Irritable bowel syndrome (IBS) affects up to 22% of the general population. Its aetiology remains unclear. Previously reported cross-sectional associations with psychological distress and depression are not fully understood. We hypothesised that psychosocial factors, particularly those associated with somatisation, would act as risk markers for the onset of IBS. We conducted a community-based prospective study of subjects, aged 25–65 years, randomly selected from the registers of three primary care practices. Responses to a detailed questionnaire allowed subjects’ IBS status to be classified using a modified version of the Rome II criteria. The questionnaire also included validated psychosocial instruments. Subjects free of IBS at baseline and eligible for follow-up 15 months later formed the cohort for this analysis (n = 3732). An adjusted participation rate of 71% (n = 2456) was achieved at follow-up. 3.5% (n = 86) of subjects developed IBS. After adjustment for age, gender and baseline abdominal pain status, high levels of illness behaviour (odds ratio (OR) = 5.2; 95% confidence interval (95% CI) 2.5–11.0), anxiety (OR = 2.0; 95% CI 0.98–4.1), sleep problems (OR = 1.6; 95% CI 0.8–3.2), and somatic symptoms (OR = 1.6; 95% CI 0.8–2.9) were found to be independent predictors of IBS onset. This study has demonstrated that psychosocial factors indicative of the process of somatisation are independent risk markers for the development of IBS in a group of subjects previously free of IBS. Similar relationships are observed in other “functional” disorders, further supporting the hypothesis that they have similar aetiologies.
Aim This study investigated self‐attitudes towards schizophrenia, depression and anxiety. Methods A survey was conducted with 564 people with a schizophrenia, depression and anxiety who are currently being treated at a psychiatric clinic in Amman, Jordan. Results The research found that stigma towards schizophrenia, depression and anxiety was based around three factors: preconceived stereotypes, personal responsibility/blame and the perceived inability of a patient to recover. Schizophrenia, in particular, was linked more strongly to negative stereotypes and an inability to recover and less associated to personal responsibility/blame in comparison to depression and anxiety. Discussion Three identical stigma factors emerged for each diagnosis which reflected themes identified in previous literature. People with schizophrenia are seen as more dangerous and less likely to recover than those suffering from other mental illness. Anxiety was seen most favourably by the self; it was associated with less negative stereotypes and seen as more likely to cure. Interestingly, anxiety and depression were seen almost identically. Conclusion The self‐perception of mental health conditions, such as schizophrenia, depression and anxiety, have important implications for the planning of anti‐stigma and awareness raising programmes. By gaining a thorough understanding of these perceptions and the rationale behind them, it may be possible to develop effective, tailor‐made interventions.
Purpose In addition to environmental causes such as TORCH infection, trauma and drug or chemical exposure, childhood cataracts (CC) frequently have a genetic basis. They may be isolated or syndromic and have been associated with mutations in over 110 genes. We have recently demonstrated that nextgeneration sequencing (NGS), a high throughput sequencing technique that enables the parallel sequencing of multiple genes, is ideally suited to the investigation of bilateral CC. This study assesses the diagnostic outcomes of traditional routine investigations and compares this with outcomes of NGS testing. Methods A retrospective review of the medical records of 27 consecutive patients with bilateral CC presenting in 2010-2012 was undertaken. The outcomes of routine investigations in these patients, including TORCH screen, urinalysis, karyotyping, and urinary and plasma organic amino acids, were collated. The success of routine genetic investigations undertaken over 10 years (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010) was also assessed. Results By April 2014, the underlying cause of bilateral CC had been identified in just one of 27 patients despite 44% (n = 12) receiving a full 'standard' investigative work-up and 22% (n = 6) investigations in addition to the standard work-up. Fifteen of these patients underwent NGS testing and nine (60%) of these received a diagnosis for their CC. Conclusion The frequency of patients receiving a diagnosis for their CC after standard care and the time taken to diagnosis was disappointing. NGS testing improved diagnostic rates and time to diagnosis, as well as changing clinical management. These data serve as a baseline for future evaluation of novel diagnostic modalities.
The study highlights the importance of enhancing knowledge about the schizophrenia-related spectrum to ensure patients seek treatment in a more timely manner.
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