Core mental state in irritable bowel syndrome

Objective: Psychiatric illness is higher among patients with irritable bowe l syndrome (IBS) who seek medical care; however, a specific psychopathology that differentiates patients with IBS from patients with other organic gas trointestinal disorders has not been found. In the study described here, we investigated the predominant psychiatric symptoms in women with IBS. Metho ds: The criteria of Manning et al., as modified by Thompson et al., were us ed to make the diagnoses of IBS. Psychiatric assessment was performed by us ing a structured interview in 64 women, aged 20 to 70 years, 36 with IBS an d 28 with chronic cholelithiasis. Diagnosis of chronic cholelithiasis was m ade by histopathological examination. The final diagnoses were confirmed by interview after 1 year. The diagnostic system based on the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) was u sed to make the current diagnoses. The Present State Examination (PSE)-Inde x of Definition (ID) computer program (CATEGO) was used to define total psy chopathology (total PSE score), current clinical severity (ID), and cluster s of psychiatric symptoms. Results: No difference in the specific DSM-IV di agnostic categories was found, but there were more total depressive disorde rs in the I]BS group. The ID and total PSE score were high among patients w ith IBS. Multiple logistic regression analysis showed that duration of gast rointestinal pain, and the symptoms of general anxiety, and hypochondriasis significantly predicted a diagnosis of IBS. Conclusions: Female patients w ith IBS are categorized into the general DSM-IV category of depressive diso rder, their current psychiatric severity is high compared with that of wome n with chronic cholelithiasis, and patients with IBS are characterized by t he psychiatric syndromes of general anxiety and hypochondriasis. The implic ations of these findings and areas for future research are discussed.