Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-27T14:32:47.679Z Has data issue: false hasContentIssue false
  • English
  • Français

Symptom complaints, psychiatric disorder and abnormal illness behaviour in patients with upper abdominal pain

Published online by Cambridge University Press:  09 July 2009

Stephen Colgan ,
Francis Creed  and
Howard Klass
Stephen Colgan*
Affiliation:
Department of Psychiatry, Manchester Royal Infirmary and the North Manchester General Hospital, Manchester
Francis Creed
Affiliation:
Department of Psychiatry, Manchester Royal Infirmary and the North Manchester General Hospital, Manchester
Howard Klass
Affiliation:
Department of Psychiatry, Manchester Royal Infirmary and the North Manchester General Hospital, Manchester
*
1 Address for correspondence: Dr S. Colgan, Department of Medicine, Withington Hospital, Nell Lane, Manchester M20 8LR.
Get access Rights & Permissions [Opens in a new window]

Synopsis

Seventy patients presenting to the gastroenterologist with upper abdominal pain were examined by a psychiatrist to establish the presence of psychiatric disorder, illness behaviour and to record in detail their symptom pattern. The 37 patients who had no organic cause for their abdominal complaints were subdivided into those with and without psychiatric disorder. The former (21 patients) demonstrated more illness behaviour, they complained of more abdominal symptoms and their pain was both more severe and more persistent than in the patients with organic disease and those with non-organic illness who did not have psychiatric disorder. The latter group reported no symptoms of ‘psychoneurosis’ and should probably be regarded as a separate group if the aetiology of functional abdominal pain is to be clarified. Those with non-organic abdominal complaints who had psychiatric illness could be distinguished by the presence of three symptoms, namely depression, anxiety and fatigue. Detection and treatment of their psychiatric disorder might lead to a decrease in their symptomatic complaints and illness behaviour.

Type
Research Article
Information
Psychological Medicine , Volume 18 , Issue 4 , November 1988 , pp. 887 - 892
Copyright
Copyright © Cambridge University Press 1988

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Canton, G., Santonastaso, P. & Fraccon, I. G. (1984). Life events, abnormal illness behaviour and appendicectomy. General Hospital Psychiatry 6, 191–195.CrossRefGoogle Scholar
Connell, A. M. (1962). The motility of the pelvic colon. II. Paradoxical motility in diarrhoea and constipation. Gut 3,342–348.CrossRefGoogle ScholarPubMed
Connell, A. M., Jones, F. A. & Rowlands, E. N. (1965). Motility of the pelvic colon. IV. Abdominal pain associated with colonic hypermotility. Gut 6, 105–112.CrossRefGoogle ScholarPubMed
Craig, T. K. & Brown, G. W. (1984). Goal frustration and life events in the aetiology of painful gastrointestinal disorders. Journal of Psychosomatic Research 28, 411–421.CrossRefGoogle Scholar
Creed, F. H. & Guthrie, E. (1987). Psychological factors in the irritable bowel syndrome. Gut 28, 1307–1318.CrossRefGoogle ScholarPubMed
Eastwood, M. A. & Nyhlin, H. (1981). Irritable bowel syndrome. Gastroenterology 80, 633.CrossRefGoogle ScholarPubMed
Elias, E. & Hawkins, C. (1985). Lecture Notes on Gastroenterology pp. 183–185. Blackwell: Oxford.Google Scholar
Fava, F. A., Pilowsky, I., Pierfederici, A., Bernardi, M. & Pathak, D. (1982). Depressive symptoms and abnormal illness behaviour in general hospital patients. General Hospital Psychiatry 4, 171–178.CrossRefGoogle ScholarPubMed
Ferguson, A., Sircus, W. & Eastwood, M. (1977). Frequency of functional gastrointestinal disorders. Lancet ii, 613–615.CrossRefGoogle Scholar
Ford, M. J., Miller, P. McC., Eastwood, J. & Eastwood, M. A. (1987). Life events, psychiatric illness and the irritable bowel syndrome. Gut 28, 160–165.CrossRefGoogle ScholarPubMed
Goldberg, D. P., Cooper, B., Eastwood, M. R., Kedwood, H. B. & Shepherd, M. (1970). A standardised psychiatric interview for use in community surveys. British Journal of Preventive and Social Medicine 24, 18–23.Google ScholarPubMed
Gomez, J. & Dally, P. (1977). Psychologically mediated abdominal pain in surgical and medical out-patient clinics. British Medical Journal i, 1451–1453.CrossRefGoogle Scholar
Harvey, R. F., Salith, S. Y. & Read, A. E. (1983). Organic and functional disorders in 2000 gastroenterology outpatients. Lancet i, 632–634.CrossRefGoogle Scholar
Hawkins, C. (1984). In Textbook of Gastroenterology (ed. Bouchier, I. A. D.Allan, R. N.Hodgson, H. J. F. & Keighly, M. R. B.), pp. 1204–1205. Bailliere Tindall: London.Google Scholar
Hislop, I. G. (1971). Psychological significance of the irritable colon. Gut 12, 452–457.CrossRefGoogle ScholarPubMed
Horrocks, J. D. & de Dombal, F. T. (1978). Clinical presentation of patients with ‘dyspepsia’: detailed symptomatic study of 360 patients. Gut 19, 19–26.CrossRefGoogle ScholarPubMed
Joyce, P. R., Bushnell, J. A., Walshe, J. W. B. & Morton, J. B. (1986). Abnormal illness behaviour and anxiety in acute nonorganic abdominal pain. British Journal of Psychiatry 149, 57–62.CrossRefGoogle ScholarPubMed
Kingham, J. G. C. & Dawson, A. M. (1985). Origin of chronic right upper quadrant pain. Gut 26, 783–788.CrossRefGoogle ScholarPubMed
MacDonald, A. J. & Bouchier, I. A. D. (1980). Non-organic gastrointestinal illness: a medical and psychiatric study. British Journal of Psychiatry 136, 276–283.CrossRefGoogle ScholarPubMed
Manning, A. P., Thompson, W. G., Heaton, K. W. & Morris, A. F. (1978). Towards a positive diagnosis of the irritable bowel. British Medical Journal 2, 653–654.CrossRefGoogle ScholarPubMed
Mollmann, K. M., Bonnevie, O., Gudbrand-Hoyer, E. & Wulff, H. R. (1975). A diagnostic study of patients with upper abdominal pain. Scandanavian Journal of Gastroenterology 10, 805–809.CrossRefGoogle ScholarPubMed
Pilowsky, I. & Spence, N. D. (1975). Patterns of illness behaviour in patients with intractable pain. Journal of Psychosomatic Research 19, 279–287.CrossRefGoogle ScholarPubMed
Swarbrick, E. T., Hegarty, J. E., Bat, L., Williams, C. B. & Dawson, A. M. (1980). Site of pain from the irritable bowel. Lancet ii, 443–436.CrossRefGoogle Scholar
Talley, N. J. & Piper, D. W. (1986). Comparison of the clinical features and illness behaviour of patients presenting with dyspepsia of unknown cause (essential dyspepsia) and organic disease. Australian and New Zealand Journal of Medicine 16, 352–359.CrossRefGoogle ScholarPubMed
Wangel, A. G. & Deller, D. J. (1965). Intestinal motility in man. III. Mechanisms of constipation and diarrhoea with particular reference to the irritable colon syndrome. Gastroenterology 48, 69–84.CrossRefGoogle Scholar
Whitehead, W. E., Winget, C., Fedoravicius, A. S., Wooley, S. & Blackwell, B. (1982). Learned illness behaviour in patients and irritable bowel syndrome and peptic ulcer. Digestive Diseases and Sciences 27, 202–208.CrossRefGoogle ScholarPubMed
Whorwell, P. J., Clouter, c. & Smith, C. L. (1981). Oesophageal motility in the irritable bowel syndrome. British Medical Journal 282, 1101–1102.CrossRefGoogle ScholarPubMed
Whorwell, P. J., McCallum, M., Creed, F. H. & Roberts, C. T. (1986). Non-colonic features of irritable bowel syndrome. Gut, 37–40.CrossRefGoogle ScholarPubMed
Young, S. J., Alpers, D. H., Norland, C. C. & Woodruff, R. A. (1976). Psychiatric illness and the irritable bowel syndrome. Practical implications for primary physician. Gastroenterology 70, 162–166.CrossRefGoogle ScholarPubMed