Gastrointestinal-specific anxiety: an important factor for severity of GI symptoms and quality of life in IBS

Abstract

Gastrointestinal (GI)-specific anxiety (GSA) has been proposed to influence symptom severity and quality of life (QOL) in patients with irritable bowel syndrome (IBS). The Visceral Sensitivity Index (VSI) is a recently developed, reliable and valid measure of GSA. Our aim was to evaluate the association between GSA, GI symptom severity, and QOL in IBS patients. Sixty healthy subjects and 306 patients fulfilling the Rome II criteria for IBS were studied. Demographic and disease-related factors were assessed. Patients completed VSI and GI Symptom Rating Scale (GSRS) and questionnaires to determine psychological symptom severity (Hospital Anxiety and Depression Scale), QOL (Short form 36), and presence of functional GI disorders (Rome II Modular Questionnaire). Compared with healthy subjects, patients with IBS had more severe GSA (34.7 +/- 16.9 vs. 2.2 +/- 4.4 [mean +/- standard deviation]; P < 0.0001). In the IBS group, more severe GSA was seen in patients with more severe GI symptoms (P < 0.0001), general anxiety (P < 0.0001) and depression (P < 0.0001), and with lower socioeconomic status (P < 0.05). In a regression analysis, GSA was the strongest predictor for GI symptom severity (GSRS total score), followed by number of Rome II diagnoses, presence of meal-related IBS symptoms, and gender (R(2) = 0.34). Gastrointestinal-specific anxiety was also, together with general anxiety, depression, socioeconomic status, and gender, found to be independently associated with mental QOL (R(2) = 0.62). Gastrointestinal-specific anxiety seems to be an important factor for GI symptom severity and QOL in patients with IBS.