Quality of life, interactions with psychological status and psychiatric comorbidities in patients of irritable bowel syndrome

Aim: It is a common opinion that there is an interaction between psychological distresses and irritable bowel syndrome (IBS) which is very common in the population. Depression and anxiety have been frequently found as accompanying psychiatric symptoms/disorders. However, there is not enough research which compares depression, anxiety and quality of life together in a sole patient group.In this study, psychiatric comorbidities in the IBS group (n=35) and IBS comorbidities in the depression group (n=35) and anxiety group (n=34) have been investigated. IBS group was also compared with healthy control group (n=35) about the effects of comorbid psychological status on quality of life. Method: Patient groups (patients diagnosed as IBS in the Gastroenterology Outpatient Clinic, and patients diagnosed as generalized anxiety disorder and depression in the PsychiatryClinics of the Medical Faculty of Abant Izzet Baysal University) and the healthy control group were matched for age and gender. Symptom Checklist-90-R (SCL-90-R), Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A)scales, a list of gastrointestinal system symptoms and MINI neuropsychiatric interview were performed in all participants. Then, all participants were evaluated by MINI for psychiatric diagnoses. Depression and anxiety disorder patients having gastrointestinal symptoms were directed to the gastroenterology outpatient clinic for evaluation of IBS. WHO Quality of Life-BREF (WHOQOL-BREF TR scale) was used for surveying deterioration of health-related quality of life.Results: Psychiatric comorbidities were detected approximately in half of the IBS patients(%48.6). %22.9 of them had more than one psychiatric disorder and themost frequent disorder was generalized anxiety disorder (%64.7). Also, about half of the patients with depression (%48.5) and anxiety disorder (%44.1) had complaints of gastrointestinal system. Anxiety and IBS groups overlapped in all symptoms. There were no siginificant differences between the symptoms, except for the severity of vianxiety. Depression (HAM-D) and anxiety (HAM-A) scores in IBS group were significantly higher than control group. IBS patients obtained significantly lower scores from control group on physical, psychological and social sub-scales of WHOQOL-Bref however there was no significant difference on the scores of environmental life quality. IBS patients withpsychiatric comorbidities showed significanltly lower scoresin terms of physical and psychological sub-scales of quality of life. After the regression analysis, it was noticed that depression strongly, anxiety disorders moderately and severity of gastrointestinal system complains slightly predicted lower quality of life. Conclusion: Clinical findings validated the interaction between IBS and psychiatric disorders. We found that, many clinical components of IBS and anxiety overlapped. According to the WHOQOL-Bref scale, IBS resulted in lower quality of life on the physical, psychological and social areas. IBS was similar to anxiety disorders in terms of lowering quality of life. Although psychiatric comorbidities do not affect the severity of gastrointestinal symptoms, they ultimately decrease the quality of life