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HeatherAdministrator

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Psychological / Psychiatric
      #13948 - 07/14/03 01:50 PM

All articles pertaining to psychological or psychiatric IBS research should be posted here.



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HeatherAdministrator

Reged: 12/09/02
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Pattern-Specific Brain Activation and Personalities Seen in IBS new
      #13976 - 07/14/03 03:12 PM

Pattern-Specific Brain Activation and Personalities Seen in Irritable Bowel Syndrome

by Martha Kerr

May 21, 2003 (Orlando) — Patterns of brain activation in patients with irritable bowel syndrome (IBS) suggest an altered perception of pain compared with healthy subjects. Patients with IBS also tend to exhibit a distinct personality profile, which varies according to sex. Research demonstrating these findings were presented here during Digestive Disease Week 2003.

Stress is a major trigger for symptom flares in IBS, and how an individual copes with stress may influence disease status. Jeffrey M. Lackner, PsyD, from the Behavioral Medicine Clinic at the University at Buffalo School of Medicine in New York, reported that submissive, unassertive, introverted personalities predominate among patients with IBS.

Dr. Lackner and colleagues set out to identify personality types in 135 patients with IBS. Of these, 113 were women and 35 were men. Mean age was 49.4 years and duration of IBS was approximately 16 years.

The investigators scored patients on the 64-item Inventory of Interpersonal Problems (IIP, Alden, Wiggins and Pincus, 1990) and categorized patients according to the Interpersonal Circumplex, which organizes behavior into two major categories: (1) affiliation, which ranges from hostility to friendliness, and (2) dominance, which ranges from submissiveness to controlling.

Dr. Lackner reported that women with IBS tend to have traits of nonassertiveness and submissiveness. Men tend to be overaccommodating and have difficulty feeling and expressing anger, "like they are walking on eggshells," he said.

"With behavior modification, about 70% of patients with IBS are able to reduce their symptoms by 50% or more," Dr. Lackner said In an interview with Medscape. "When looked at in terms of the benefits of pharmacologic treatment, that's pretty impressive."

In a separate study, IBS patients showed different patterns of brain activation on gastrointestinal distention compared with healthy controls, reported Bruce D. Naliboff, PsyD, from the CNS Center for Neurovisceral Science and Female Health at the University of California in Los Angeles (UCLA).

Dr. Naliboff showed positron emission tomography (PET) images of the brains of 12 IBS patients — 10 men and 2 women — with a mean age of 39 years. He compared these with images taken of the brains of 12 healthy controls, also 10 men and 2 women. PET scans were taken at rest and after inflation of a balloon placed in the subjects' rectums.

IBS patients reported a higher level of discomfort or pain on balloon inflation than controls. PET scans of IBS patients showed activation in the hypothalamus, the anterior cingulate cortex and the dorsolateral prefrontal cortex while controls showed activation in the dorsal pons/PAG, which is a pontine pain inhibition area.

"IBS patients show more activation in areas that control cognition and evaluation of visceral sensation. They may have possible deficits in pain inhibition," Dr. Nabiloff said.

Management of these patients should include education about the illness, the UCLA psychologist said. "And at this point, we're still trying to figure out what IBS is.... It is important to give patients a positive model, of something they can do something about."

Dr. Lackner added that "cognitive behavioral therapy helps these patients process information differently. These patients show negativity, jump to conclusions, blow things out of proportion. Those behaviors make symptoms worse. They need to unlearn that style of thinking."

DDW 2003: Abstracts T1434, presented May 20, 2003; Abstract W1446, presented May 21, 2003.

Reviewed by Gary D. Vogin, MD

Medscape Medical News 2003. © 2003 Medscape

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HeatherAdministrator

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Psychiatric illness, personality traits and the irritable bowel syndrome. new
      #14341 - 07/18/03 12:27 PM

Ann Acad Med Singapore. 2001 Nov;30(6):611-4.

Psychiatric illness, personality traits and the irritable bowel syndrome.

Fock KM, Chew CN, Tay LK, Peh LH, Chan S, Pang EP.

Division of Gastroenterology, Department of Medicine, Changi General Hospital, 2 Simei Street 3, Singapore 529889.

INTRODUCTION: Irritable bowel syndrome is a common functional gastrointestinal disorder. Although its aetiology is still unknown, visceral hypersensitivity, disorders of motility and psychosocial factors have been proposed as possible factors that affect the "gut-brain" function. The objective of this study was to determine if psychiatric disorders exist in patients with irritable bowel syndrome. PATIENTS AND METHODS: During a 10-month period, 43 outpatients, after exclusion of organic bowel pathology and meeting Manning's criteria for the diagnosis of irritable bowel syndrome, were assessed using the Eysenck Personality Questionnaire. In addition, a psychiatric interview was conducted by two psychiatrists. Twenty patients with organic bowel disorders, who were age matched, were selected as patient control. RESULTS: Psychiatric diagnoses (62.5%) were present in significantly more female patients with irritable bowel syndrome than female patients with organic bowel disorders (16.7%, P < 0.05). On Eysenck Personality testing, female patients with irritable bowel syndrome scored significantly higher on neuroticism (15.25 versus 8.58) and lower on need for social desirability (14.04 versus 17.0) than the organic disease group. Male patients with irritable bowel syndrome were comparable with male patients with organic bowel disorders in terms of presence of minor psychiatric morbidity, psychiatric diagnoses and Eysenck Personality scores. CONCLUSION: There is a difference between male and female patients with irritable bowel syndrome in terms of psychopathology.

PMID: 11817289 [PubMed - indexed for MEDLINE]
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HeatherAdministrator

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The relationship between irritable bowel syndrome and psychiatric illness. new
      #16106 - 08/02/03 10:34 PM

Psychosomatics. 1998 Jan-Feb;39(1):45-54. Related Articles, Links


The relationship between irritable bowel syndrome and psychiatric illness. A family study.

Woodman CL, Breen K, Noyes R Jr, Moss C, Fagerholm R, Yagla SJ, Summers R.

University of Iowa, Department of Psychiatry, Iowa City 52242, USA.

Although irritable bowel syndrome (IBS) is a common disorder among gastrointestinal clinic outpatients, it continues to be a diagnosis of exclusion. In treatment-seeking populations, IBS has been frequently associated with psychiatric illness, and this co-occurrence has added to controversy about the validity of the IBS diagnosis. This study is a preliminary effort to examine the nature of this relationship by using the family study design. The probands consisted of 20 patients with IBS and 20 patients who had undergone laproscopic cholecystectomy. Their first-degree relatives were interviewed to obtain lifetime diagnoses of functional gastrointestinal and psychiatric syndromes. Significantly more IBS probands had lifetime psychiatric illness than the cholecystectomy probands. The lifetime prevalence of IBS as well as other functional gastrointestinal syndromes was not significantly different between the groups of relatives. However, significantly more relatives of the IBS probands had lifetime psychiatric illness than the relatives of the cholecystectomy probands. Among the relatives with functional gastrointestinal disorders, significantly more had psychiatric illness. This preliminary study provides support for a relationship between IBS and psychiatric illness by the finding of an increased prevalence of psychiatric disorders among the relatives of patients who have IBS.

PMID: 9538675 [PubMed - indexed for MEDLINE]


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HeatherAdministrator

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Psychopathology in irritable bowel syndrome new
      #17748 - 08/19/03 01:50 PM

J Behav Med. 2003 Aug;26(4):361-72. Related Articles, Links


Psychopathology in irritable bowel syndrome: support for a psychophysiological model.

Sykes MA, Blanchard EB, Lackner J, Keefer L, Krasner S.

Department of Psychology, Center for Stress and Anxiety Disorders, University at Albany, State University of New York, 1535 Western Avenue, Albany, New York 12203, USA. masykes@go.com

Previous research has established that patients with irritable bowel syndrome (IBS) frequently have comorbid psychiatric disorders. This study sought to establish if the timing of the onset of psychiatric disorders indicated that IBS was more likely to be caused by or more likely to cause psychological difficulties. Participants were 188 treatment-seeking IBS patients who were assessed for psychiatric diagnoses using a semistructured clinical interview. Timing of the onset of any lifetime psychiatric disorders was noted in an attempt to determine if psychiatric disorders were more likely to precede or follow the onset of IBS symptoms. Those participants that met criteria for an Axis I disorder sometime during their life were significantly more likely to develop an Axis I disorder before the onset of IBS symptoms. Anxiety disorders were the most likely disorder to develop before IBS. These results support the theory that psychiatric symptoms, especially anxiety, play a role in the development of IBS.

PMID: 12921009

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HeatherAdministrator

Reged: 12/09/02
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Computer game cure for stress related illnesses new
      #27735 - 11/18/03 03:26 PM

A computer game which works by the power of thought could help people with stress-related illnesses.

Doctors at the Royal Free Hospital in London have tested the game on 40 patients with irritable bowel syndrome (IBS).

The syndrome, which causes abdominal pain and problems going to the toilet, affects 15% of the population.

The computer game uses lie detector technology to detect stress.

Patients are wired up to lie detector pads by nurses. By relaxing they can control their progress through a virtual bowel on the computer screen.

The aim is to progress through the bowel to red spots of pain or bubbly areas representing the bloated feeling suffered by some people with IBS.

The Royal Free Hospital has pioneered the virtual bowel game.

Once the patient has broken through those areas, they emerge into a country scene with a free-flowing stream, symbolising a problem-free bowel.

Dr Owen Epstein, head of the Royal Free's gastroenterology team, which pioneered the game, said it was based on software developed by a company called Ultramind.

"It is a very interesting technique. I hope it can be used in GP surgeries," he said.


He believes it could be used to treat other stress-related disorders, such as asthma, and could eventually be sold on the high street.

"There is the potential for selling them for use in the home, but I think there is more to them than just relaxation.

"There is a lot of value in the interaction between patient and the nurse who monitors the game," he said.

The two-year trials found that patients needed on average four half-hour sessions at the computer, making it simple and cheap to run.

The software costs between £100 and £200.

The patients also had to do some homework, for example, practising the relaxation techniques learnt through the game whenever they felt stressed and visualising the game five minutes every evening.

The findings of the Royal Free study are published by the Royal College of Physicians on Friday.

Dr Epstein hopes to continue with trials of the game and is hoping to use it to treat other bowel disorders, such as Crohn's Disease.

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HeatherAdministrator

Reged: 12/09/02
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Social learning, affective state and passive coping in irritable bowel syndrome and IBD new
      #44157 - 02/10/04 01:43 PM

Gen Hosp Psychiatry. 2004 Jan-Feb;26(1):50-8.

Social learning, affective state and passive coping in irritable bowel syndrome and inflammatory bowel disease.

Crane C, Martin M.

Department of Psychiatry, University of Oxford, Oxford, UK

The association between the use of passive coping strategies to deal with pain and reported levels of anxiety, depression, and parental reinforcement of illness behavior was examined in individuals with Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD). Individuals with IBS and IBD recruited primarily from outpatient clinics completed questionnaire measures of pain-coping (the Vanderbilt Pain Management Inventory, VPMI) as well as measures of anxiety and depression, parental reinforcement of illness behavior and physical symptoms. Factor analysis of the passive coping sub-scale of the VPMI indicated that it was comprised of two components corresponding to emotional and behavioral facets of passive coping. Higher levels of behavioral passive coping were associated with higher levels of parental reinforcement of illness behavior and higher levels of depression, but only amongst individuals with IBS. In contrast emotional passive coping was associated in both groups with higher levels of anxiety and depression (but not illness-related social learning). Different factors predict the use of emotional and behavioral passive coping strategies in IBS and IBD. It is suggested that illness-related social learning occurring during childhood influences the development of habitual illness behaviors and that, because of the more benign nature of symptoms in IBS, individuals with IBS may be more likely than individuals with IBD to revert to such habitual behaviors to cope with symptoms. The degree to which the emotional component of passive coping, associated with psychological distress in both groups, can be considered in terms of 'coping strategies', rather than markers of illness-related distress, is discussed.

PMID: 14757303 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14757303&dopt=Abstract

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HeatherAdministrator

Reged: 12/09/02
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Beyond abuse: the association among parenting style, abdominal pain, & somatization in IBS patients new
      #44174 - 02/10/04 02:27 PM

Behav Res Ther. 2004 Jan;42(1):41-56.

Beyond abuse: the association among parenting style, abdominal pain, and somatization in IBS patients.

Lackner JM, Gudleski GD, Blanchard EB.

Behavioral Medicine Clinic, Department of Medicine, University at Buffalo School of Medicine and Biomedical Sciences, SUNY, ECMC, 462, Grider Street, 14215, Buffalo, NY, USA

This study assessed the relative strength of the association between abuse, negative parenting style, and somatization in irritable bowel syndrome (IBS) patients. Drawing from preclinical stress physiology and abuse research identifying the family social climate as a frequently stronger and independent determinant of long-term health effects than abuse-specific variables, we predicted that negative parenting behaviors would more strongly correlate with somatization than abuse. Subjects were 81 consecutively evaluated patients, who at baseline underwent psychological testing, measuring perceived parental style, abuse history, somatization, and pain. Although abuse correlated with maternal and paternal rejection, abuse was not associated with somatization. Higher levels of rejection and/or hostility among fathers (not mothers) were more strongly correlated with somatization than was abuse. Further, paternal parenting behaviors were more predictive of somatization than abuse, age, and gender. The lack of an association between abuse and somatization is discussed in light of limitations of biopsychosocial IBS models, whose strong focus on "pathological stressors" (e.g., abuse, trauma) as risk factors may overlook the importance of "less extreme" parenting variables in influencing somatic complaints. The relationship between parenting and somatization is discussed in the context of broader behavioral science research linking disruptions in the quality of parenting to dramatic and long-term changes in patterns of stress reactivity and brain abnormalities seen in IBS patients.

PMID: 14744522 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14744522&dopt=Abstract

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HeatherAdministrator

Reged: 12/09/02
Posts: 7679
Loc: Seattle, WA
Psychological factors in the irritable bowel syndrome new
      #44176 - 02/10/04 02:30 PM

Eur J Med Res. 2003 Dec 9;8(12):549-56.

Psychological factors in the irritable bowel syndrome.

Solmaz M, Kavuk I, Sayar K.

Vakif Gureba Training and Research Hospital, Istanbul, Turkey.

OBJECTIVE: The role of psychological factors in the irritable bowel syndrome (IBS) is a matter of debate. The prevalence of psychiatric disorders is high in IBS patients. Positive response to antidepressant therapy and presence of family history of depression in IBS patients have led speculations whether this syndrome might be regarded as an affective spectrum disorder. In this study we tried to examine the possible association of IBS with affective spectrum disorders. METHOD: Forty IBS patients from gastroenterology outpatient clinics of a university hospital and state hospital, 32 controls with inflammatory bowel disease and 34 healthy hospital workers were included in the study. Psychiatric interviews were done using SCID-NP (Structured Clinical Interview for DSM-Non-patients) and psychological factors were assessed by the SCL-90-R (Symptom Checklist-90-Revised), the Beck Depression Inventory, the Beck Anxiety Scale and the Hamilton Rating Scale for Depression. Family histories were obtained by FH-RDC (Family History Research Diagnostic Criteria). All groups were matched for sociodemographic variables. RESULTS: The prevalence of psychiatric disorders and mood disorders was higher in the IBS group than the control groups. Also IBS group rated higher on anxiety and depression scales than the other groups, where the differences were statistically significant. Presence of positive family history for mood disorders was higher in the IBS group. CONCLUSION: These results support the hypothesis that IBS might be linked to affective spectrum disorder. Psychiatric assessment and therapy might be useful in the course of irritable bowel syndrome.

PMID: 14711602 [PubMed - in process

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14711602&dopt=Abstract

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HeatherAdministrator

Reged: 12/09/02
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Psychosocial Factors are Linked to Functional Gastrointestinal Disorders new
      #60857 - 04/13/04 03:39 PM

Psychosocial Factors are Linked to Functional Gastrointestinal Disorders: A Population Based Nested Case-Control Study

Posted 03/25/2004

G. Richard Locke, III, M.D.; Amy L. Weaver, M.S.; L. Joseph Melton III, M.D.; Nicholas J. Talley, M.D., Ph.D.

Abstract

Background: It is widely accepted based on volunteer studies that levels of psychological distress are similar in those with functional gastrointestinal (GI) disorders and health in the community, while increased psychological distress in outpatients is largely explained by health-care seeking.

Aims: To determine if psychological distress, life event stress, or social support is associated with functional GI disorders in a population-based study.

Methods: A nested case-control study was performed by first mailing a self-report bowel disease questionnaire to a random sample of Olmsted County, Minnesota, aged 20-50 yr. All persons who reported symptoms of nonulcer dyspepsia (NUD) or irritable bowel syndrome (IBS) (cases), or an absence of GI symptoms (controls), were invited to complete a series of validated questionnaires designed to measure psychological distress, life event stress, social support, current symptoms, and physician visits.

Results: 103 subjects with functional GI disorders and 119 controls participated (85% of eligible). Functional GI disorders were more likely to be reported by those with higher scores on each of the nine SCL-90-R scales used to measure psychological distress (except phobic anxiety), and those with more negative and total life event stress. In a multiple logistic regression model (including age and gender), somatization, interpersonal sensitivity, and total life event stress were independently associated with functional GI disorders. Findings were similar when subjects with the IBS and NUD were analyzed separately compared to controls.

Conclusions: Contrary to current dogma, psychosocial factors were significantly associated with functional GI disorders in this community sample. This suggests that these factors may be involved in the etiopathogenesis rather than just driving health-care utilization.

http://www.medscape.com/viewarticle/468754?mpid=26625

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