title: Distress criterion influences prevalence rates of functional gastrointestinal disorders.
abstract: BACKGROUND
  Functional gastrointestinal disorders (FGID) are defined by a combination of chronic or recurrent gastrointestinal symptoms. Prevalence rates of FGID are high. Symptoms are associated with distress, and sufferers show high stress levels. However, the current diagnostic criteria do not consider subjective distress elicited by the symptoms, thus potentially leading to overestimated prevalence rates. The aim of this study was to explore the reduction in prevalence rates when distress is considered in the diagnostic criteria.
  
  
  METHODS
  In this web-based study, FGID were diagnosed using the Rome II criteria. Prevalence rates with and without subjective distress elicited by the symptoms were computed. Additionally, stress levels and stress reactivity were assessed.
  
  
  RESULTS
  Prevalence rates of FGID in our sample were similar to those in other studies. However, when considering the distress criterion, on average, a decrease of 38.51% was found in the prevalence rates of FGID. Sufferers who were subjectively distressed by their symptoms reported significantly higher stress levels than non-distressed subjects (all p < 0.001).
  
  
  CONCLUSIONS
  The consideration of a criterion of subjective distress in the diagnosis of FGID has consequences for actual prevalence rates of FGID. Distressed subjects differ markedly from non-distressed subjects in terms of their stress levels. The inclusion of a distress criterion in the ongoing development of diagnostic criteria for FGID is therefore warranted.
authors.affiliation: Department of Psychology, University of Marburg, Gutenbergstrasse 18,35037, Marburg, Germany. markert@staff.uni-marburg.de.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Markert
authors.affiliation: Department of Psychology, University of Zurich, Binzmühlestrasse 14,8050, Zurich, Switzerland. klenhardt@sunrise.ch.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Suarez-Hitz
authors.affiliation: Department of Psychology, University of Zurich, Binzmühlestrasse 14,8050, Zurich, Switzerland. u.ehlert@psychologie.uzh.ch.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Ehlert
authors.affiliation: Department of Psychology, University of Marburg, Gutenbergstrasse 18,35037, Marburg, Germany. nater@uni-marburg.de.
authors.forename: Urs M
authors.initials: UM
authors.lastname: Nater
mesh_terms: D000328:Adult; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D008297:Male; D015995:Prevalence; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult