Abstract
A large proportion of the general population are said to have bowel movement disturbances, but most of them do not consult doctors. Patients with irritable bowel syndrome (IBS) are more sensitive to their symptoms, and more distressed by their symptoms than non IBS patients. This may suggest that IBS patients are more psychologically disturbed than non IBS patients. We investigated the relations between the subtypes of IBS and psychological assessment based on DSM-III-R. A psychological assessment was made by the doctor who diagnosed and treated the patient, taking account of psychological tests as well as drug responses. The subjects included 53 male and 64 female patients with IBS who visited the Department of Psychosomatic Medicine, Kyushu University and the Department of Psychosomatic Medicine at the Saiseikai Fukuoka General Hospital during the period of April, 1985-June, 1991. We subdivided bowel movement disorders of IBS into 5 subtypes-diarrhea type, constipation type, alternate type, gas type, and unclassified type according to the dominant bowel movement disorder examined at the first visit. The results are summarized as follows : l) A depressive disorder accounted for about 70% of diarrhea and alternate types of IBS and about 60% of constipation type of IBS. 2) The gas type IBS was quite different from the other types regarding psychological features. 3) Maladjustment was most often recognized in the gas type of IBS while overadjustment was most often recognized in the constipation type of IBS. 4) Antidepressants proved to be most effective for all types of IBS.
