?????.........MOLD EXPOSURE

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MOLD/IBS?

Pain. 2007 Oct 8; : 17928145 (P,S,E,B,D) Psychosocial risk markers

for new onset irritable bowel syndrome - Results of a large

prospective population-based study.

[My paper] B I Nicholl, S L Halder, G J Macfarlane, D G , S

O'brien, M Musleh, J McBeth

Irritable bowel syndrome (IBS) affects up to 22% of the general

population. Its aetiology remains unclear. Previously reported cross-

sectional associations with psychological distress and depression are

not fully understood. We hypothesised that psychosocial factors,

particularly those associated with somatisation, would act as risk

markers for the onset of IBS. We conducted a community-based

prospective study of subjects, aged 25-65years, randomly selected

from the registers of three primary care practices. Responses to a

detailed questionnaire allowed subjects' IBS status to be classified

using a modified version of the Rome II criteria. The questionnaire

also included validated psychosocial instruments. Subjects free of

IBS at baseline and eligible for follow-up 15months later formed the

cohort for this analysis (n=3732). An adjusted participation rate of

71% (n=2456) was achieved at follow-up. 3.5% (n=86) of subjects

developed IBS. After adjustment for age, gender and baseline

abdominal pain status, high levels of illness behaviour (odds ratio

(OR)=5.2; 95% confidence interval (95% CI) 2.5-11.0), anxiety

(OR=2.0; 95% CI 0.98-4.1), sleep problems (OR=1.6; 95% CI 0.8-3.2),

and somatic symptoms (OR=1.6; 95% CI 0.8-2.9) were found to be

independent predictors of IBS onset. This study has demonstrated that

psychosocial factors indicative of the process of somatisation are

independent risk markers for the development of IBS in a group of

subjects previously free of IBS. Similar relationships are observed

in other " functional " disorders, further supporting the hypothesis

that they have similar aetiologies.