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Common mental disorders in irritable bowel syndrome: pathophysiology, management, and considerations for future randomised controlled trials
journal contribution
posted on 2021-05-01, 00:00 authored by Heidi StaudacherHeidi Staudacher, Antonina Mikocka-WalusAntonina Mikocka-Walus, A C FordThe frequent co-occurrence of irritable bowel syndrome and the common mental disorders of anxiety and depression is well established. A range of biological and psychosocial disease mechanisms are common to both disorders, many of which contribute to a dysregulated gut–brain axis. Clinical and subthreshold psychological comorbidity adds to the functional impairment and disease burden in individuals with irritable bowel syndrome. Progress is being made with regard to understanding irritable bowel syndrome in the clinical setting from a biopsychosocial perspective. However, until now, most trials of irritable bowel syndrome treatment still consider the disease as a gut disorder in isolation, which leaves major gaps in knowledge about disease–disease interactions and treatment outcomes in irritable bowel syndrome. In this Viewpoint, we review the epidemiology, pathophysiology, and management of anxiety and depression in individuals with irritable bowel syndrome. We also provide methodological recommendations for future randomised controlled trials and outline guidance for research that better incorporates psychiatric comorbidity into its design, with a view to improve treatment outcomes for individuals with irritable bowel syndrome.
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Journal
The Lancet Gastroenterology and HepatologyVolume
6Issue
5Pagination
401 - 410Publisher DOI
ISSN
2468-1253Publication classification
C1 Refereed article in a scholarly journalCopyright notice
2021, Crown CopyrightUsage metrics
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