The interface of psychiatry and irritable bowel syndrome.

The interface of psychiatry and irritable bowel syndrome (IBS) is well established, with psychiatric comorbidity approaching 20% to 60%. Anxiety disorders, depressive disorders, and somatoform disorders are the more frequently occurring comorbid conditions. Moreover, psychosocial stressors and history of trauma and abuse play a significant role in the onset and perpetuation of IBS symptoms. The psychiatric management of IBS more effectively uses a collaborative approach between a mental health practitioner and a primary care clinician or gastroenterologist. Psychiatric treatment includes the use of pharmacotherapy with antidepressants or anxiolytics, psychotherapy, and attention to psychosocial stressors. Psychiatric interventions have consistently demonstrated effectiveness in reducing IBS symptoms and improvement of patient functioning.