A controlled study of psychopathology, life events, personality and sociodemographic factors in irritable bowel syndrome

ABSTRACT

Background: Irritable Bowel syndrome (IBS) is a common gastroenterological problem with symptoms causing a significant impact on the quality of life of patients. Psychopathology is associated in most of the cases affecting its overall prognosis. Life stressors influence significantly; either by precipitating or causing exacerbation of symptoms. IBS patients exhibit high levels of neuroticism and introversion. Dietary factors also play a role in IBS .Only few Indian studies reported these aspects in IBS. Aims: To identify the sociodemographic, dietary factors, psychopathology, life events and personality factors in irritable bowel syndrome (IBS) in the Indian context. Methods: Patients having IBS were selected for the study by purposive sampling. Normal controls without bowel symptoms were randomly selected from the population. After taking informed consent; sociodemographic data, diet details and illness details were obtained from all subjects. All the subjects were given a 30 item General Health Questionnaire (GHQ); Hamilton Anxiety Rating Scale (HARS); Hamilton Depression Rating Scale (HDRS); Eysenck Personality Inventory (EPI) and Presumptive Stressful Life Events Scale (PSLE). Parametric and non-parametric tests of comparison were employed in analysis of the data and results were interpreted. Results: IBS group scored significantly more than controls on GHQ scores, HDRS scores, Psychic and Somatic sub scores of HARS and PSLE mean stress scores. There was higher neuroticism score, especially in female patients. Family conflict; illness of family member; financial problems and change in sleeping habits were the frequently reported undesirable life event and going on a pleasure trip was the desirable event reported as stressor in these patients. Dietary sensitivities were significantly higher in patient group. Conclusions: We observed higher psychopathology scores consistent with earlier studies. In addition to undesirable stressors, going on a pilgrimage was the only desirable stressor associated with symptom exacerbation which was not reported earlier. Food sensitivities were significantly higher in IBS patients consistent with earlier studies. Key Message We propose that psychological and dietary factors play a significant role in IBS. Hence, a multimodality treatment approach in the form of psychosocial therapy; dietary changes along with pharmacotherapy may be more effective in treatment of IBS.