J Neurogastroenterol Motil.  2018 Jan;24(1):79-86. 10.5056/jnm17004.

Sexual Abuse Is Associated With an Abnormal Psychological Profile and Sleep Difficulty in Patients With Irritable Bowel Syndrome in Taiwan

Affiliations
  • 1Division of Gastroenterology, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Foundation, Chia-Yi, Taiwan.
  • 2School of Medicine, Tzu Chi University, Hualien, Taiwan.
  • 3Institute of Brain Science, National Yang-Ming University School of Medicine, Taipei, Taiwan. cllu@ym.edu.tw
  • 4Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
  • 5Endoscopic Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan.
  • 6Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • 7Division of Gastroenterology, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.

Abstract

BACKGROUND/AIMS
Both sexual and physical abuse history have been reported to be associated with irritable bowel syndrome (IBS) in Western countries. The impact of abuse history in IBS patients in Asia remains unclear. We aim to determine the prevalence of abuse history, its associated psychological profiles, and sleep problems among IBS patients in Taiwan.
METHODS
In total, 194 Rome III-defined IBS patients were invited to participate. Age- and sex-matched healthy carriers of chronic hepatitis B or hepatitis C without chronic abdominal symptoms were identified as disease-controls. We administered a validated questionnaire to evaluate bowel symptoms, physical/sexual abuse history, anxiety/depression (Hospital Anxiety and Depression Scale [HADS]), and sleep quality.
RESULTS
IBS patients had a significantly higher prevalence of sexual abuse history than the disease-control group both before (16.5% vs 6.7%, P < 0.05) and after (16.0% vs 6.6%, P < 0.05) adolescence. These significant differences were mainly observed in women (13.4% vs 3.4%, P < 0.05). No difference was noted in history of physical abuse between the 2 groups. IBS patients with a history of sexual abuse had significantly higher HADS scores and higher frequencies of sleep difficulty than those without.
CONCLUSIONS
In Taiwan, sexual abuse history was more prevalent in female IBS patients than controls. Sexual abuse history may contribute to higher anxiety/depression levels and sleep difficulties, which are commonly experienced in IBS patients. In Asia, abuse history should be obtained when approaching IBS patients to facilitate better management.

Keyword

Depression; Irritable bowel syndrome; Physical abuse; Sexual abuse

MeSH Terms

Adolescent
Anxiety
Asia
Depression
Female
Hepatitis B, Chronic
Hepatitis C
Humans
Irritable Bowel Syndrome*
Physical Abuse
Prevalence
Sex Offenses*
Taiwan*
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