Berens S¹, Banzhaf P², Baumeister D², Gauss A³, Eich W², Schaefert R⁴, Tesarz J². J Psychosom Res. 2020 Jan;128:109846. doi: 10.1016/j.jpsychores.2019.109846. Epub 2019 Oct 19.

Author information

1 Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany; Institute of Psychology, Heidelberg University, Hauptstraße 47-51, D-69117 Heidelberg, Germany. Electronic address: sabrina.berens@med.uni-heidelberg.de.

2 Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany.

3 Department of Gastroenterology and Hepatology, University Hospital Heidelberg, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany.

4 Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany; Department of Psychosomatic Medicine, Division of Internal Medicine, University Hospital Basel, Hebelstrasse 2, CH-4031 Basel, Switzerland; Faculty of Medicine, University of Basel, Klingelbergstrasse 61, CH-4056 Basel, Switzerland.

Abstract

OBJECTIVE: Irritable bowel syndrome (IBS) is a functional disorder with a complex biopsychosocial etiopathogenesis. Various psychosocial factors like adverse childhood experiences (ACE) and illness anxiety appear to be relevant, but underlying mechanisms are still not fully understood. Furthermore, there are indicators of gender specific effects of ACE on IBS. Therefore, this study analyzed group differences between IBS patients and healthy controls (HCs) according to ACE and illness anxiety, and the relationship between ACE and illness anxiety by taking gender differences into consideration.

METHODS: A cross-sectional multi-center study was conducted comparing IBS patients with HCs. Illness anxiety was recorded using the Whiteley-Index-7, childhood adversities via the 10-item Adverse-Childhood-Experiences-score, anxiety by the Generalized Anxiety Disorder seven-item questionnaire and depressive symptoms using the nine-item depression module of the patient-health-questionnaire. Group differences between IBS patients and HCs were analyzed and correlation analyses were performed.

RESULTS: Overall, 127 gender and education matched participants per group were included. Compared to HCs, IBS patients were characterized by higher prevalences for adverse childhood experiences (63.8% vs. 48.0%, p?=?.02, OR?=?1.33) and increased levels of illness anxiety (p?2?=?0.595). Taking into account gender specific effects, there was a significant correlation between adverse childhood experiences and illness anxiety in female IBS patients, but not in male (r?=?0.242, p?=?.03 vs. r?=?0.162, p?=?.29). However, after controlling for depression and anxiety, this correlation disappeared.

CONCLUSION: Our findings suggest a possible gender-specific association of ACE with illness anxiety in female IBS patients that might be linked to increased levels of depression and anxiety.

TRIAL REGISTRATION: DRKS00011685.