TITLE

The cognitive behavioural model of irritable bowel syndrome: a prospective investigation of patients with gastroenteritis

AUTHOR(S)
Spence, Meagan J.; Moss-Morris, Rona
PUB. DATE
August 2007
SOURCE
Gut;Aug2007, Vol. 56 Issue 8, p1066
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Aim: To determine whether a combination of mood and personality factors together with illness beliefs and behaviours predict the onset of irritable bowel syndrome (IBS) post gastroenteritis, as suggested by the cognitive behavioural model of lBS. Methods: Primary care patients with a positive test for Campylobacter gastroenteritis, and no previous history of lBS or serious bowel conditions were recruited into this prospective study (n = 620). Participants completed a questionnaire at the time of infection, which included standardised measures of mood, perceived stress, perfectionism, negative illness beliefs and illness behaviours. Participants completed follow-up questionnaires designed to determine whether they met the Rome criteria for lBS 3 and 6 months after initial infection. Results: A total of 49 participants met the criteria for lBS at both follow-up points. Logistic regressions indicated that those who developed lBS had significantly higher levels of perceived stress (1.10, 95% Cl 1.02 to -1.15), anxiety (1 .14, 95% Cl 1 .05 to 1 .23), somatisation (1 .17, 95% Cl 1 .02 to 1 .35) and negative illness beliefs (1.14, 95% Cl 1.03 to 1.27) at the time of infection than those who did not develop lBS. Patients with lBS were also significantly more likely to remain active in the face of their acute symptoms until they felt forced to rest (all-or-nothing behaviour) (1.09, 95% Cl 1.03 to 1.16), and significantly less likely to initially rest in response to their acute illness (0.93, 95% Cl 0.88 to 0.97). Depression and perfectionism were not associated with the onset of lBS. Conclusions: Results suggest that patients with high stress and anxiety levels are more prone to develop lBS after a bout of gastroenteritis. Additional risk factors include a tendency to interpret illness in a pessimistic fashion and to respond to symptoms in an all-or-nothing manner.
ACCESSION #
25972133

 

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