Association of Psychological Disorders with Extra-intestinal Symptoms in Patients with Irritable Bowel Syndrome
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present study, we determined the relationship between psychological disorders and extraintestinal symptoms in patients with IBS.
Methods: Adult patients with IBS referred to 4 gastroenterology clinics in Isfahan, Iran, completed the irritable bowel severity scoring system (IBSSS), extraintestinal symptoms scale, Hospital Anxiety and Depression Scale, and Irritable Bowel SyndromeQuality of Life (IBS-QOL) Questionnaire. Univariate and multivariate analyses were conducted.
Results: The patients included 113 females and 45 males with mean age of 34.8 ± 11.1 years. Cumulative frequency of extraintestinal symptoms was 3.3 ± 2.4 (0 to 10). Anxiety and depression were present in 79.7% and 54.4% of the patients, respectively. Frequency of extraintestinal symptoms was correlated with anxiety and depression (r = 0.289 to 0.531), IBS severity (r = 0.373 to 0.505), and quality of life (r = -0.317 to -0.398). Severity of IBS was independently associated with extraintestinal digestive symptoms' frequency (β = 0.248). Female gender, education level, and anxiety were independently associated with extraintestinal non-digestive symptoms' frequency (β= -0.225 to 0.260). Severity of IBS and frequency of non-digestive symptoms were independent predictors of quality of life (β = -0.494 and -0.218). After controlling for psychological factors, IBS severity and depression were independent predictors of quality of life (β = -0.435 and -0.318).
Conclusion: Extraintestinal symptoms and psychological disorders are common in patients with IBS and impact their quality of life. Psychological disorders are associated with extraintestinal symptoms, especially non-digestive symptoms. These results highlight the need for an integrated biopsychosocial approach to the management of IBS patients with physical and mental comorbidities.
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