Irritable bowel syndrome, its cognition, anxiety sensitivity, and anticipatory anxiety in panic disorder patients
Article first published online: 25 JUL 2013
© 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology
Psychiatry and Clinical Neurosciences
Volume 67, Issue 6, pages 397–404, September 2013
How to Cite
Sugaya, N., Yoshida, E., Yasuda, S., Tochigi, M., Takei, K., Ohtani, T., Otowa, T., Minato, T., Umekage, T., Sakano, Y., Chen, J., Shimada, H., Nomura, S., Okazaki, Y., Kaiya, H., Tanii, H. and Sasaki, T. (2013), Irritable bowel syndrome, its cognition, anxiety sensitivity, and anticipatory anxiety in panic disorder patients. Psychiatry and Clinical Neurosciences, 67: 397–404. doi: 10.1111/pcn.12069
- Issue published online: 2 SEP 2013
- Article first published online: 25 JUL 2013
- Manuscript Accepted: 29 MAY 2013
- Manuscript Revised: 26 MAY 2013
- Manuscript Received: 22 JUN 2011
- Ministry of Education, Culture, Sports, Science and Technology of Japan. Grant Numbers: 17019029, 21300242
- cognitive factors;
- irritable bowel syndrome;
- panic disorder
The present study examined the effect of irritable bowel syndrome (IBS), cognitive appraisal of IBS, and anxiety sensitivity on anticipatory anxiety (AA) and agoraphobia (AG) in patients with panic disorder (PD).
We examined 244 PD patients who completed a set of questionnaires that included the Rome II Modular Questionnaire to assess the presence of IBS, the Anxiety Sensitivity Index (ASI), the Cognitive Appraisal Rating Scale (CARS; assessing the cognitive appraisal of abdominal symptoms in four dimensions: commitment, appraisal of effect, appraisal of threat, and controllability), and items about the severity of AA and AG. The Mini International Neuropsychiatric Interview was used to diagnose AG and PD.
After excluding individuals with possible organic gastrointestinal diseases by using ‘red flag items,’ valid data were obtained from 174 participants, including 110 PD patients without IBS (PD/IBS[–]) and 64 with IBS (PD/IBS[+]). The PD/IBS[+] group had higher AA and higher comorbidity with AG than the PD/IBS[–] group. In the PD/IBS[+] group, the controllability score of CARS was significantly correlated with AA and ASI. Multiple regression analysis showed a significant effect of ASI but not of controllability on AA in PD/IBS[+] subjects.
This study suggested that the presence of IBS may be related to agoraphobia and anticipatory anxiety in PD patients. Cognitive appraisal could be partly related to anticipatory anxiety in PD patients with IBS with anxiety sensitivity mediating this correlation.