[The relation between irritable bowel syndrome and a major depression].

It has been demonstrated that physical or psychological stress induces dysfunction of bowel movement and intestinal transit in rodents and human. There have been several reports concerning the psychiatric factors involved in the onset and clinical course of irritable bowel syndrome (IBS). We investigated patients with IBS who had been markedly disturbed in their daily life, and it was concluded that the most important psychiatric factor related to the onset and the clinical course of severely impaired IBS is a major depression, fulfilling the criteria of the DSM-III-R. Especially, in diarrhea predominant type of IBS, a major depression was considered to be strongly involved in the onset and the clinical course of IBS. Most of IBS patients with a major depression can be effectively treated with antidepressants and brief psychotherapy. Concerning treatment, the psychological background should be carefully considered.