Negative emotions in irritable bowel syndrome: which differences among IBS subtypes?

There are conflicting data on peculiar negative emotional patterns in Irritable Bowel Syndrome subtypes. Our study was aimed to determine possible differences in depression, anxiety and anger in patients suffering from Irritable Bowel Syndrome constipation, diarrhoea and mixed subtypes. The sample underwent a psychometric examination for the assessment of depression (Hamilton Rating Scale Depression), anxiety (Hamilton Rating Scale Anxiety), and anger (State-Trait Anger Expression Scale 2). Differences among groups were assessed using the Analysis of variance with Bonferroni post hoc comparisons, or the χ²-test if requested. 111 subjects (diarrhoea subtype =37; constipation subtype=34; mixed subtype=40) were included in the study. The severity of depressive symptoms was “moderate” in patients with constipation subtype and “mild” in patients with diarrhoea and mixed subtypes 17.15±6.7 vs 14.24±6.6 vs 12.50±4.9); no statistically significant differences were documented among subtypes. Severity of anxiety symptoms was “mild to moderate” in patients with constipation subtype (mean = 18.53 ± 7.7), and mild in patients with diarrhoea (mean = 13.35 ± 7.1) and mixed subtypes (mean = 13.25 ± 4.7); statistically significant differences among subgroups were found (Constipation vs Diarrhoea: p=0.004; Constipation vs Mixed: =0.003). Regarding anger, significant differences among subgroups emerged at State Anger Feeling Angry and Anger In variables, both higher in constipation subtype group than in mixed subtype group (State Anger Feeling Angry: p=0.002; Anger In: p=0.001). Results showed that IBS-C patients were characterized by higher levels of anxiety than the other two subgroups, and that a consistent number of subjects from the IBS-C subgroup had anxiety scores within the pathological range. Furthermore, IBS-C patients showing a trend to experience more depressive symptoms than IBS-D and IBS-M patients.