[Depressive and anxiety symptoms, coping strategies in patients with irritable bowel syndrome and inflammatory bowel disease].

INTRODUCTION

Psychological factors play an important role in the etiopathogenesis of functional gastrointestinal disorders, like irritable bowel syndrome. In our study we compared certain psychological characteristics of patients suffering from functional and organic gastrointestinal disorders and healthy subjects.

METHODS

Age and gender matched irritable bowel syndrome and inflammatory bowel disease patients and healthy subjects were compared on their depressive symptoms (Beck Depression Inventory), anxiety symptoms (Spielberger State-Trait Anxiety Inventory) and coping strategies (Folkman-Lazarus Ways of Coping Questionnaire).

RESULTS

GI patients groups were characterized by significantly more severe depressive and anxiety symptoms and by the prevalence of passive coping strategies. On the Beck Depression Inventory "Performance Difficulty" and "Somatic Symptoms" subscales, significant differences were observed between patients and healthy subjects, while on the "Negative affect" subscale, only IBS patients but not IBD patients scored significantly higher compared to healthy subjects. The functional GI group showed significantly more severe depressive and also more severe anxiety symptoms, but this latter did not reach statistical significance. No differences were detected regarding the use of coping strategies.

DISCUSSION

Psychological screening and psychological and/or pharmacological interventions are recommended for GI patients, at least in the most severe and treatment resistant cases. Differences between IBS and IBD groups underline the importance of the increased psychic vulnerability of functional GI patients and emphasize the role of affective components in the etiopathogenesis of the disorder. Future studies should be directed toward the assessment of disease-specific psychic characteristics (e.g. pain-coping strategies, cognitive schemas), subjective symptom experience and illness-behavior.