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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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“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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“This is consistent with pain as the single most important factor (but not the only one) influencing both men and women to seek health care for their IBS symptoms (40).”
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Self-citationComorbid Clinical Conditions in Chronic Fatigue. A Co-Twin Control Study
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“One possible explanation for the observed high proportion of IBS consulters, similar to that reported from Australia but higher than in other Western countries, is the public healthcare system in Norway with its high accessibility and low costs for the patient [1,20].”
ResultPrevalence of irritable bowel syndrome in Hong Kong
KWAN, A. C., Hu, W. H., Chan, Y., Yeung, Y., Lai, T. S. T., & Yuen, H. (2002) · Journal of Gastroenterology and Hepatology · doi:10.1046/j.1440-1746.2002.02871.x · Cited by 134
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“Bowel scoring was done by asking the patients the below questions and each positive answer was given a score of 1 while each negative answer was given a score of 0 ( Talley et al., 1997 ).”
BackgroundSelf-management for women with irritable bowel syndrome
Heitkemper, M. M., Jarrett, M. E., Levy, R. L., Cain, K. C., Burr, R. L., Feld, A., Barney, P., & Weisman, P. (2004) · Clinical Gastroenterology and Hepatology · doi:10.1016/s1542-3565(04)00242-3 · Cited by 119
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Self-citationImpact of irritable bowel syndrome (IBS) on health-related quality of life (HRQOL)
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MethodKoloski, N. A., Talley, N. J., & Boyce, P. M. (2003) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2003.07388.x · Cited by 111
“Consistent with our previous population-based studies (3, 20, 21), we found that a considerable proportion of subjects in the abdominal pain group consulted medical care for abdominal and/or bowel problems.”
ResultSelf-citationBijkerk, C. J., de Wit, N. J., Stalman, W. A. B., Knottnerus, J. A., Hoes, A. W., & Muris, J. W. M. (2003) · Canadian Journal of Gastroenterology · doi:10.1155/2003/532138 · Cited by 104
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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
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 108
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
Pathways in gut-brain communication: Evidence for distinct gut-to-brain and brain-to-gut syndromes
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“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
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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
“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 87
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
“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
“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
“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
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Emerging disease model for functional gastrointestinal disorders
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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
“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
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
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“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 68
“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
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
“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. (2012) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm.2012.18.3.298 · Cited by 69
“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
“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
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
“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
“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
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
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
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
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
“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
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
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
“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
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
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 44
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
Johnson, A. C., Farmer, A. D., Ness, T. J., & Meerveld, B. G. (2019) · Neurogastroenterology & Motility · doi:10.1111/nmo.13776 · Cited by 45
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
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
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
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
“(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
Scope of the problem of functional digestive disorders
Talley, N. J. (2002) · The European Journal of Surgery · doi:10.1080/11024159850191427 · Cited by 42
Self-citationLane, M. M., Weidler, E. M., Czyzewski, D. I., & Shulman, R. J. (2009) · PEDIATRICS · doi:10.1542/peds.2008-0227 · Cited by 42
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
Metadata
- 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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