Irritable bowel syndrome with psychiatric symptoms
ILIAS S., FOTIADOU A., HRISTONAKIS A., ALEXANDRI N., KONSTANTOPOULOU A
The purpose of this study is to investigate the mental disorders (M.D.) in patients with irritable bowel syndrome (IBS) and the reduction of IBS symptoms following the treatment of mental disorders.
We studied 20 patients with IBS diagnosed according to Manning criteria. We used questionnaires or scales for anxiety, depression, phobias, obsessive - compulsive symptoms and MMPI. The therapies were: a) 10 patients recieved pharmacological treatment (atprazolame or antidepressants, b) 5 recieved brief psychotherapy and pharmacological treatment and c) 5 received only brief psychotherapy.
The pattern of psychotherapy that was performed consisted of behavior-cognitive techniques and psychoanalytic elements. The number of sessions was between 16 and 40, once a week. The brief psychotherapy method that was used is an outcome of our clinical experience.
Half of the patients (50%) exhibited disorders 25% mood disorders 15%, somatoform disorders and 10% personality disorders 40% of our patients fulfilled the criteria of more than one of the previous mental disorders.
The reduction of IBS symptoms was proportional to the reduction of symptoms of mental disorders. After six weeks, 60% of group a, 60% of group b and 40% of group c of patients preshowed a reduction of IBS symptoms. At the end of therapy, amelioration of IBS symptoms was present in 70% of patients in-group a, and 100% of patients of groups b and c. In follow-up examination one year after the end of treatment, amelioration was still present in 40% of patients of group a and in 80% of patients of groups b and c.
The IBS symptoms mainly concerned anxiety and mood disorders. We had improvement of IBS symptoms in all three-treatment groups but this improvement was more significant in patients who received psychotherapy.
The combination of different treatment methods give better therapeutic results in patients with IBS.
Key words: Irritable bowel syndrome mental disorders pharmacological treatment brief psychotherapy.