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The cognitive behavioural model of irritable bowel syndrome: a prospective investigation of gastroenteritis patients.
  1. Meagan J Spence
  1. University of Auckland, New Zealand
    1. Rona Moss-Morris (remm{at}
    1. University of Southampton, United Kingdom


      Background and aims: The aim of this study was to determine whether a combination of mood and personality factors together with illness beliefs and behaviours predict the onset of irritable bowel syndrome (IBS) post gastroenteritis, as suggested by the cognitive behavioural model of IBS.

      Methods: Primary care patients with a positive test for Campylobacter gastroenteritis, and no previous history of IBS or serious bowel conditions were recruited into this prospective study (N=620). Participants completed a questionnaire at the time of infection which included standardised measures of mood, perceived stress, perfectionism, negative illness beliefs and illness behaviours. 3 and 6 months after initial infection, participants completed follow-up questionnaires designed to determine whether they met Rome criteria for IBS.

      Results: A total of 49 participants met criteria for IBS at both follow-up points. Logistic regressions indicated that those who developed IBS had significantly higher levels of perceived stress (1.10 [95%CI, 1.02- 1.15]), anxiety (1.14 [95%CI, 1.05-1.23]), somatisation, (1.17 [95%CI, 1.02-1.35]), and negative illness beliefs (1.14 [95%CI, 1.03-1.27]) at the time of infection than those who did not develop IBS. IBS cases were also significantly more likely to remain active in the face of their acute symptoms until they felt forced to rest (all-or-nothing behaviour) (1.09 [95%CI, 1.03-1.16]), and significantly less likely to initially rest in response to their acute illness (0.93 [95%CI, .88- .97]). Depression and perfectionism were not associated with IBS onset.

      Conclusions: Results suggest that patients with high stress and anxiety levels are more prone to develop IBS after a bout of gastroenteritis. Additional risk factors include a tendency to interpret illness in a pessimistic fashion and to respond to symptoms in an all- or-nothing manner

      • biopsychosocial
      • campylobacter gastroenteritis
      • cognitive behavioural
      • functional somatic syndromes
      • irritable bowel syndrome

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