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- Ålander, Ture, et al.
(author)
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Abuse in Women and Men with and without Functional Gastrointestinal Disorders
- 2008
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In: Digestive Diseases and Sciences. - : Springer Science and Business Media LLC. - 0163-2116 .- 1573-2568. ; 53:7, s. 1856-1864
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Journal article (peer-reviewed)abstract
- We aimed to investigate the history of abuse in childhood and adulthood and health-related quality of life (HRQL) in women and men with FGID in the general adult population. A cross-sectional study in a random population sample (n = 1,537, 20-87 years) living in Osthammar municipality, Sweden, in 1995 was performed. Persons with FGID (n = 141) and a group of abdominal symptom-free controls (SSF, n = 97) were selected by means of a validated questionnaire assessing gastrointestinal symptoms (the ASQ). Abuse, anxiety and depression (the HADS) and HRQL (the PGWB) were measured. Women with FGID had a higher risk of having a history of some kind of abuse, as compared with the SSF controls (45% vs.16%, OR = 2.0, 95% CI: 1.01-3.9; SSF = 1), in contrast to men (29% vs. 24% n.s.). Women with a history of abuse and FGID had reduced HRQL 91 (95% CI 85-97) as compared with women without abuse history 100 (95% CI 96-104, P = 0.01, "healthy" = 102-105 on PGWB). Childhood emotional abuse was a predictor for consulting with OR = 4.20 (95% CI: 1.12-15.7.7). Thus, previous abuse is common in women with FGID and must be considered by the physician for diagnosis and treatment of the disorder.
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| 2. |
- Ålander, Ture
(author)
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Functional gastrointestinal disorders : co-morbidity and non-somatic aspects
- 2008
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Doctoral thesis (other academic/artistic)abstract
- Aims of the thesis: The first aim, (Study I) of this thesis was to compare co-morbidity of the reported symptoms and its relation to healthcare seeking behaviour among non-patients who had persistent functional gastro-intestinal disorders (FGID) or who were strictly GI symptom free (SSF). The second aim (study II) was to compare FGID sufferers primary health care consumption, as registered in their medical records. The third aim (study III) was to investigate the occurrence of a history of abuse, and the possible association with consultation rate, and the fourth aim (study IV) was to investigate the possible influence of a negative parental rearing experienced during childhood. Methods: The Abdominal symptom questionnaire (ASQ) was mailed to a random sample of 1537 adults aged 20-87 years from the municipality of Östhammar, Sweden (n= 21,545 in 1995). From the obtained response and by integrating results from previous studies performed in 1988 and 1989, 244 subjects with FGID (e.g. FD and/or IBS) and 219 SSF subjects were invited to their local health centers for completing the ASQ again in addition to a set of other questionnaires. From the results in the ASQ, 141 subjects with persistent FGID and 97 SSF subjects formed the study groups of the studies I, III and IV. A subgroup living in the eastern part of Östhammar constituted the study groups in study II. The used questionnaires were; Complaint score questionnaire (CSQA), Psychological General Well-Being (PGWB), Hospital Anxiety and Depression Scale (HADS), Sexual, physical and emotional abuse (ABQ), Coping strategies questionnaire (CSQ), Social support (ISSI), and the Multidimensional Health locus of control scale (MHLC). Results: In study I: Non-patients with FGID have a higher risk of psychological illness (OR 8.4, CI95: 4.0-17.5) than somatic illness (OR 2.8, CI95: 1.3-5.7) or ache and fatigue symptoms (OR 4.3, CI95:2.1-8.7). Patients with FGID have more severe GI symptoms than healthy controls. In study II: of the FGID patients, 97% had a non-GI diagnosis, compared to 100% of SSF (ns). The mean number of consultations, prescriptions, diagnoses as well as anxiety level and depression were all statistically significantly higher (p<0.05) in FGID compared to SSF, whereas the number of referrals and sick leave were not. Besides a GI diagnosis, there was no significant difference (p>0.05) in the spectrum of morbidity in terms of ICD-9 subgroup classification, except an increased proportion of older SSF subjects with circulatory disorders and hypertension. In study III: Women with FGID had a higher risk of having a history of some kind of abuse, as compared with the SSF controls (45% vs.16%), in contrast to men (29% vs. 24% n.s.). Women with a history of abuse and FGID had reduced HRQoL as compared with women without abuse history. In study IV: Neuroticism and a parental rejective rearing style were identified as risk factors for FGID. FGID consulters reported an increased parental rejection and reduced health-related quality of life. Moreover, consulters had a higher exposure to abuse in childhood, a lower availability of social attachment and less adequacy of social interaction than non-consulters. Conclusions: FGID is related to an increased demand on primary health care due to an increased overall co-morbidity. Women with longstanding FGID often have a history of physical, emotional or sexual abuse which is associated with a poor HRQoL and increased health care seeking. Negative parental upbringing represents an aggravating factor in FGID. The treatment of FGID should involve assessment of psychological distress.
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| 3. |
- Ålander, Ture, et al.
(author)
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Psychological illness is commonly associated with functional gastrointestinal disorders and is important to consider during patient consultation : a population-based study
- 2005
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In: BMC Medicine. - : Springer Science and Business Media LLC. - 1741-7015. ; 3:1, s. 8-
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Journal article (peer-reviewed)abstract
- BACKGROUND: Some individuals with functional gastrointestinal disorders (FGID) suffer long-lasting symptoms without ever consulting their doctors. Our aim was to study co-morbidity and lifestyle differences among consulters and non-consulters with persistent FGID and controls in a defined adult population. METHODS: A random sample of the general adult Swedish population was obtained by a postal questionnaire. The Abdominal Symptom Questionnaire (ASQ) was used to measure GI symptomatology and grade of GI symptom severity and the Complaint Score Questionnaire (CSQ) was used to measure general symptoms. Subjects were then grouped for study by their symptomatic profiles. Subjects with long-standing FGID (n = 141) and subjects strictly free from gastrointestinal (GI) symptoms (n = 97) were invited to attend their local health centers for further assessment. RESULTS: Subjects with FGID have a higher risk of psychological illness [OR 8.4, CI95(4.0-17.5)] than somatic illness [OR 2.8, CI95(1.3-5.7)] or ache and fatigue symptoms [OR 4.3, CI95(2.1-8.7)]. Subjects with psychological illness have a higher risk of severe GI symptoms than controls; moreover they have a greater chance of being consulters. Patients with FGID have more severe GI symptoms than non-patients. CONCLUSION: There is a strong relation between extra-intestinal, mental and somatic complaints and FGID in both patients and non-patients. Psychological illness increases the chance of concomitantly having more severe GI symptoms, which also enhance consultation behaviour.
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