The Impact of Physical Complaints, Social Environment, and Psychological Functioning on IBS Patients’ Health Perceptions: Looking Beyond GI Symptom Severity

In the absence of a reliable biomarker, clinical decisions for a functional gastrointestinal (GI) disorder like irritable bowel syndrome (IBS) depend on asking patients to appraise and communicate their health status. Self-ratings of health (SRH) have proven a powerful and consistent predictor of he...

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Vydáno v:The American journal of gastroenterology Ročník 109; číslo 2; s. 224 - 233
Hlavní autoři: Lackner, Jeffrey M, Gudleski, Gregory D, Thakur, Elyse R, Stewart, Travis J, Iacobucci, Gary J, Spiegel, Brennan MR
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins 01.02.2014
Témata:
Adult
Age Distribution
Anxiety - epidemiology
Anxiety - psychology
Cross-Sectional Studies
Depressive Disorder - diagnosis
Depressive Disorder - epidemiology
Diagnostic Self Evaluation
Fatigue - epidemiology
Fatigue - psychology
Female
Gastroenterology
Humans
Irritable Bowel Syndrome - epidemiology
Irritable Bowel Syndrome - physiopathology
Irritable Bowel Syndrome - psychology
Male
Middle Aged
Prognosis
Psychiatric Status Rating Scales
Psychology
Quality of Life
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Sex Distribution
Sickness Impact Profile
Social Environment
Somatoform Disorders - epidemiology
Somatoform Disorders - psychology
Surveys and Questionnaires
Young Adult
ISSN:0002-9270, 1572-0241, 1572-0241
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Shrnutí:In the absence of a reliable biomarker, clinical decisions for a functional gastrointestinal (GI) disorder like irritable bowel syndrome (IBS) depend on asking patients to appraise and communicate their health status. Self-ratings of health (SRH) have proven a powerful and consistent predictor of health outcomes, but little is known about how they relate to those relevant to IBS (e.g., quality of life (QOL), IBS symptom severity). This study examined what psychosocial factors, if any, predict SRH among a cohort of more severe IBS patients. Subjects included 234 Rome III-positive IBS patients (mean age=41 years, female=78%) without comorbid organic GI disease. Subjects were administered a test battery that included the IBS Symptom Severity Scale, Screening for Somatoform Symptoms, IBS Medical Comorbidity Inventory, SF-12 Vitality Scale, Perceived Stress Scale, Beck Depression Inventory, Trait Anxiety Inventory, and Negative Interactions Scale. Partial correlations identified somatization, depression, fatigue, stress, anxiety, and medical comorbidities as variables with the strongest correlations with SRH (r values=0.36-0.41, P values <0.05). IBS symptom severity was weakly associated with SRH (r=0.18, P<0.05). The final regression model explained 41.3% of the variance in SRH scores (F=8.49, P<0.001) with significant predictors including fatigue, medical comorbidities, somatization, and negative social interactions. SRH are associated with psychological (anxiety, stress, depression), social (negative interactions), and extraintestinal somatic factors (fatigue, somatization, medical comorbidities). The severity of IBS symptoms appears to have a relatively modest role in how IBS patients describe their health in general.
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ISSN:0002-9270
1572-0241
1572-0241
DOI:10.1038/ajg.2013.410