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Depression, anxiety, and the gastrointestinal system
E A Mayer1, M Craske, B D Naliboff
1Department of Medicine, University of California, Los Angeles, USA. emayer@ucla.edu
The Journal of Clinical Psychiatry
|July 11, 2002
Summary
Functional gastrointestinal (GI) disorders are linked to affective disorders like depression and PTSD. Stressors impact both GI symptoms and mental health, suggesting shared neurobiological pathways.
Area of Science:
- Neurobiology
- Gastroenterology
- Psychiatry
Background:
- Functional gastrointestinal (GI) disorders, including irritable bowel syndrome, frequently co-occur with affective disorders such as depression, anxiety, panic, and posttraumatic stress disorder (PTSD).
- These associations are present in both clinical and general population samples, indicating underlying shared pathophysiologic mechanisms.
- Life-threatening stressors, both acute and sustained, are implicated in the development and exacerbation of GI symptoms and affective disorders, including PTSD.
Purpose of the Study:
- To propose a neurobiological model explaining the link between functional GI disorders and affective disorders.
- To elucidate the mechanisms contributing to visceral hypersensitivity in functional GI disorders.
- To understand the neuroendocrine and autonomic dysfunction associated with functional GI disorders and their overlap with affective disorders.
Main Methods:
- Literature review and synthesis of existing research on functional GI disorders, affective disorders, and stress.
- Development of a conceptual neurobiological model integrating findings from various scientific disciplines.
- Analysis of the role of neuroendocrine and autonomic systems in the pathophysiology of both GI and affective conditions.
Main Results:
- The proposed model integrates the impact of stressors on GI and affective systems.
- It highlights the development of visceral hypersensitivity as a key feature of functional GI disorders.
- The model explains the neurobiological underpinnings of the overlap between functional GI disorders and affective disorders like PTSD.
Conclusions:
- A shared neurobiological framework can explain the co-occurrence of functional GI disorders and affective disorders.
- Stress-related neurobiological changes are central to the pathophysiology of both conditions.
- Understanding these mechanisms may lead to integrated treatment strategies for patients with comorbid GI and affective disorders.