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Psychiatric symptoms inconsistently predict health care use for patients with IBS
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Patients with irritable bowel syndrome and psychiatric comorbidities are more likely to seek psychiatric care but not gastrointestinal care when they also have extra-gastrointestinal symptoms, according to study results.
Michael P. Jones, PhD, of the department of psychology at Macquarie University, in Australia, and colleagues wrote that the health care demands of individuals with IBS is disproportionate compared with the general population, with an estimated annual cost per patient of $7,547 in the United States. However, their GI symptoms alone cannot predict health care use.
“The remaining variance is thought to be associated with a variety of lifestyle and psychological factors such as elevated stress, co-morbidity, history of abuse and lower education level,” they wrote. “There is, however, mixed evidence regarding how strongly psychological factors predict health care utilization in IBS sufferers.”
Researchers performed a population-based prospective study of health care use in Sweden over a 12-year period to explore whether psychological factors increase health use among patients with IBD, as well as the impact of extra-GI symptoms.
At baseline between 2002 and 2006, patients underwent an examination with a GI and completed questionnaires, including the Rome II modular questionnaire. Researchers used the Hospital Anxiety and Depression scale to evaluate psychological factors and measured extra-GI symptoms with a symptom checklist.
Investigators matched responses from 1,159 individuals with health records from 2016. They identified 164 patients with IBS based on Rome II criteria.
Among patients with IBS, researchers found that higher depression is associated with increased number of inpatient GI visits, while higher anxiety is related to a lower probability of seeking psychiatric consultations.
Jones and colleagues found that having extra-GI symptoms at baseline strengthened the relationship between anxiety or depression and psychiatric visits among patients with and without IBS. However, extra-GI symptoms did not make individuals more likely to seek GI health care.
“Our data highlight that anxiety and depressive symptoms at baseline inconsistently predict medical consultations over a 12-year period, with some increasing health care utilization, while others lead to reduced tendency to seek help,” Jones and colleagues wrote. “Further, individuals with high baseline anxiety or depression are more likely to receive a psychiatric diagnosis in the presence of extra-GI symptoms, but not GI or extra-GI diagnoses. This reinforces the importance of a comprehensive assessment of psychological and extra-GI symptoms in subjects with IBS.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.
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