Gender differences in irritable bowel syndrome: the interpersonal connection.
BACKGROUND
While irritable bowel syndrome (IBS) affects women more than men, the reasons are unclear. Research on the female preponderance of IBS has focused on gender differences in sex-linked biological processes; much less attention has been paid to the role of psychosocial factors. Interpersonal difficulties may be one source of stress that may significantly impact on women with IBS. Because of the importance that women attach to relationships, we suspected they would be more reactive to interpersonal stress.


METHODS
A total of 283 (M age = 41 years, F = 80%), Rome III-diagnosed IBS patients completed a test battery that included the IBS Symptom Severity Scale, McGill Pain Questionnaire, Inventory of Interpersonal Problems (IIP), interpersonal support evaluation list (social support), Negative Interactions Scale, Brief Symptom Inventory (distress), Beck Depression Inventory, Anxiety Sensitivity Inventory, and IBS-Quality of Life as part of baseline assessment of an NIH trial.


RESULTS
Males scored higher on two IIP scales reflecting a hostile-dominant interpersonal pattern, and reported less social support. The quality of relationship problems (more interpersonal difficulties, lower support) correlated with IBS symptom severity as measured mainly by gastroenterologists.


CONCLUSIONS
Male, not female, IBS patients reported more interpersonal difficulties. Male patients-a population for whom little is known-are characterized by hostile-dominant interpersonal problems. This finding has clinical importance, given that relationship problems may influence MDs' estimation of IBS symptom severity and undermine the physician-patient relationship.
Department of Psychology, Wayne State University, Detroit, MI, USA.|Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
E R
ER
Thakur
Department of Psychology, University of Wisconsin-Parkside, Kenosha, WI, USA.
M B
MB
Gurtman
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
L
L
Keefer
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
D M
DM
Brenner
Department of Medicine, University at Buffalo School of Medicine, SUNY, Buffalo, NY, USA.
J M
JM
Lackner
D000328:Adult; D005260:Female; D006791:Hostility; D006801:Humans; D007398:Interpersonal Relations; D043183:Irritable Bowel Syndrome / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012720:Severity of Illness Index; D012737:Sex Factors; D012930:Social Dominance; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology*
circumplex; gender; interpersonal stress; physician-patient relationship