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Psychosocial factors are linked to functional gastrointestinal disorders: a population based nested case-control study.

Abstract

BACKGROUND

It is widely accepted based on volunteer studies that levels of psychological distress are similar in those with functional gastrointestinal (GI) disorders and health in the community, while increased psychological distress in outpatients is largely explained by health-care seeking.

AIMS

To determine if psychological distress, life event stress, or social support is associated with functional GI disorders in a population-based study.

METHODS

A nested case-control study was performed by first mailing a self-report bowel disease questionnaire to a random sample of Olmsted County, Minnesota, aged 20-50 yr. All persons who reported symptoms of nonulcer dyspepsia (NUD) or irritable bowel syndrome (IBS) (cases), or an absence of GI symptoms (controls), were invited to complete a series of validated questionnaires designed to measure psychological distress, life event stress, social support, current symptoms, and physician visits.

RESULTS

103 subjects with functional GI disorders and 119 controls participated (85% of eligible). Functional GI disorders were more likely to be reported by those with higher scores on each of the nine SCL-90-R scales used to measure psychological distress (except phobic anxiety), and those with more negative and total life event stress. In a multiple logistic regression model (including age and gender), somatization, interpersonal sensitivity, and total life event stress were independently associated with functional GI disorders. Findings were similar when subjects with the IBS and NUD were analyzed separately compared to controls.

CONCLUSIONS

Contrary to current dogma, psychosocial factors were significantly associated with functional GI disorders in this community sample. This suggests that these factors may be involved in the etiopathogenesis rather than just driving health-care utilization.

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  • Authors+Show Affiliations

    ,

    Division of Gastroenterology and Internal Medicine, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota 55905, USA.

    , ,

    Source

    MeSH

    Adult
    Case-Control Studies
    Female
    Gastrointestinal Diseases
    Humans
    Life Change Events
    Male
    Middle Aged
    Social Support
    Stress, Psychological

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    15046228

    Citation

    Locke, G Richard, et al. "Psychosocial Factors Are Linked to Functional Gastrointestinal Disorders: a Population Based Nested Case-control Study." The American Journal of Gastroenterology, vol. 99, no. 2, 2004, pp. 350-7.
    Locke GR, Weaver AL, Melton LJ, et al. Psychosocial factors are linked to functional gastrointestinal disorders: a population based nested case-control study. Am J Gastroenterol. 2004;99(2):350-7.
    Locke, G. R., Weaver, A. L., Melton, L. J., & Talley, N. J. (2004). Psychosocial factors are linked to functional gastrointestinal disorders: a population based nested case-control study. The American Journal of Gastroenterology, 99(2), pp. 350-7.
    Locke GR, et al. Psychosocial Factors Are Linked to Functional Gastrointestinal Disorders: a Population Based Nested Case-control Study. Am J Gastroenterol. 2004;99(2):350-7. PubMed PMID: 15046228.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Psychosocial factors are linked to functional gastrointestinal disorders: a population based nested case-control study. AU - Locke,G Richard,3rd AU - Weaver,Amy L, AU - Melton,L Joseph,3rd AU - Talley,Nicholas J, PY - 2004/3/30/pubmed PY - 2004/5/7/medline PY - 2004/3/30/entrez SP - 350 EP - 7 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 99 IS - 2 N2 - BACKGROUND: It is widely accepted based on volunteer studies that levels of psychological distress are similar in those with functional gastrointestinal (GI) disorders and health in the community, while increased psychological distress in outpatients is largely explained by health-care seeking. AIMS: To determine if psychological distress, life event stress, or social support is associated with functional GI disorders in a population-based study. METHODS: A nested case-control study was performed by first mailing a self-report bowel disease questionnaire to a random sample of Olmsted County, Minnesota, aged 20-50 yr. All persons who reported symptoms of nonulcer dyspepsia (NUD) or irritable bowel syndrome (IBS) (cases), or an absence of GI symptoms (controls), were invited to complete a series of validated questionnaires designed to measure psychological distress, life event stress, social support, current symptoms, and physician visits. RESULTS: 103 subjects with functional GI disorders and 119 controls participated (85% of eligible). Functional GI disorders were more likely to be reported by those with higher scores on each of the nine SCL-90-R scales used to measure psychological distress (except phobic anxiety), and those with more negative and total life event stress. In a multiple logistic regression model (including age and gender), somatization, interpersonal sensitivity, and total life event stress were independently associated with functional GI disorders. Findings were similar when subjects with the IBS and NUD were analyzed separately compared to controls. CONCLUSIONS: Contrary to current dogma, psychosocial factors were significantly associated with functional GI disorders in this community sample. This suggests that these factors may be involved in the etiopathogenesis rather than just driving health-care utilization. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/15046228/full_citation L2 - http://Insights.ovid.com/pubmed?pmid=15046228 DB - PRIME DP - Unbound Medicine ER -