Anxiety and depression in irritable bowel syndrome: Exploring the interaction with other symptoms and pathophysiology using multivariate analyses

Background Anxiety or depression, in other words, psychological distress, are common comorbidities in patients with irritable bowel syndrome (IBS), but their interaction with pathophysiological factors and other symptoms are unclear. Methods Patients with IBS (Rome III criteria), thoroughly characte...

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Bibliographic Details
Published in:Neurogastroenterology and motility 2019-08, Vol.31 (8), p.1-14
Main Authors: Midenfjord, Irina, Polster, Annikka, Sjövall, Henrik, Törnblom, Hans, Simrén, Magnus
Format: Article
Language:English
Subjects:
Anxiety
Autonomic nervous system
depression
Fatigue
Gastroenterologi
Gastroenterology & Hepatology
Gastroenterology and Hepatology
heart-rate-variability
Hypersensitivity
impact
Intestine
Irritable bowel syndrome
Mental depression
microbiota
multivariate analysis
Neurosciences & Neurology
Patients
Principal components analysis
Psychiatry
Psykiatri
Quality of life
questionnaire
severity
somatization
system
validation
visceral hypersensitivity
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Summary:Background Anxiety or depression, in other words, psychological distress, are common comorbidities in patients with irritable bowel syndrome (IBS), but their interaction with pathophysiological factors and other symptoms are unclear. Methods Patients with IBS (Rome III criteria), thoroughly characterized regarding pathophysiology (colonic transit time, visceral sensitivity, and autonomic nervous system [ANS] function), symptom profile (IBS severity, somatic symptoms, gastrointestinal [GI]‐specific anxiety and fatigue), and quality of life, were explored for differences regarding pathophysiology and symptoms between patients with and without reported psychological distress in univariate and multivariate analyses (Principal Component Analysis [PCA] with Hotelling's T2 and Orthogonal Partial Least Squares‐Discriminant Analysis [OPLS‐DA]). Key Results When using Hospital Anxiety and Depression Scale score ≥8 as cut‐off score, including both borderline and clinically significant cases, 345 (44.9%) out of 769 IBS patients reported anxiety, and 198 (25.7%) depression. In univariate analyses, patients reporting psychological distress demonstrated more severe GI and non‐GI symptoms, fatigue, GI‐specific anxiety and lower quality of life, and differences for some pathophysiological measures. IBS patients with and without reported psychological distress showed significant differences between the multivariate means in symptom reporting (PCA; both P 
ISSN:1350-1925
1365-2982
DOI:10.1111/nmo.13619