title: Irritable bowel syndrome, its cognition, anxiety sensitivity, and anticipatory anxiety in panic disorder patients.
abstract: OBJECTIVE
  The present study examined the effect of irritable bowel syndrome (IBS), cognitive appraisal of IBS, and anxiety sensitivity on anticipatory anxiety (AA) and agoraphobia (AG) in patients with panic disorder (PD).
  
  
  METHODS
  We examined 244 PD patients who completed a set of questionnaires that included the Rome II Modular Questionnaire to assess the presence of IBS, the Anxiety Sensitivity Index (ASI), the Cognitive Appraisal Rating Scale (CARS; assessing the cognitive appraisal of abdominal symptoms in four dimensions: commitment, appraisal of effect, appraisal of threat, and controllability), and items about the severity of AA and AG. The Mini International Neuropsychiatric Interview was used to diagnose AG and PD.
  
  
  RESULTS
  After excluding individuals with possible organic gastrointestinal diseases by using 'red flag items,' valid data were obtained from 174 participants, including 110 PD patients without IBS (PD/IBS[-]) and 64 with IBS (PD/IBS[+]). The PD/IBS[+] group had higher AA and higher comorbidity with AG than the PD/IBS[-] group. In the PD/IBS[+] group, the controllability score of CARS was significantly correlated with AA and ASI. Multiple regression analysis showed a significant effect of ASI but not of controllability on AA in PD/IBS[+] subjects.
  
  
  CONCLUSIONS
  This study suggested that the presence of IBS may be related to agoraphobia and anticipatory anxiety in PD patients. Cognitive appraisal could be partly related to anticipatory anxiety in PD patients with IBS with anxiety sensitivity mediating this correlation.
authors.affiliation: Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan. nagisa618@gmail.com
authors.forename: Nagisa
authors.initials: N
authors.lastname: Sugaya
authors.forename: Eiji
authors.initials: E
authors.lastname: Yoshida
authors.forename: Shin
authors.initials: S
authors.lastname: Yasuda
authors.forename: Mamoru
authors.initials: M
authors.lastname: Tochigi
authors.forename: Kunio
authors.initials: K
authors.lastname: Takei
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ohtani
authors.forename: Takeshi
authors.initials: T
authors.lastname: Otowa
authors.forename: Takanobu
authors.initials: T
authors.lastname: Minato
authors.forename: Tadashi
authors.initials: T
authors.lastname: Umekage
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sakano
authors.forename: Junwen
authors.initials: J
authors.lastname: Chen
authors.forename: Hironori
authors.initials: H
authors.lastname: Shimada
authors.forename: Shinobu
authors.initials: S
authors.lastname: Nomura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Okazaki
authors.forename: Hisanobu
authors.initials: H
authors.lastname: Kaiya
authors.forename: Hisashi
authors.initials: H
authors.lastname: Tanii
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Sasaki
mesh_terms: D000328:Adult; D000379:Agoraphobia / Q000523:psychology; D001007:Anxiety / Q000523:psychology*; D003071:Cognition; D003627:Data Interpretation, Statistical; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000523:psychology*; D008297:Male; D016584:Panic Disorder / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires
keywords: anxiety; cognitive factors; irritable bowel syndrome; panic disorder