Temperament and character traits in patients with irritable colon

Objective: Irritable Bowel Syndrome (IBS) is a chronic, continuous or intermittent illness characterized by frequent and unexplained symptoms that include abdominal pain, bloating, and bowel disturbance. It is considered to be the most common gastrointestinal (GI) dysfunction with an estimated prevalence of 8-22% in general population. Though a number of biological triggers have been proposed for onset of IBS, it has also been suggested that psychological factors, particularly those associated with the process of somatization play an important role and may even act as markers of IBS onset. Recent studies have shown that subjects with IBS have higher levels of depression, anxiety and neuroticism as compared to those without IBS. There is a growing literature about the relationship between irritable colon and psychiatric symptoms and also the relationship between temperament and character traits and organic diseases. However, to the best of our knowledge the relationship between IBS and temperament and character traits has not been investigated yet. Thus, the aim of this study was to research if there is a relationship between temperament and character traits and IBS.

Methods: This study is conducted with 57 patients with irritable colon and 57 healthy controls. Participants who accepted voluntarily to join the study and who are between the ages of 18-65 with no psychiatric diagnosis are included into the study. Approval of local ethics committee has been obtained and all patients gave written consent. A sociodemographical data form is completed by all participants. Irritable colon is evaluated according to the ROME III criteria. All of the participants in the irritable colon group and the healthy control group were evaluated by a psychiatric interview for the psychiatric diagnosis and the ones with any active psychiatric disorder were excluded. Structured Clinical Interview for DSM-IV (clinical version) is used for the psychiatric evaluation. Then Temperament and Character Inventory is completed by all participants of the study.

Results: This study is conducted with 57 patients with irritable colon and 57 healthy controls. In comparison between the groups, it was determined that in the group of irritable colon, scores of persistence, which is one of the temperament characteristics, was lower than in the control group; and self-directedness and cooperativeness, which are two of the character traits, were lower than in the control group (p<0.05). In correlation analysis, positive correlation between cooperativeness and irritable bowel disease duration was determined (p0.280, p<0.05). According to regression analysis, having ‘irritable colon’ was a predictor factor for ‘persistence’ trait (beta:-0.253, t:-2.230, p<0.05), yet it was not a predictor factor for other traits. However, level of education was a predictor factor for ‘self-directedness’ (beta 0.329, t 3.008, p<0.005).

Conclusion: This study showed that there is a relationship between personality and irritable colon. Persistence, self-directedness and cooperativeness are personality traits found to have a relationship with IBS. Further studies with larger sample sizes are needed.