title: Predictors of health care seeking for irritable bowel syndrome: a population based study.
abstract: BACKGROUND
  It has been suggested that psychological factors rather than symptoms drive subjects with irritable bowel syndrome (IBS) to seek medical care, but this issue has not been tackled in a population based study.
  
  
  OBJECTIVE
  To identify whether psychological factors or abuse explain health care seeking for IBS.
  
  
  METHODS
  A sample of residents of Penrith (a Sydney suburb representative of the Australian population) selected randomly from the electoral rolls (that by law include the entire population > or = 18 years) was mailed a validated self-report questionnaire. Measured were gastrointestinal symptoms including the Manning (and Rome) criteria for IBS, health care seeking, neuroticism (Eysenck Personality Questionnaire), psychological morbidity (General Health Questionnaire: GHQ) and sexual, physical and emotional abuse (including the standardised Drossman questions).
  
  
  RESULTS
  Among 730 subjects, 96 (13%, 95% confidence interval (CI) 11-16%) had IBS by the Manning criteria. Of those with IBS, 73% (95% CI 63-81%) had sought medical care for abdominal pain or discomfort. Only increasing pain severity (odds ratio (OR) = 2.10, 95% CI 1.11-3.95) and duration of pain (OR = 1.53, 95% CI 1.10-2.13) were independently associated with seeking health care for IBS. Pain severity was also predictive of recent care seeking (OR = 1.74, 95% CI 1.12-1.96). Neuroticism, psychological morbidity and abuse history were not significant predictors.
  
  
  CONCLUSIONS
  Psychological factors do not seem to explain health care seeking among community subjects with IBS.
authors.affiliation: Department of Medicine, University of Sydney, Nepean Hospital, Penrith, NSW, Australia.
authors.forename: N J
authors.initials: NJ
authors.lastname: Talley
authors.forename: P M
authors.initials: PM
authors.lastname: Boyce
authors.forename: M
authors.initials: M
authors.lastname: Jones
mesh_terms: D001315:Australia; D002648:Child; D002649:Child Abuse; D003109:Colonic Diseases, Functional / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011795:Surveys and Questionnaires