Irritable bowel symptoms and the development of common mental disorders and functional somatic syndromes identified in secondary care: a long-term, population-based study

Chalotte Heinsvig Poulsen; Lene Falgaard Eplov; Carsten Hjorthøj; Marie Eliasen; Sine Skovbjerg; Thomas Meinertz Dantoft; Andreas Schröder; Torben Jørgensen

doi:10.2147/CLEP.S141344

Irritable bowel symptoms and the development of common mental disorders and functional somatic syndromes identified in secondary care: a long-term, population-based study

Chalotte Heinsvig Poulsen^*, Lene Falgaard Eplov, Carsten Hjorthøj, Marie Eliasen, Sine Skovbjerg, Thomas Meinertz Dantoft, Andreas Schröder, Torben Jørgensen

^*Corresponding author af dette arbejde

Institut for Folkesundhedsvidenskab

3 Citationer (Scopus)

66 Downloads (Pure)

Abstract

Objective: Irritable bowel syndrome (IBS) is associated with mental vulnerability, and half of patients report comorbid somatic and mental symptoms. We aimed to investigate the relationship between an IBS symptom continuum and the subsequent development of common mental disorders (CMDs) and functional somatic syndromes (FSSs). Methods and study design: A longitudinal population-based study comprising two 5-year follow-up studies, Dan-MONICA 1 (1982-1987) and Inter99 (1999-2004), recruited from the western part of Copenhagen County. The total study population (n = 7,278) was divided into symptom groups according to the degree of IBS definition fulfillment at baseline and/or follow-up and was followed until December 2013 in Danish central registries. Cox regression was used for the analyses, adjusting for age, sex, length of education and cohort membership. In a subsequent analysis, we adjusted for mental vulnerability as a risk factor for both CMDs and FSSs, including IBS. Results: Over a 5-year period, 51% patients had no IBS symptoms, 17% patients had IBS symptoms without abdominal pain, 22% patients had IBS symptoms including abdominal pain and 10% patients fulfilled the IBS definition. IBS and IBS symptoms including abdominal pain were significantly associated with the development of CMDs and other FSSs identified in secondary care. When adjusting for mental vulnerability, IBS and IBS symptoms including abdominal pain were no longer associated with CMDs, but the significant relationship to other FSSs remained. Conclusion: In a clinical setting, the perspective should be broadened to individuals not fulfilling the symptom cluster of IBS but who report frequent abdominal pain. Additionally, it is important to combine symptom-based criteria of IBS with psychosocial markers such as mental vulnerability, because it could guide clinicians in decisions regarding prognosis and treatment.

Originalsprog	Engelsk
Tidsskrift	Clinical Epidemiology
Vol/bind	9
Sider (fra-til)	393-402
ISSN	1179-1349
DOI	https://doi.org/10.2147/CLEP.S141344
Status	Udgivet - 2017

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10.2147/CLEP.S141344Licens: CC BY-NC

CLEP-141344-irritable-bowel-symptoms-and-the-development-of-common-menta_073117Forlagets udgivne version, 177 KBLicens: CC BY-NC

Citationsformater

Poulsen, C. H., Eplov, L. F., Hjorthøj, C., Eliasen, M., Skovbjerg, S., Dantoft, T. M., Schröder, A., & Jørgensen, T. (2017). Irritable bowel symptoms and the development of common mental disorders and functional somatic syndromes identified in secondary care: a long-term, population-based study. Clinical Epidemiology, 9, 393-402. https://doi.org/10.2147/CLEP.S141344

Irritable bowel symptoms and the development of common mental disorders and functional somatic syndromes identified in secondary care : a long-term, population-based study. / Poulsen, Chalotte Heinsvig; Eplov, Lene Falgaard; Hjorthøj, Carsten et al.

I: Clinical Epidemiology, Bind 9, 2017, s. 393-402.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

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title = "Irritable bowel symptoms and the development of common mental disorders and functional somatic syndromes identified in secondary care: a long-term, population-based study",

abstract = "Objective: Irritable bowel syndrome (IBS) is associated with mental vulnerability, and half of patients report comorbid somatic and mental symptoms. We aimed to investigate the relationship between an IBS symptom continuum and the subsequent development of common mental disorders (CMDs) and functional somatic syndromes (FSSs). Methods and study design: A longitudinal population-based study comprising two 5-year follow-up studies, Dan-MONICA 1 (1982-1987) and Inter99 (1999-2004), recruited from the western part of Copenhagen County. The total study population (n = 7,278) was divided into symptom groups according to the degree of IBS definition fulfillment at baseline and/or follow-up and was followed until December 2013 in Danish central registries. Cox regression was used for the analyses, adjusting for age, sex, length of education and cohort membership. In a subsequent analysis, we adjusted for mental vulnerability as a risk factor for both CMDs and FSSs, including IBS. Results: Over a 5-year period, 51% patients had no IBS symptoms, 17% patients had IBS symptoms without abdominal pain, 22% patients had IBS symptoms including abdominal pain and 10% patients fulfilled the IBS definition. IBS and IBS symptoms including abdominal pain were significantly associated with the development of CMDs and other FSSs identified in secondary care. When adjusting for mental vulnerability, IBS and IBS symptoms including abdominal pain were no longer associated with CMDs, but the significant relationship to other FSSs remained. Conclusion: In a clinical setting, the perspective should be broadened to individuals not fulfilling the symptom cluster of IBS but who report frequent abdominal pain. Additionally, it is important to combine symptom-based criteria of IBS with psychosocial markers such as mental vulnerability, because it could guide clinicians in decisions regarding prognosis and treatment.",

keywords = "Abdominal pain, Comorbidity, Functional gastrointestinal symptoms, Neuroticism, Somatization",

author = "Poulsen, {Chalotte Heinsvig} and Eplov, {Lene Falgaard} and Carsten Hjorth{\o}j and Marie Eliasen and Sine Skovbjerg and Dantoft, {Thomas Meinertz} and Andreas Schr{\"o}der and Torben J{\o}rgensen",

year = "2017",

doi = "10.2147/CLEP.S141344",

language = "English",

volume = "9",

pages = "393--402",

journal = "Clinical Epidemiology",

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TY - JOUR

T1 - Irritable bowel symptoms and the development of common mental disorders and functional somatic syndromes identified in secondary care

T2 - a long-term, population-based study

AU - Poulsen, Chalotte Heinsvig

AU - Eplov, Lene Falgaard

AU - Hjorthøj, Carsten

AU - Eliasen, Marie

AU - Skovbjerg, Sine

AU - Dantoft, Thomas Meinertz

AU - Schröder, Andreas

AU - Jørgensen, Torben

PY - 2017

Y1 - 2017

N2 - Objective: Irritable bowel syndrome (IBS) is associated with mental vulnerability, and half of patients report comorbid somatic and mental symptoms. We aimed to investigate the relationship between an IBS symptom continuum and the subsequent development of common mental disorders (CMDs) and functional somatic syndromes (FSSs). Methods and study design: A longitudinal population-based study comprising two 5-year follow-up studies, Dan-MONICA 1 (1982-1987) and Inter99 (1999-2004), recruited from the western part of Copenhagen County. The total study population (n = 7,278) was divided into symptom groups according to the degree of IBS definition fulfillment at baseline and/or follow-up and was followed until December 2013 in Danish central registries. Cox regression was used for the analyses, adjusting for age, sex, length of education and cohort membership. In a subsequent analysis, we adjusted for mental vulnerability as a risk factor for both CMDs and FSSs, including IBS. Results: Over a 5-year period, 51% patients had no IBS symptoms, 17% patients had IBS symptoms without abdominal pain, 22% patients had IBS symptoms including abdominal pain and 10% patients fulfilled the IBS definition. IBS and IBS symptoms including abdominal pain were significantly associated with the development of CMDs and other FSSs identified in secondary care. When adjusting for mental vulnerability, IBS and IBS symptoms including abdominal pain were no longer associated with CMDs, but the significant relationship to other FSSs remained. Conclusion: In a clinical setting, the perspective should be broadened to individuals not fulfilling the symptom cluster of IBS but who report frequent abdominal pain. Additionally, it is important to combine symptom-based criteria of IBS with psychosocial markers such as mental vulnerability, because it could guide clinicians in decisions regarding prognosis and treatment.

AB - Objective: Irritable bowel syndrome (IBS) is associated with mental vulnerability, and half of patients report comorbid somatic and mental symptoms. We aimed to investigate the relationship between an IBS symptom continuum and the subsequent development of common mental disorders (CMDs) and functional somatic syndromes (FSSs). Methods and study design: A longitudinal population-based study comprising two 5-year follow-up studies, Dan-MONICA 1 (1982-1987) and Inter99 (1999-2004), recruited from the western part of Copenhagen County. The total study population (n = 7,278) was divided into symptom groups according to the degree of IBS definition fulfillment at baseline and/or follow-up and was followed until December 2013 in Danish central registries. Cox regression was used for the analyses, adjusting for age, sex, length of education and cohort membership. In a subsequent analysis, we adjusted for mental vulnerability as a risk factor for both CMDs and FSSs, including IBS. Results: Over a 5-year period, 51% patients had no IBS symptoms, 17% patients had IBS symptoms without abdominal pain, 22% patients had IBS symptoms including abdominal pain and 10% patients fulfilled the IBS definition. IBS and IBS symptoms including abdominal pain were significantly associated with the development of CMDs and other FSSs identified in secondary care. When adjusting for mental vulnerability, IBS and IBS symptoms including abdominal pain were no longer associated with CMDs, but the significant relationship to other FSSs remained. Conclusion: In a clinical setting, the perspective should be broadened to individuals not fulfilling the symptom cluster of IBS but who report frequent abdominal pain. Additionally, it is important to combine symptom-based criteria of IBS with psychosocial markers such as mental vulnerability, because it could guide clinicians in decisions regarding prognosis and treatment.

KW - Abdominal pain

KW - Comorbidity

KW - Functional gastrointestinal symptoms

KW - Neuroticism

KW - Somatization

U2 - 10.2147/CLEP.S141344

DO - 10.2147/CLEP.S141344

M3 - Journal article

C2 - 28814899

AN - SCOPUS:85028605900

SN - 1179-1349

VL - 9

SP - 393

EP - 402

JO - Clinical Epidemiology

JF - Clinical Epidemiology

ER -

Irritable bowel symptoms and the development of common mental disorders and functional somatic syndromes identified in secondary care: a long-term, population-based study

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