title: Medical comorbidity and distress in patients with irritable bowel syndrome: The moderating role of age.
abstract: Irritable bowel syndrome (IBS) affects people across the age spectrum and is highly comorbid with other medical conditions. The aim of this study was to determine the moderating effect of age on the relationship between medical comorbidity and health outcomes in IBS patients.
  
  
  
  Patients (n=384) across the age spectrum (18 to 70) completed questionnaires regarding medical comorbidities, anxiety, depression, IBS symptom severity, and IBS quality of life (QOL).
  
  
  
  The mean age was 41 (SD=15). Age interacted with medical comorbidities to predict anxiety, F(7,354)=5.82, p=0.009, R(2)=0.10. Results revealed significant main effects for education, β=-0.16, p<0.05, age, β=-0.15, p<0.05, medical comorbidities, β=0.25, p<0.05, and a significant interaction, β=-0.15, p<0.01. Anxiety was greater among patients with many comorbidities, with this effect being more pronounced for younger adults. Depression, also predicted by the interaction between age and comorbidities, showed the same pattern as anxiety. There was no significant interaction between age and medical comorbidities in predicting IBS symptom severity or IBS QOL.
  
  
  
  Distress among IBS patients with medical comorbidities varies with age, with higher levels of anxiety and depression among younger adults than their older counterparts. Medical comorbidity may have a more selective impact on psychological distress as compared to IBS symptom severity and quality of life for younger adults with IBS. Distress may increase IBS burden for these patients and complicate its medical management.
authors: VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, United States; VA South Central Mental Illness Research, Education and Clinical Center; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States. Electronic address: ethakur@bcm.edu.
authors: Elyse R
authors: ER
authors: Thakur
authors: Research Institute on Addictions, University at Buffalo, SUNY, Buffalo, NY, United States. Electronic address: Quigley@ria.buffalo.edu.
authors: Brian M
authors: BM
authors: Quigley
authors: VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, United States; Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, United States. Electronic address: hasheme@bcm.edu.
authors: Hashem B
authors: HB
authors: El-Serag
authors: Department of Medicine, University at Buffalo School of Medicine, SUNY, Buffalo, NY, United States. Electronic address: gudleski@buffalo.edu.
authors: Gregory D
authors: GD
authors: Gudleski
authors: Department of Medicine, University at Buffalo School of Medicine, SUNY, Buffalo, NY, United States. Electronic address: lackner@buffalo.edu.
authors: Jeffrey M
authors: JM
authors: Lackner
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001007:Anxiety / Q000209:etiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Anxiety; Depression; IBS QOL; IBS symptom severity; Irritable bowel syndrome; Medical comorbidity