title: More negative self-esteem and inferior coping strategies among patients diagnosed with IBS compared with patients without IBS--a case-control study in primary care.
abstract: BACKGROUND
  Irritable Bowel Syndrome (IBS) is a chronic, relapsing gastrointestinal disorder, that affects approximately 10% of the general population and the majority are diagnosed in primary care. IBS has been reported to be associated with altered psychological and cognitive functioning such as mood disturbances, somatization, catastrophizing or altered visceral interoception by negative emotions and stress. The aim was to investigate the psychosocial constructs of self-esteem and sense of coherence among IBS patients compared to non-IBS patients in primary care.
  
  
  METHODS
  A case-control study in primary care setting among IBS patients meeting the ROME III criteria (n = 140) compared to controls i.e. non-IBS patients (n = 213) without any present or previous gastrointestinal complaints. The data were collected through self-reported questionnaires of psychosocial factors.
  
  
  RESULTS
  IBS-patients reported significantly more negative self-esteem (p < 0.001), lower scores for positive self-esteem (p < 0.001), and lower sense of coherence (p < 0.001) than the controls. The IBS-cases were also less likely to report 'good' health status (p < 0.001) and less likely to report a positive belief in the future (p < 0.001). After controlling for relevant confounding factors in multiple regressions, the elevation in negative self-esteem among IBS patients remained statistically significant (p = 0.02), as did the lower scores for sense of coherence among IBS cases (p = 0.04).
  
  
  CONCLUSIONS
  The more frequently reported negative self-esteem and inferior coping strategies among IBS patients found in this study suggest the possibility that psychological therapies might be helpful for these patients. However these data do not indicate the causal direction of the observed associations. More research is therefore warranted to determine whether these psychosocial constructs are more frequent in IBS patients.
authors.affiliation: Department of Medicine and Health, Unit of Research and Development, County Council of Östergötland, Linköping, Drug Research, Linkoping University, Linköping, Sweden. ewa.grodzinsky@rmv.se.
authors.forename: Ewa
authors.initials: E
authors.lastname: Grodzinsky
authors.affiliation: Institution of Clinical and Experimental Medicine, Faculty of Health Sciences, Division of Gastroenterology, Linköping University, Linköping, Sweden. susanna.walter@liu.se.
authors.forename: Susanna
authors.initials: S
authors.lastname: Walter
authors.affiliation: Department of Medicine and Health, Unit of Research and Development, County Council of Östergötland, Linköping, Drug Research, Linkoping University, Linköping, Sweden. lisa.viktorsson@regionostergotland.se.
authors.forename: Lisa
authors.initials: L
authors.lastname: Viktorsson
authors.affiliation: Primary care, County Council of Östergötland, Linköping, Sweden. ann.kristin.Carlsson@regionostergotland.se.
authors.forename: Ann-Kristin
authors.initials: AK
authors.lastname: Carlsson
authors.affiliation: Psychology Department, Macquarie University, Sydney, NSW, Australia. Mike.Jones@mq.edu.au.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Jones
authors.affiliation: Department of Medicine and Health, Community Medicine, Faculty of Health Sciences Linköping University, SE-581 83, Linköping, Sweden. ashild.olsen.faresjo@liu.se.
authors.forename: Åshild
authors.initials: Å
authors.lastname: Faresjö
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011320:Primary Health Care; D012649:Self Concept; D060685:Sense of Coherence