Christopher J Black1,2, Yan Yiannakou3, Lesley A Houghton2, Farag Shuweihdi4, Robert West4, Elspeth Guthrie4, Alexander C Ford1,2. 1. Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK. 2. Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK. 3. County Durham and Darlington NHS Foundation Trust, Durham, UK. 4. Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
Abstract
BACKGROUND: Gastrointestinal symptom-specific anxiety and somatization have both been associated with higher symptom severity in patients with irritable bowel syndrome (IBS); however, this relationship has not been explored fully. Moreover, the performance of the visceral sensitivity index (VSI) for measuring gastrointestinal symptom-specific anxiety has not been examined in a UK population. We conducted a cross-sectional survey to examine these issues. METHODS: Gastrointestinal symptom-specific anxiety was measured using the VSI, and somatization was measured via the patient health questionnaire-12 (PHQ-12) in adults from the UK community with Rome IV-defined IBS. Exploratory factor analysis was performed on the VSI, prior to subsequent analyses, to establish its factor structure. Multiple regression analysis was used to determine the relationship between demographic features, different factors of the VSI, somatization, and IBS symptom severity. KEY RESULTS: A total of 811 individuals with IBS provided complete data. Factor analysis of the VSI revealed a three-factor structure, accounting for 47% of the variance. The first of these VSI factors and the PHQ-12 were both strongly and independently associated with IBS symptom severity, for the group as a whole and for all four IBS subtypes. Most VSI items concerned with overt gastrointestinal symptom-specific anxiety loaded onto the other two VSI factors that were not associated with symptom severity. CONCLUSIONS AND INFERENCES: The factor structure of the VSI requires further investigation. Our findings cast doubt on the central role of gastrointestinal symptom-specific anxiety as a driver for symptom severity in IBS. Awareness of both gastrointestinal and extra-intestinal symptoms, however, is strongly associated with symptom severity.
BACKGROUND: Gastrointestinal symptom-specific anxiety and somatization have both been associated with higher symptom severity in patients with irritable bowel syndrome (IBS); however, this relationship has not been explored fully. Moreover, the performance of the visceral sensitivity index (VSI) for measuring gastrointestinal symptom-specific anxiety has not been examined in a UK population. We conducted a cross-sectional survey to examine these issues. METHODS: Gastrointestinal symptom-specific anxiety was measured using the VSI, and somatization was measured via the patient health questionnaire-12 (PHQ-12) in adults from the UK community with Rome IV-defined IBS. Exploratory factor analysis was performed on the VSI, prior to subsequent analyses, to establish its factor structure. Multiple regression analysis was used to determine the relationship between demographic features, different factors of the VSI, somatization, and IBS symptom severity. KEY RESULTS: A total of 811 individuals with IBS provided complete data. Factor analysis of the VSI revealed a three-factor structure, accounting for 47% of the variance. The first of these VSI factors and the PHQ-12 were both strongly and independently associated with IBS symptom severity, for the group as a whole and for all four IBS subtypes. Most VSI items concerned with overt gastrointestinal symptom-specific anxiety loaded onto the other two VSI factors that were not associated with symptom severity. CONCLUSIONS AND INFERENCES: The factor structure of the VSI requires further investigation. Our findings cast doubt on the central role of gastrointestinal symptom-specific anxiety as a driver for symptom severity in IBS. Awareness of both gastrointestinal and extra-intestinal symptoms, however, is strongly associated with symptom severity.
Authors: Luis Alberto Bravo-Vázquez; Ixchel Medina-Ríos; Luis David Márquez-Gallardo; Josué Reyes-Muñoz; Francisco I Serrano-Cano; Surajit Pathak; Antara Banerjee; Anindya Bandyopadhyay; Asim K Duttaroy; Sujay Paul Journal: Dig Dis Sci Date: 2022-05-04 Impact factor: 3.487
Authors: James M Keane; Ali S Khashan; Fergus P McCarthy; Louise C Kenny; James M Collins; Sarah O'Donovan; Jillian Brown; John F Cryan; Timothy G Dinan; Gerard Clarke; Siobhain M O'Mahony Journal: JCI Insight Date: 2021-01-25