reported in the international literature: 10-20% with the Manning criteria [2, 13] or 3-10% with the Rome I and Rome II criteria [14-16, 18-21].”
MethodResultTalley, N. J. (2006) · Internal Medicine Journal · doi:10.1111/j.1445-5994.2006.01217.x · Cited by 86 · see citing works
Self-citationGoodwin, R. D., Cox, B. J., & Clara, I. P. (2006) · Journal of Behavioral Medicine · doi:10.1007/s10865-006-9048-5 · Cited by 83 · see citing works
“Specifically, physical disorders to which neuroticism has been linked include: Self-perceived hearing problems (Jang et al., 2002), irritable bowel syndrome ( Talley et al., 1997, 1998 ), joint pain (Charles et al., 1999), chronic pain (Wade et al., 1992), cancer (Aarstad et al., 2002), non-ulcer dyspepsia (Jain et al…”
BackgroundRandomised clinical trial: pregabalin vs placebo for irritable bowel syndrome
Saito, Y. A., Almazar, A. E., Tilkes, K. E., Choung, R. S., Van Norstrand, M. D., Schleck, C. D., Zinsmeister, A. R., & Talley, N. J. (2019) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.15077 · Cited by 79 · see citing works
“Several studies have shown that abdominal pain is one of the key drivers of health care seeking.(1,2) Symptoms greatly impact patients’ ability to go to school and/or work,(3) and health‐related quality of life has been shown to be lower in IBS patients.”
BackgroundSelf-citationDyspepsia 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
“The same population sample has been used to determine predictors of health care seeking for the irritable bowel syndrome (14) and the potential link between psychological factors, abuse, and IBS (15) .”
MethodResultInfluentialSelf-citationThe relationship between psychosocial parameters and outcome in irritable bowel syndrome
Creed, F. H. (1999) · The American Journal of Medicine · doi:10.1016/s0002-9343(99)00083-2 · Cited by 73 · see citing works
Buono, J. L., Mathur, K., Averitt, A., & Andrae, D. A. (2016) · Journal of Managed Care & Specialty Pharmacy · doi:10.18553/jmcp.2016.16138 · Cited by 72 · see citing works
Emerging disease model for functional gastrointestinal disorders
Mayer, E. A. (1999) · The American Journal of Medicine · doi:10.1016/s0002-9343(99)00277-6 · Cited by 69 · see citing works
The development of a brief personality scale to measure vulnerability to postnatal depression
Boyce, P. M., Hickey, A. R., Gilchrist, J., & Talley, N. J. (2001) · Archives of Women s Mental Health · doi:10.1007/s007370170012 · Cited by 71 · see citing works
“Further details of this study can be found elsewhere (Talley et al., 1997; Talley et al., 1998).”
BackgroundSelf-citationA Population Study on Irritable Bowel Syndrome and Mental Health
E. Österberg, L. B. (2000) · Scandinavian Journal of Gastroenterology · doi:10.1080/003655200750024128 · Cited by 104 · see citing works
Determinants of healthcare‐seeking behaviour among subjects with irritable bowel syndrome
Williams, R., BLACK, C. L., KIM, H. ‐., Andrews, E. B., Mangel, A. W., Buda, J. J., & Cook, S. (2006) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2006.02928.x · Cited by 68 · see citing works
Luscombe, F. A. (2000) · Quality of Life Research · doi:10.1023/a:1008970312068 · Cited by 69 · see citing works
“The neuroticism scale from the Eysenck Personality Questionnaire (EPQ), the PSC, and a 12- item General Health Questionnaire (GHQ) that assesses psychological morbidity are additional measures administered to community samples and a group of hospital sta volunteers in Sydney, Australia [33, 58, 101].”
BackgroundMethodInfluentialWhy do subjects with irritable bowel syndrome seek health care for their symptoms?
Ringström, G., Abrahamsson, H., Strid, H., & Simrén, M. (2007) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365520701320455 · Cited by 67 · see citing works
“In some studies psychological factors were the main predictors for health-care seeking [7,8], whereas GI symptom severity was more important in other studies [9,10].”
ResultFunctional Gastrointestinal Disorders: An Update for the Psychiatrist
Jones, M. P., Crowell, M. D., Olden, K. W., & Creed, F. H. (2007) · Psychosomatics · doi:10.1176/appi.psy.48.2.93 · Cited by 67 · see citing works
Self-citationComorbidity and use of health-care services among irritable bowel syndrome sufferers
Hillilä, M. T., Siivola, M., & Färkkilä, M. A. (2007) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365520601113927 · Cited by 66 · see citing works
“A more recent population-based study has, however, failed to identify psychiatric conditions as independent predictors of health-care seeking [35].”
BackgroundRajindrajith, S., & Devanarayana, N. M. (2012) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm.2012.18.3.298 · Cited by 66 · see citing works
“Furthermore, females seek health care for IBS more often than males.(10) Gender difference in sympto-”
BackgroundCreed, F. H., Guthrie, E., Ratcliffe, J., Fernandes, L., Rigby, C., Tomenson, B., Read, N., & Thompson, D. G. (2005) · Psychosomatic Medicine · doi:10.1097/01.psy.0000163457.32382.ac · Cited by 66 · see citing works
“016 Married/cohabiting 138 (70) 14 (50) 17 (55) Separated/divorced 19 (10) 4 (14) 9 (29) Widowed 3 (2) 2 (7) 1 (3) Ethnicity: white 196 (99) 27 (96) 30 (97) 1.”
Attree, E. A., Dancey, C. P., Keeling, D., & Wilson, C. (2003) · Applied Neuropsychology · doi:10.1207/s15324826an1002_05 · Cited by 65 · see citing works
Identification of Gut Microbiota and Metabolites Signature in Patients With Irritable Bowel Syndrome
Zhu, S., Liu, S., Li, H., Zhang, Z., Zhang, Q., Chen, L., Zhao, Y., Chen, Y., Gu, J., Min, L., et al. (2019) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2019.00346 · Cited by 64 · see citing works
“In addition, IBS patients appeared to have a higher frequency of psychosocial stress, a lower quality of life and lower levels of work productivity (Drossman et al., 1988, 2000; Talley et al., 1997).”
Psychosocial aspects of functional gastrointestinal disorders
Budavari, A. I., & Olden, K. W. (2003) · Gastroenterology Clinics of North America · doi:10.1016/s0889-8553(03)00030-x · Cited by 63 · see citing works
“Once pain severity is accounted for, however, increased psychologic distress determines which individuals with IBS seek treatment [46,87,88].”
BackgroundExtra‐intestinal manifestations associated with irritable bowel syndrome: a twin study
Svedberg, P., Johansson, S., Wallander, M. ‐., Hamelin, B., & Pedersen, N. L. (2002) · Alimentary Pharmacology & Therapeutics · doi:10.1046/j.1365-2036.2002.01254.x · Cited by 60 · see citing works
Societal costs for irritable bowel syndrome – a population based study
Hillilä, M. T., Färkkilä, N., & Färkkilä, M. A. (2010) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365521003637211 · Cited by 58 · see citing works
Functional bowel symptoms in a general Dutch population and associations with common stimulants
Boekema, P. J. (2001) · The Netherlands Journal of Medicine · doi:10.1016/s0300-2977(01)00128-0 · Cited by 57 · see citing works
Mikocka‐Walus, A. A., Turnbull, D. A., Moulding, N., Wilson, I. G., Andrews, J. M., & Holtmann, G. (2008) · Journal of Gastroenterology and Hepatology · doi:10.1111/j.1440-1746.2007.05245.x · Cited by 56 · see citing works
Consultations and referrals for dyspepsia in general practice—a one year database survey
van Bommel, M. J. J., Numans, M. E., de Wit, N. J., & Stalman, W. A. B. (2001) · Postgraduate Medical Journal · doi:10.1136/pmj.77.910.514 · Cited by 55 · see citing works
“Considering the determinants of referral, we found that urgent problems clearly play a part in the decision to refer. Furthermore, the roles of age, sex, and previous history must be taken into account. The role of irritable bowel syndrome comorbidity, however, needs further attention. Reasons for consultations about…”
BackgroundKoloski, N. A., Boyce, P. M., & Talley, N. J. (2006) · European Journal of Gastroenterology & Hepatology · doi:10.1097/01.meg.0000231755.42963.c6 · Cited by 49 · see citing works
Self-citationHerman, J. R., Pokkunuri, V. B., Braham, L., & Pimentel, M. (2010) · Gender Medicine · doi:10.1016/j.genm.2010.06.007 · Cited by 50 · see citing works
Splitting Irritable Bowel Syndrome: From Original Rome to Rome II Criteria
Mearin, F., Roset, M., Badia, X. C., Balboa, A., Baró, E., Ponce, J. D. C., Díaz‐Rubio, M., Caldwell, E., Cucala, M., Fueyo, A., et al. (2004) · The American Journal of Gastroenterology · doi:10.1046/j.1572-0241.2003.04024.x · Cited by 48 · see citing works
“The high number of subjects meeting IBS or other FBD criteria who seek medical attention in our country is noteworthy; our IBS data are closer to those published for the Australian population—around 73% (40)—than to those for the USA—around 25% (20).”
ResultSelf-citationMasuy, I., Oudenhove, L. V., Tack, J. F., & Biesiekierski, J. R. (2017) · Neurogastroenterology & Motility · doi:10.1111/nmo.13167 · Cited by 47 · see citing works
Perona, M. C., Benasayag, R., Juan, A. P., Santos, J., Zárate-López, N., Zárate, P., & Mearin, F. (2005) · Clinical Gastroenterology and Hepatology · doi:10.1016/s1542-3565(04)00776-1 · Cited by 47 · see citing works
A randomly selected population sample undergoing colonoscopy
Kjellström, L., Molinder, H. K. M., Agréus, L., Nyhlin, H., Talley, N. J., & Andréasson, A. (2014) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0000000000000024 · Cited by 45 · see citing works
Self-citationAnger and childhood sexual abuse are independently associated with irritable bowel syndrome
Beesley, H., Rhodes, J. M., & Salmon, P. (2009) · British Journal of Health Psychology · doi:10.1348/135910709x466496 · Cited by 45 · see citing works
Johnson, A. C., Farmer, A. D., Ness, T. J., & Meerveld, B. G. (2019) · Neurogastroenterology & Motility · doi:10.1111/nmo.13776 · Cited by 45 · see citing works
Characterization of Episodes of Irritable Bowel Syndrome Using Ecological Momentary Assessment
Weinland, S. R., Morris, C. B., Hu, Y., Leserman, J., Bangdiwala, S. I., & Drossman, D. A. (2011) · The American Journal of Gastroenterology · doi:10.1038/ajg.2011.170 · Cited by 44 · see citing works
Khademolhosseini, F., Mehrabani, D., Nejabat, M., Beheshti, M., Heydari, S. T., Mirahmadizadeh, A., Salehi, M., Zare, N., & Saberifiroozi, M. (2011) · Europe PMC (PubMed Central) · Cited by 44 · see citing works
An international study of irritable bowel syndrome: Family relationships and mind-body attributions
Gerson, M., Gerson, C. D., Awad, R. A., Dancey, C. P., Poitras, P., Porcelli, P., & Sperber, A. D. (2005) · Social Science & Medicine · doi:10.1016/j.socscimed.2005.10.019 · Cited by 44 · see citing works
Weinryb, R. M., Österberg, E., Blomquist, L., Hultcrantz, R., Krakau, I., & Åsberg, M. (2003) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365520310002166 · Cited by 45 · see citing works
“(20), however, found that pain rather than psychological factors seemed to explain careseeking among IBS subjects in the community.”
BackgroundTHE EPIDEMIOLOGY OF HYSTERECTOMY AND IRRITABLE BOWEL SYNDROME IN A UK POPULATION
Kennedy, T., & Jones, R. (2000) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2000.tb10949.x · Cited by 44 · see citing works
Scope of the problem of functional digestive disorders
Talley, N. J. (2002) · The European Journal of Surgery · doi:10.1080/11024159850191427 · Cited by 42 · see citing works
Self-citationLane, M. M., Weidler, E. M., Czyzewski, D. I., & Shulman, R. J. (2009) · PEDIATRICS · doi:10.1542/peds.2008-0227 · Cited by 42 · see citing works
Goodoory, V. C., Houghton, L. A., Yiannakou, Y., Black, C. J., & Ford, A. C. (2021) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2021.04.043 · Cited by 42 · see citing works
- Authors
- Talley, N. J., Boyce, P. M., & Jones, M.
- Affiliations
- The University of Sydney (AU)
- Corresponding author
- Talley, N J
- ORCID
- Venue
- Gut
- Publisher
- BMJ
- Published
- 1997-09-01
- Volume
- 41
- Issue
- 3
- Pages
- 394-398
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1891476
- OpenAlex
- W2159752479
- Cited by
- 250
- References
- 33
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 11 · 2020: 5 · 2019: 8 · 2018: 6 · 2017: 5 · 2016: 4 · 2015: 3 · 2014: 8 · 2013: 5 · 2012: 12
- FWCI
- 8.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- 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, health-seeking behavior, psychological factors, pain intensity, pain duration, neuroticism, psychological morbidity, abuse history, Manning criteria, Rome criteria, abdominal pain, community population
- MeSH terms
- Australia, Child, Child Abuse, Colonic Diseases, Functional, Female, Humans, Male, Middle Aged, Pain, Patient Acceptance of Health Care, Surveys and Questionnaires
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