PSYCHIATRIC-DISORDERS AND CHILDHOOD ABUSE IN THE IRRITABLE-BOWEL-SYNDROME

Objective: We aimed to determine whether psychiatric disorders and psy chological symptoms are associated with the irritable bowel syndrome, and whether childhood sexual abuse is reported more often by patients with irritable bowel syndrome, as these issues continue to be controve rsial. Design: Prospectively, 32 symptomatic married outpatients with irritable bowel syndrome completed selected portions of the Structured Clinical Interview for DSM-III-R psychiatric diagnoses, a standardize d interview for childhood abuse, and a series of self-report psycholog ical symptom inventories. Controls comprised 20 currently symptomatic married outpatients who had undergone a partial colectomy or ileectomy for organic disease, the spouses of the patients with irritable bowel syndrome, and the spouses of the organic disease controls. Results: C urrent psychiatric disorders were reported significantly more frequent ly by patients with irritable bowel syndrome compared with controls, a lthough 69% of these patients were not affected. Childhood abuse was r eported more frequently by patients with irritable bowel syndrome, but after adjusting for age and gender, a significant association with di agnostic group was not detected. However, psychiatric disorders were s ignificantly more frequent in those with a history of childhood abuse. Self-report psychological symptom inventories did not discriminate be tween patients with the irritable bowel syndrome and controls. Conclus ion: Our findings suggest that while standardized psychiatric intervie ws give more information than self-report rating scales, psychopatholo gy may not be the major explanation for at least a subset of patients with the irritable bowel syndrome.