effect of psychiatric consultation and intervention on the health outcome of G.I.T. patients

ABSTRACT

Psychological factors has been linked with both irritable bowel syndrome and peptic ulcers since the conditions were first defined. They used to be called psychosomatic disorders. Recently the credibility of the term psychosomatic has been questioned in the tenth edition of the international classification of diseases ICD 10. This study aims at shading new light on the relationship between the psychological factors and gastrointestinal disorders in terms of prevalence of psychological symptoms, personality profile, frequency of negative life events within the past year and the possible role of antidepressants and standardized psychotherapeutic intervention in the health outcome of the gastrointestinal patients. Ninety I.B.S. patients, 90 peptic ulcer patients and 90 controls has been evaluated for the above named factors. Depressive symptoms have been found very prominent in the patients groups. Patients have high neuroticism and introversion scores on Eysenk personality inventory, negative life events were more prominent in patients than controls with no difference between I.B.S. and peptic ulcer patients. The gastrointestinal symptoms become better after treatment by antidepressants and supportive psychotherapy. Depressive symptoms were also better but the degree of improvement was not correlated. Antidepressants play its role through its antimuscarinic effect sedating or analgesic effect in addition to its antidepressant effect. The authors concluded that the term psychosomatic is to be used at least to describe conditions such as I.B.S. which has been called functional before, specially if psychological factors proved to play a crucial role in its causation, course and cure