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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2016; 22(28): 6402-6415
Published online Jul 28, 2016. doi: 10.3748/wjg.v22.i28.6402
Personality traits and emotional patterns in irritable bowel syndrome
Maria Rosaria A Muscatello, Antonio Bruno, Carmela Mento, Gianluca Pandolfo, Rocco A Zoccali
Maria Rosaria A Muscatello, Antonio Bruno, Carmela Mento, Gianluca Pandolfo, Rocco A Zoccali, Psychiatry Unit, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy
Author contributions: Muscatello MRA contributed to the literature search, manuscript writing, and final revision; Bruno A suggested topics to be included and contributed to the writing of the manuscript; Mento C managed the literature search and contributed to the writing; Pandolfo G contributed to the literature search and to the writing of manuscript; and Zoccali RA contributed to the study idea, manuscript writing and the final revision of the article.
Conflict-of-interest statement: The Authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. Rocco A Zoccali, Professor, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 98125 Messina, Italy.
Telephone: +39-90-2212092 Fax: +39-90-695136
Received: March 26, 2016
Peer-review started: March 27, 2016
First decision: May 12, 2016
Revised: May 26, 2016
Accepted: June 15, 2016
Article in press: June 15, 2016
Published online: July 28, 2016

The review focuses on those personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness), constructs (alexithymia and distressed - Type D personality) and emotional patterns (negative and positive) that are of particular concern in health psychology, with the aim to highlight their potential role on the pathogenesis, onset, symptom clusters, clinical course, and outcome of irritable bowel syndrome (IBS). Personality traits and emotional patterns play key roles in affecting autonomic, immune, inflammatory, and endocrine functions, thus contributing not only to IBS clinical expression and symptomatic burden, but also to disease physiopathology. In this sense, psychological treatments should address those personality traits and emotional features that are constitutive of, and integral to IBS. The biopsychosocial model of illness applied to IBS acknowledges the interaction between biological, psychological, environmental, and social factors in relation to pain and functional disability. A holistic approach to IBS should take into account the heterogeneous nature of the disorder, and differentiate treatments for different types of IBS, also considering the marked individual differences in prevalent personality traits and emotional patterns. Beyond medications, and lifestyle/dietary interventions, psychological and educational treatments may provide the optimal chance of addressing clinical symptoms, comorbid conditions, and quality of life in IBS patients.

Keywords: Alexithymia, Depression, Anxiety, Anger, Conscientiousness, Irritable bowel syndrome, Emotions, Personality, Neuroticism, Extraversion

Core tip: The complex nature of irritable bowel syndrome (IBS) requires a multidisciplinary approach from different fields of scientific knowledge. This review examines the contribution of personality traits and emotional patterns to pathophysiology, clinical expression, and outcome of IBS. Several personality traits and constructs, such as neuroticism, conscientiousness, and alexithymia, are closely associated with IBS. Negative emotions, which are probably more entangled with neurobiological substrates, seem to have a key role in the brain-gut axis dysfunction which characterizes IBS. Based on the reviewed evidence, effective treatments for IBS should also address personality traits and emotions to improve outcomes in IBS patients.