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Patients with irritable bowel syndrome (IBS) (n = 121) were compared to 46 patients with inflammatory bowel disease (IBD), and to 45 nonpatient controls on a variety of psychological tests and on symptomatology. The most consistent finding was the ordering of group psychological test means such that, on 11 or 14 measures, IBS patients scored higher than IBD patients, who in turn scored higher than the nonpatient controls. The two patient groups differed significantly only on measures of anxiety with the IBS patients scoring significantly higher on all three measures. IBS patients also reported significantly more severity of abdominal pain than the IBD patients; while IBD patients reported more episodes of diarrhea, they did not rate them as significantly more severe than did the IBS patients. Various other parameters of the IBS population are also explored and implications for treatment and future study are discussed.

Summary - The presence of a diagnosable Axis I psychiatric disorder predicted significantly (P < 0.001) lower likelihood of significant improvement among 90 irritable bowel syndrome patients given cognitive and behavioral treatments to help the disorder. Other psychological tests, including the MMPI, BDI, STAI, as well as demographic variables, failed to yield significant prediction.

We report two controlled comparisons of a previously validated multicomponent (relaxation, thermal biofeedback, and cognitive therapy) treatment for irritable bowel syndrome (IBS) to an ostensible attention-placebo control (pseudo-meditation and EEG alpha suppression biofeedback) and to a symptom-monitoring control. In Study 1 (n = 10 per condition) there were nonsignificant trends for the multicomponent treatment to be superior to the attention-placebo condition. In study 2 (n = 30 per condition), we found no advantage for the multicomponent treatment over the attention-placebo condition. Subjects in both treatment conditions showed significant reductions in GI symptoms, as measured by daily symptom diaries, and significant reductions in trait anxiety and depression. The GI symptom reductions held up over a 6 month follow-up. Possible explanations for the results are explored.

Using a reliable and valid structured diagnostic interview scale (ADIS-R), and patients with careful medical characterization, we found significantly more diagnosable psychopathology, particularly anxiety disorders, among treatment seeking patients with irritable bowel syndrome than among comparable age and sex samples of treatment seeking patients with Inflammatory Bowel Disease. Significant differences were also found on the Hamilton Anxiety Rating Scale and Hamilton Rating Scale for Depression between IBS patients and the IBD patients and controls, who did not differ. Comparable levels of psychiatric disorder among parents of probands were found in all three groups. The results are consistent with Latimer's (1983) notion of IBS patients being a subclass of 'neurotics.'