Major depression and irritable bowel syndrome: is there a relationship?

Irritable bowel syndrome (IBS) has been reported in 10% to 22% of adults. Seventy percent to 90% of patients with IBS who seek medical attention have psychiatric comorbidity, most commonly major depression. In contrast, few studies have looked at the prevalence of IBS among psychiatric patients.

Using a semistructured clinical interview to study the prevalence of IBS, we compared 56 patients seeking treatment for major depression in an outpatient setting to an age- and sex-matched control group of patients (N = 40) who were seeking treatment in a general physician's office for other medical illnesses. The control group had no Axis I disorders. IBS was diagnosed according to the criteria of Drossman et al.

Twenty-seven percent (N = 15) of patients with major depression met criteria for IBS in contrast to 2.5% (N = 1) of the control group (p = .0005). Patients with major depression and IBS were more likely to report symptoms of back pain, weakness, heartburn, and nocturnal bowel movements as well as a personal or family history of bowel disease compared with patients with major depression but without IBS.

IBS is fairly common in patients seeking treatment for major depression. Prospective studies should address the question whether treatment of major depression leads to an improvement or resolution of the symptoms of IBS.