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©2012 Baishideng Publishing Group Co.
World J Gastroenterol. Feb 21, 2012; 18(7): 616-626
Published online Feb 21, 2012. doi: 10.3748/wjg.v18.i7.616
Published online Feb 21, 2012. doi: 10.3748/wjg.v18.i7.616
Table 1 Psychological and social factors in irritable bowel syndrome
Environmental factors |
Early life events |
Upbringing environment |
Incentives |
Family function |
Abuse history |
Psychosocial stressors |
Life events (divorce, unemployment, death of a close relative) |
Daily hassles |
Personality traits |
Neuroticism, agreeableness, conscientiousness |
Alexithymia |
Health beliefs |
Hypochondriacal beliefs |
Illness representation |
Perceived susceptibility |
Coping strategies |
Maladaptive coping (catastrophyzing, self-blame, substance abuse) |
Negative emotions and psychiatric disorders |
Mood disorders (major depression and dysthymic disorder) |
Anxiety disorders (generalized anxiety disorder, panic disorder, posttraumatic stress disorder) |
Somatization and somatoform disorders |
Neurasthenia |
Table 2 Environmental factors associated with irritable bowel syndrome
Prenatal traumatic events (e.g., nutrition in fetal life) |
Early stressful life events (surgery, emotional, physical or sexual abuse) |
Upbringing environment (low temperature, affluent childhood social class) |
Family function (divorce, death of a parent) |
Family history of abdominal pain, bowel dysfunction, inflammatory bowel diseases |
Social learning (modeling) |
Abuse history either in childhood or during adult life |
Table 3 Psychosocial stressors and their relation to irritable bowel syndrome
Daily hassles, major life events (divorce, unemployment, or death of a close relative), and major social events (surviving holocaust, revolution, social changes) determine the onset of irritable bowel syndrome symptoms in susceptible individuals |
Psychosocial stressors determine symptom exacerbation and health care seeking |
Table 4 Personality traits and irritable bowel syndrome
Neuroticism and alexithymia are common in irritable bowel syndrome patients |
Neuroticism is a predictor of illness perception and influences coping strategies |
Examples of measurement tools: Toronto Alexithymia Scale (TAS-20), Neuroticism Extraversion Openness Personality Inventory[46] |
Table 5 Health beliefs and coping with stress in relation to irritable bowel syndrome
Health beliefs in IBS may be irrational, leading to hypochondriacal attitudes |
Coping strategies can be inefficient in IBS patients, patients often adopt maladaptive coping strategies such as catastrophyzing |
Patients with a high degree of catastrophyzing report more severe pain |
Measurement methods: CSQ, CISS, WCQ |
Table 6 Comorbid psychiatric diagnoses and their relation to irritable bowel syndrome
Psychiatric symptoms and psychiatric diseases are frequent in IBS, especially in severe forms |
Depression is the most common psychiatric disorder in IBS (approximately 30% of patients) |
Generalized anxiety disorder is present in about 15% of patients |
High gastrointestinal specific anxiety predicts symptom severity |
High levels of somatization determine frequent use of health care services, a poor response to treatment and a poor health-related quality of life |
Other psychiatric disorders in IBS patients: posttraumatic stress disorder, panic disorder, hypochondriasis, dysthymia, phobias, undifferentiated somatoform disorder, drug or alcohol problems |
Patients with severe IBS may have more than one psychiatric disorder |
Measurement methods: Symptom checklist-90-revised for overall psychological distress; state-trait anxiety inventory, beck depression Inventory |
- Citation: Surdea-Blaga T, Băban A, Dumitrascu DL. Psychosocial determinants of irritable bowel syndrome. World J Gastroenterol 2012; 18(7): 616-626
- URL: https://www.wjgnet.com/1007-9327/full/v18/i7/616.htm
- DOI: https://dx.doi.org/10.3748/wjg.v18.i7.616