Irritable bowel syndrome: Relations with functional, mental, and somatoform disorders

Abstract

This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is considered to be a functional somatic syndrome (FSS) with a considerable symptom overlap with other FSSs like chronic fatigue syndrome or fibromyalgia syndrome. IBS patients show an increased prevalence of psychiatric symptoms and disorders, especially depression and anxiety. IBS is largely congruent with the concepts of somatoform and somatic symptom disorders. Roughly 50% of IBS patients complain of gastrointestinal symptoms only and have no psychiatric comorbidity. IBS concepts, treatment approaches, as well as health care structures should acknowledge its variability and multidimensionality by: (1) awareness of additional extraintestinal and psychobehavioral symptoms in patients with IBS; (2) general and collaborative care rather than specialist and separated care; and (3) implementation of “interface disorders” to abandon the dualistic classification of purely organic or purely mental disorders.

Keywords: Functional somatic syndrome; Somatoform disorder; Somatic symptom disorder; Bodily distress syndrome; Interface; Irritable bowel syndrome

Core tip: Irritable bowel syndrome should be seen as a potentially multidimensional condition, even if cases with an uncomplicated, solely gastrointestinal course occur. Often, patients’ general mental and physical functioning, participation, as well as quality of life are also affected.