The role of anxiety and depression in the irritable bowel syndrome

Blanchard, Edward B.; Scharff, Lisa; Schwarz, Shirley P.; Suls, Jerry; Barlow, David H.

doi:10.1016/0005-7967(90)90159-g

Cited by 156 publications

(79 citation statements)

References 13 publications

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“…The finding of a higher level of depression in the FGID group than in the IBD group, but of similar levels of anxiety, contrasts with a previous study in which patients with irritable bowel syndrome scored higher than IBD patients on both the HADS-A and the HADS-D [53]. It must be noted, however, that the HADS measures state anxiety and depression, which fluctuate over time, as was demonstrated in our previous longitudinal study with IBD patients [14].…”

Section: Discussioncontrasting

confidence: 99%

Alexithymia and Functional Gastrointestinal Disorders

Porcelli

Taylor

Bagby

et al. 1999

Psychother Psychosom

107

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Background: Although the alexithymia construct was derived from observations of patients with classical psychosomatic diseases, empirical studies have found only a moderate association between alexithymia and inflammatory bowel disease (IBD). Indeed, there is some evidence that alexithymia may be associated more strongly with functional somatic symptoms than with the psychosomatic diseases. The present study examined the relationship between alexithymia and functional gastrointestinal disorders (FGIDs) in a group of 121 FGID patients, and compared the results with findings from a group of 116 IBD patients and a group of 112 healthy subjects. Method: The subjects completed the 20-item Toronto Alexithymia Scale and the Hospital Anxiety and Depression Scale. Results: The FGID group was significantly more alexithymic than the IBD group, and the two gastrointestinal groups were more alexithymic than the normal healthy group. These differences remained even after controlling for the influence of education, gender, anxiety, depression and gastrointestinal symptoms. Conclusions: The finding of a high rate of alexithymia (66%) in the group of FGID patients is consistent with the propensity of these patients to somatization and to high levels of poorly differentiated psychological distress.

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Section: Discussioncontrasting

confidence: 99%

Alexithymia and Functional Gastrointestinal Disorders

Porcelli

Taylor

Bagby

et al. 1999

Psychother Psychosom

107

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“…[13][14][15][16][17] Previously, it has been reported that nursing professionals who participate in a rotating shift schedule are at a higher risk of psychosocial problems than are those who work the day shift. 18 However, the role of psychosocial risk in shift-working professionals in the development of FGIDs remains obscure.…”

Section: Discussionmentioning

confidence: 99%

Psychosocial Stress in Nurses With Shift Work Schedule Is Associated With Functional Gastrointestinal Disorders

Koh¹,

Kim²,

Oh³

et al. 2014

J Neurogastroenterol Motil

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Background/Aims The aim of this study was to investigate the role of psychosocial problems and their associations with rotating shift work in the development of functional gastrointestinal disorders. Methods In this cross-sectional observation study, survey was administered to nurses and nurse assistants in a referral hospital. In addition to demographic questions, subjects were asked to complete the Rome III Questionnaire, Pittsburgh Sleep Quality Index and Rome III Psychosocial Alarm Questionnaire. Results Responses from 301 subjects were assessed. The overall prevalence of irritable bowel syndrome (IBS) and functional dyspepsia (FD) were 15.0% and 19.6%, respectively. Psychosocial alarms were prevalent in the nursing personnel (74.8% with alarm presence and 23.3% with serious condition) and were more frequent among rotating shift workers (84.7% vs. 74.5% for alarm presence and 28.1% vs. 13.3% for serious condition). The prevalence of both IBS and FD significantly increased with psychosocial risk. An independent risk factor for IBS was serious psychosocial alarm (adjusted odds ratio [aOR], 10.75; 95% confidence interval (CI), 1.30–88.99; P = 0.028). Serious psychosocial alarm was an independent risk factor for FD (aOR, 7.84; 95% CI, 1.98–31.02; P = 0.003). Marriage (aOR 0.30; 95% CI, 0.09–0.93; P = 0.037) was associated with the decreased risk of FD. Conclusions The high prevalence of psychosocial stress among nurses who work rotating shifts is associated with the development of functional gastrointestinal disorders.

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“…† Distilled water (100 l͞10 ml). (20-22) is complicated by symptomatic association to psychological disorders (28)(29)(30)(31). Disturbances in gut and the brain 5-HT account for the majority of intestinal and psychological illnesses (4).…”

Section: Discussionmentioning

confidence: 99%

l -Lysine acts like a partial serotonin receptor 4 antagonist and inhibits serotonin-mediated intestinal pathologies and anxiety in rats

Smriga

Torii

2003

Proc. Natl. Acad. Sci. U.S.A.

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S tress and stress-induced anxiety play a major role in functional intestinal disorders (1). The stimulation of intestinal contraction and colonic transit are the most consistent patterns in the motility response of the intestinal tract to acute stress (2, 3); however, the stress-gut interactions are enormously complex (1). Both stress-induced anxiety and intestinal disorders are traced, from among other molecular pathologies, to the inappropriate responses of the central and͞or peripheral serotonin (5-HT) system (4, 5). Among the 5-HT receptors, the 5-HT 4 receptor plays a ''prostress'' role in the gut and throughout the body by mobilizing energy and facilitating behavioral, gastrointestinal, and cardiovascular stress responses (6, 7).5-HT 4 receptors are located within the cells and neurons of the gastrointestinal tract (6,8). Agonists on the 5-HT 4 receptor increase cholinergic transmission (9) and thus contract the smooth muscle in the rat and guinea pig ileum † and the human colon (11). Antagonists on the 5-HT 4 receptor do not affect normal, healthy gut function (12) but prevent the disturbances caused by stress (4) or high 5-HT activity (13). Thus, 5-HT 4 receptor antagonists are promising targets for the treatment of diarrhea-predominant irritable bowel syndrome (12). In addition to their effect on the gastrointestinal tract, 5-HT 4 antagonists block corticosteroid secretion in the adrenal cortex (14), 5-HTinduced tachycardia (15, 16), and stress-induced anxiety (17).However, the 5-HT receptor system is heterogeneous (18), and direct receptor targeting often causes side effects, such as diarrhea, gastric bleeding, and anxiety (19). Therefore, it is not surprising that few satisfying pharmacological treatments of stress-triggered, 5-HT-mediated intestinal disorders exist and that other therapeutic approaches, namely nutritional ones, are sought (20)(21)(22)). An interesting candidate to include in ''nutritional management'' of stress-related gastrointestinal disorders would be an essential amino acid, L-lysine (Lys). Lys blunted stress-induced anxiety in rats (23), whereas a dietary deficiency of Lys increased stress-induced colonic transit and anxiety, because of an enhanced transmission of 5-HT in the amygdala (24).Because the effects of Lys overlap with the ''antistress'' effects of the 5-HT 4 receptor antagonists (4), we hypothesized that dietary Lys could act as a partial antagonist on the 5-HT 4 receptors. The present study examined whether the provision of oral L-lysine might result in the blockage of 5-HT-mediated pathologies linked to stress exposure and͞or 5-HT sensitization in rats. Ileum contractions, stress-induced fecal excretion, diarrhea, anxiety, and tachycardia were monitored. The fractions obtained were washed once by centrifugation with 10-fold volume of the buffer, and the microsomal fraction was stored as receptor at Ϫ80°C until use. To determine the binding degree, the inhibition rate of Lys and a positive reference substance were calculated from binding of a tracer to a receptor. D...

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The role of anxiety and depression in the irritable bowel syndrome

Cited by 156 publications

References 13 publications

Alexithymia and Functional Gastrointestinal Disorders

Alexithymia and Functional Gastrointestinal Disorders

Psychosocial Stress in Nurses With Shift Work Schedule Is Associated With Functional Gastrointestinal Disorders

l -Lysine acts like a partial serotonin receptor 4 antagonist and inhibits serotonin-mediated intestinal pathologies and anxiety in rats

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