title: Outcome in severe irritable bowel syndrome with and without accompanying depressive, panic and neurasthenic disorders.
abstract: BACKGROUND
  Irritable bowel syndrome often leads to impaired functioning.
  
  
  OBJECTIVE
  To assess the contribution of psychiatric disorders to impaired outcome in severe irritable bowel syndrome.
  
  
  METHODS
  Patients with severe irritable bowel syndrome entering a psychological treatment trial (n=257) were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry. Outcomes were number of days of restricted activity, role limitation (physical) score of the Short Form Health Survey and costs.
  
  
  RESULTS
  At baseline, depressive disorder (29% of patients), panic (12%) and neurasthenia (35%) were associated with impairment; number of psychiatric disorders was associated in a dose-response fashion (P=0.005). At follow-up, depressive disorder and neurasthenia were associated with role limitation score. Improved depression was associated with improved role functioning.
  
  
  CONCLUSIONS
  Depressive, panic and neurasthenic disorders contribute to poor outcomes in severe irritable bowel syndrome, and appropriate treatment should be available to these patients.
authors.affiliation: School of Psychiatry and Behavioural Science, University of Manchester, Oxford Road, Manchester M13 9WL, UK. francis.creed@man.ac.uk
authors.forename: Francis
authors.initials: F
authors.lastname: Creed
authors.forename: Joy
authors.initials: J
authors.lastname: Ratcliffe
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Fernandes
authors.forename: Stephen
authors.initials: S
authors.lastname: Palmer
authors.forename: Christine
authors.initials: C
authors.lastname: Rigby
authors.forename: Barbara
authors.initials: B
authors.lastname: Tomenson
authors.forename: Elspeth
authors.initials: E
authors.lastname: Guthrie
authors.forename: Nicholas
authors.initials: N
authors.lastname: Read
authors.forename: David G
authors.initials: DG
authors.lastname: Thompson
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009440:Neurasthenia / Q000175:diagnosis / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D016584:Panic Disorder / Q000175:diagnosis / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D011795:Surveys and Questionnaires