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Psychosocial risk markers for new onset irritable bowel syndrome--results of a large prospective population-based study.

Abstract

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.

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  • Authors+Show Affiliations

    ,

    Arthritis Research Campaign (ARC) Epidemiology Unit, School of Translational Medicine, Stopford Building, University of Manchester, Oxford Road, Manchester M13 9PT, United Kingdom.

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    Source

    Pain 137:1 2008 Jul pg 147-55

    MeSH

    Adult
    Aged
    Female
    Follow-Up Studies
    Humans
    Irritable Bowel Syndrome
    Male
    Middle Aged
    Population
    Prospective Studies
    Psychiatric Status Rating Scales
    Risk Factors
    Sickness Impact Profile
    Stress, Psychological
    Surveys and Questionnaires
    Time Factors

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    17928145

    Citation

    Nicholl, B I., et al. "Psychosocial Risk Markers for New Onset Irritable Bowel Syndrome--results of a Large Prospective Population-based Study." Pain, vol. 137, no. 1, 2008, pp. 147-55.
    Nicholl BI, Halder SL, Macfarlane GJ, et al. Psychosocial risk markers for new onset irritable bowel syndrome--results of a large prospective population-based study. Pain. 2008;137(1):147-55.
    Nicholl, B. I., Halder, S. L., Macfarlane, G. J., Thompson, D. G., O'Brien, S., Musleh, M., & McBeth, J. (2008). Psychosocial risk markers for new onset irritable bowel syndrome--results of a large prospective population-based study. Pain, 137(1), pp. 147-55.
    Nicholl BI, et al. Psychosocial Risk Markers for New Onset Irritable Bowel Syndrome--results of a Large Prospective Population-based Study. Pain. 2008;137(1):147-55. PubMed PMID: 17928145.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Psychosocial risk markers for new onset irritable bowel syndrome--results of a large prospective population-based study. AU - Nicholl,B I, AU - Halder,S L, AU - Macfarlane,G J, AU - Thompson,D G, AU - O'Brien,S, AU - Musleh,M, AU - McBeth,J, Y1 - 2007/10/10/ PY - 2007/03/22/received PY - 2007/08/14/revised PY - 2007/08/21/accepted PY - 2007/10/12/pubmed PY - 2008/12/17/medline PY - 2007/10/12/entrez SP - 147 EP - 55 JF - Pain JO - Pain VL - 137 IS - 1 N2 - 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. SN - 1872-6623 UR - https://www.unboundmedicine.com/medline/citation/17928145/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0304-3959(07)00465-4 DB - PRIME DP - Unbound Medicine ER -