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Nature and specificity of altered cognitive functioning in IBS
Author(s) -
Wong Kenneth ManFung,
Mak Arthur Dun Ping,
Yuen Suet Ying,
Leung Owen Ngo Wang,
Ma Duan Yang,
Chan Yawen,
Cheong Pui Kuan,
Lui Rashid,
Wong Sunny Hei,
Wu Justin CheYuen
Publication year - 2019
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.13696
Subject(s) - wisconsin card sorting test , irritable bowel syndrome , anxiety , medicine , generalized anxiety disorder , stroop effect , executive dysfunction , cognition , depression (economics) , psychiatry , beck depression inventory , psychology , gastroenterology , neuropsychology , economics , macroeconomics
Background It is unknown whether cognitive dysfunction found in patients with irritable bowel syndrome (IBS) was attributable to the different subtypes, ongoing pathophysiological processes, trait characteristics, or psychiatric comorbidity. Methods Forty Rome‐III patients with IBS (20 diarrhea‐predominant [IBS‐D] and 20 constipation‐predominant [IBS‐C]) and 40 age‐, sex‐, education‐matched healthy controls were systematically recruited and compared on their cognitive function with continuous performance test (CPT), Wisconsin Card Sorting Test (WCST) and emotional Stroop test. Beck Anxiety Inventory (BAI), Beck Depression Inventory‐II (BDI‐II), Patient Health Questionnaire‐15 (PHQ‐15) and a structured bowel symptom questionnaire were performed to measure anxiety, depressive, somatization, and bowel symptoms, respectively. Psychiatric diagnoses were ascertained with SCID‐I (Structured Clinical Interview for DSM‐IV Axis I Disorders). Key Results Patients with IBS showed significantly increased standard deviation of reaction time (SDRT) ( P = .003) on CPT, increased failure to maintain set (FMS) ( P =.002), and percentage of perseverative errors ( P = .003) on WCST. SDRT did not correlate with illness chronicity or bowel symptoms. FMS correlated with bowel symptom severity. In logistic regression models controlled for BAI, BDI‐II, and PHQ‐15, SDRT (AOR = 1.08, P = .025), but not FMS ( P = .25) or percentage of perseverative errors ( P = .24), significantly differentiated IBS from controls. Cognitive function was not significantly different between IBS‐C and IBS‐D ( P > .05), or between pure IBS (n = 22) and IBS with generalized anxiety disorder (GAD) (n = 17) ( P > .05). Conclusions & Inferences Patients with IBS showed attentional and executive function impairment irrespective of subtypes but otherwise heterogeneous in terms of its state‐trait correlations and overlap with anxiety comorbidity.