Outcome in severe irritable bowel syndrome with and without accompanying depressive, panic and neurasthenic disorders

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Abstract
Background Irritable bowel syndrome often leads to impaired functioning. Aims To assess the contribution of psychiatric disorders to impaired outcome in severe irritable bowel syndrome. Method Patients with severe irritable bowel syndrome entering a psychological treatment trial ( n =257) were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry. Outcomes were number of days of restricted activity, role limitation (physical) score of the Short Form Health Survey and costs. Results At baseline, depressive disorder (29% of patients), panic (12%) and neurasthenia (35%) were associated with impairment; number of psychiatric disorders was associated in a dose-response fashion ( P =0.005). At follow-up, depressive disorder and neurasthenia were associated with role limitation score. Improved depression was associated with improved role functioning. Conclusions Depressive, panic and neurasthenic disorders contribute to poor outcomes in severe irritable bowel syndrome, and appropriate treatment should be available to these patients.