فهرست مطالب farnaz torkzadeh

Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders with signifcant impact on quality of life (QOL). Considering the role of stress in the clinical course of IBS, we investigated associations between stress coping skills and symptoms and QOL in IBS patient. A cross‑sectional study was conducted on 95 IBS patients referring to tertiary care centers. Coping skills (Jalowiec coping scale), IBS symptom severity scale, disease‑specifc QOL (IBS‑QOL), and symptoms of depression and anxiety (Hospital Anxiety and Depression Scale [HADS]) were evaluated by questionnaires. Bivariate and multivariate analyses were performed to investigate association among these parameters. Disease severity was positively correlated with emotive (r = 0.30) and fatalistic (r = 0.41) and negatively correlated with optimistic (r = -0.25) and confrontive (r = -0.24) coping strategies. Psychological dysfunction (total HADS score, B [95% (confdence interval) CI] = 2.61 [0.001–5.21]) and fatalistic coping (B [95% CI] = 35.27 [0.42–70.13]) were signifcant predictors of IBS severity. However, IBS patients involved in this study utilized adaptive coping strategies more frequently. Our study showed that use of maladaptive coping strategies had positive correlation with symptom severity and degree of anxiety and depression among patients, while implementation of optimistic strategies were found to be negatively correlated to severity of symptoms and also utilization of adaptive coping styles was associated with lesser degree of anxiety and depression.

 Inflammatory bowel diseases (IBD) are chronic diseases with significant impact on patients' well-being. The aim of this study was to determine stress coping strategies in IBD patients and their association with disease activity, psychological health, and quality of life (QOL).

 This cross-sectional study was conducted on IBD patients referred to a gastroenterology clinic in Isfahan city (Iran). Disease activity, severity of anxiety and depression symptoms, stress coping strategies, and QOL were assessed using self-administered questionnaires. Coping strategies in IBD patients were compared to an unaffected control group.

 In the present study, 80 patients with mean age of 52.9 years (57.5% female) and mean disease duration of 6.5 years were studied. Compared to the controls, IBD patients had higher scores in the maladaptive coping styles (evasive and palliative) (P < 0.05). Association between coping strategies and disease activity was not significant. Severity of anxiety and depression was directly correlated with the maladaptive strategies (fatalistic and emotional) (r = 0.283 to 0.468) and inversely correlated with the adaptive strategies (confrontive, optimistic, and self-reliant) (r = -0.320 to -0.534). In addition, QOL was inversely correlated with the maladaptive strategies (fatalistic and emotional) (r = -0.278 to -0.327) and directly correlated with the adaptive strategies (confrontive and optimistic) (r = 0.262 to 0.355).

 Patients with IBD use more maladaptive and less adaptive stress coping strategies which are associated with their psychological health and QOL. Larger and prospective studies on the dynamic and interactive network of biopsychosocial factors in IBD patients are required.
 

Extraintestinal symptoms are common in patients with irritable bowel syndrome (IBS). In the present study, we determined the relationship between psychological disorders and extraintestinal symptoms in patients with IBS.

Adult patients with IBS referred to 4 gastroenterology clinics in Isfahan, Iran, completed the irritable bowel severity scoring system (IBSSS), extraintestinal symptoms scale, Hospital Anxiety and Depression Scale, and Irritable Bowel SyndromeQuality of Life (IBS-QOL) Questionnaire. Univariate and multivariate analyses were conducted.

The patients included 113 females and 45 males with mean age of 34.8 ± 11.1 years. Cumulative frequency of extraintestinal symptoms was 3.3 ± 2.4 (0 to 10). Anxiety and depression were present in 79.7% and 54.4% of the patients, respectively. Frequency of extraintestinal symptoms was correlated with anxiety and depression (r = 0.289 to 0.531), IBS severity (r = 0.373 to 0.505), and quality of life (r = -0.317 to -0.398). Severity of IBS was independently associated with extraintestinal digestive symptoms’ frequency (A = 0.248). Female gender, education level, and anxiety were independently associated with extraintestinal non-digestive symptoms’ frequency (A = -0.225 to 0.260). Severity of IBS and frequency of non-digestive symptoms were independent predictors of quality of life (A = -0.494 and -0.218). After controlling for psychological factors, IBS severity and depression were independent predictors of quality of life (A = -0.435 and -0.318).

Extraintestinal symptoms and psychological disorders are common in patients with IBS and impact their quality of life. Psychological disorders are associated with extraintestinal symptoms, especially non-digestive symptoms. These results highlight the need for an integrated biopsychosocial approach to the management of IBS patients with physical and mental comorbidities.