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Biomedical subjects

Philip M Boyce

Publications and source records attributed to Philip M Boyce.

9 recordsLinked to original sources
PubMed2006

Somatization an independent psychosocial risk factor for irritable bowel syndrome but not dyspepsia: a population-based study.

BACKGROUND: A psychosocial conceptualization for irritable bowel syndrome and unexplained dyspepsia has been proposed, but remains untested. We conducted a comprehensive population-based study to determine what psychiatric and psychosocial factors, if any, are important in irritable bowel syndrome and dyspepsia. METHODS: Two hundred and seven participants identified from two previous Australian population surveys who also met Rome I criteria for irritable bowel syndrome (n=156) or unexplained dyspepsia (n=51) were included in the study. Consulters (n=103) were those who had had visited their general practitioner for gastrointestinal symptoms at least once in the prior 12 months. Nonconsulters had not sought medical care for gastrointestinal symptoms in the past year. Controls (n=100) did not report having any abdominal pain in a previous population survey. Psychosocial variables were assessed using structured interviews and validated self-report measures. RESULTS: Psychiatric diagnoses, neuroticism, more highly threatening life event stress, an external locus of control and ineffectual coping styles were significantly associated with having a diagnosis of irritable bowel syndrome and/or dyspepsia. Only somatization (odds ratio=5.28, 95% confidence interval 1.57-17.68), however, was independently associated with irritable bowel syndrome. Psychosocial factors did not discriminate between consulters and nonconsulters. CONCLUSIONS: Somatization is likely play a key role in explaining irritable bowel syndrome but not dyspepsia.

Adaptation, Psychological↗
PubMed2005

A history of abuse in community subjects with irritable bowel syndrome and functional dyspepsia: the role of other psychosocial variables.

BACKGROUND/AIMS: Why abuse is associated with irritable bowel syndrome and functional dyspepsia remains unclear but other psychosocial factors may be important. We hypothesized that other psychosocial variables may confound the association. METHODS: 207 subjects identified from a previous population survey who also met Rome I criteria for IBS (n=156) or functional dyspepsia (n=51) were included in the study. Controls (n=100) did not report having any abdominal pain in a previous population survey. Sexual, physical, emotional/verbal abuse as a child ( or=14 years) was assessed using validated self-report questions. Other psychological variables were assessed via validated self-report. RESULTS: Adulthood abuse was significantly more common in IBS and/or functional dyspepsia (40%) compared with healthy controls (25%). Abuse was not an independent predictor for IBS or functional dyspepsia when psychological and buffering factors were controlled for in the analyses. Having a diagnosis of depression and using a self-controlling coping style were significantly associated with having a history of abuse. CONCLUSIONS: Abuse occurring as an adult was significantly associated with IBS and/or functional dyspepsia, but it was not an important factor when psychosocial factors were controlled for in these disorders.

Case-Control Studies↗
PubMed2005

Is health care seeking for irritable bowel syndrome and functional dyspepsia a socially learned response to illness?

In a population-based study of 207 subjects with irritable bowel syndrome (IBS) or functional dyspepsia (FD) and controls (n = 100), we aimed to determine whether dimensions of abnormal illness behavior from the Abnormal Illness Behaviour Questionnaire and aspects of social learning of illness behavior from the Social Learning of Illness Behaviour scale were independent predictors of health care seeking for IBS and FD. Results showed that dimensions of abnormal illness behavior and aspects of social learning of illness behavior (encouragement, reinforcement, and modeling) did not significantly differentiate between consulters and nonconsulters with IBS and/or FD. The Disease Conviction scale (OR = 1.55; 95% CI, 1.15-2.09) of the Abnormal Illness Behaviour Questionnaire was an independent predictor of having a diagnosis of IBS and/or FD, independent of age and gender, psychiatric diagnoses, and symptom severity. We conclude that a belief in the presence of serious pathology characterizes community subjects with IBS and FD, but not health care seeking.

Adult↗
PubMed2003

Does psychological distress modulate functional gastrointestinal symptoms and health care seeking? A prospective, community Cohort study.

OBJECTIVE: Little is known about the natural history of functional GI symptoms, including what factors influence GI symptom patterns and health care seeking for them over the long term. We aimed to determine whether psychological factors play a role in the development and long-term course of these symptoms. METHODS: A random sample of community subjects (n = 361) who reported having unexplained abdominal pain for > or =1 month in a previous population survey were included in the study. Controls (n = 120) were defined as not having abdominal pain for > or =1 month from this initial survey. Subjects were prospectively followed up via a questionnaire every 4 months over a 12-month period. The questionnaire asked about the presence of GI symptoms over the past week and psychological distress over the past 3 wk (psychological caseness being defined as a score of > or=2 of 12 on the General Health Questionnaire). The number of visits made to a physician or medical specialist over the past 4 months was evaluated. RESULTS: GI symptoms were common among community controls and subjects with abdominal pain. Similar onset and disappearance rates were observed for the majority of GI symptom categories, accounting for the stability of the prevalence rates over a 1-yr period. Changes in a state measure of psychological distress were not significantly associated with changes in GI symptom status between the 4- and 8-month (r = 0.14, p = 0.08) and 8- and 12-month (r = 0.02, p = 0.77) follow-ups. Baseline psychological distress, however, was an independent predictor of having persistent GI symptoms, including abdominal pain, bloating, and constipation, and frequently seeking health care for GI symptoms over 1 yr. CONCLUSIONS: Psychological distress levels do not seem to be important in explaining GI symptom change over a 1-yr period. Psychological distress, however, is linked to having persistent GI symptoms and frequently seeking health care for them over time. Clinicians should consider psychological factors in the treatment of this subset of irritable bowel syndrome patients.

Adult↗
PubMed2003

A randomized controlled trial of cognitive behavior therapy, relaxation training, and routine clinical care for the irritable bowel syndrome.

OBJECTIVES: Psychological treatments are considered to be useful in the irritable bowel syndrome (IBS), although the evidence is based on small, often flawed trials. Although cognitive behavior therapy (CBT) and relaxation therapy have both been promising, we hypothesized that CBT would be superior to relaxation and standard care alone in IBS patients. The objective of this study was to test this assumption by comparing the effects of cognitive behavior therapy with relaxation therapy and routine clinical care alone in individuals with IBS. METHODS: Patients (n = 105) with Rome I criteria for IBS were recruited from advertisement (n = 51) and outpatient clinics (n = 54); those patients with resistant IBS were not included. A randomized controlled trial with three arms (standard care for all groups plus either CBT or relaxation) for 8 wk was conducted, which applied blinded outcome assessments using validated measures with 1 yr of follow-up. The primary outcome for this study was bowel symptom severity. RESULTS: Of 105 patients at the commencement of treatment, the mean bowel symptom frequency score for the whole sample was 21.1 and at the end of treatment had fallen to 18.1; this persisted at the 52-wk follow-up, with a significant linear trend for scores to change over time (F = 39.57 p < 0.001). However, there were no significant differences among the three treatment conditions. Significant changes over time were found for physical functioning (F = 4.37, p < 0.001), pain (F = 3.12, p < 0.05), general health (F = 2.71, p < 0.05), vitality (F = 2.94, p < 0.05), and the social functioning scales on the Medical Outcomes Study Short Form 36 (F = 4.08, p < 0.05); however, all three arms showed similar improvement. There were significant reductions in anxiety, depression, and locus of control scales, but no significant differences among the treatment groups were detected. CONCLUSION: Cognitive behavior and relaxation therapy seem not to be superior to standard care alone in IBS.

Adult↗
PubMed2002

Response inhibition deficits in obsessive-compulsive disorder.

Difficulty inhibiting irrelevant information may play a central role in the aetiology of obsessive-compulsive disorder (OCD). The aim of the present study was to determine whether OCD subjects (n=20) exhibit deficits in behavioural and cognitive inhibition compared with a clinical control group diagnosed with panic disorder (n=20). All subjects were administered a Go/Nogo task (a measure of behavioural inhibition) and a Stroop test (a measure of cognitive inhibition). OCD subjects made more commission errors on the Go/Nogo task, and they made more errors and displayed longer reaction times on the interference trial of the Stroop task. Trends towards correlations were observed between OCD severity scores and Stroop reaction time, where the more severe the OCD symptoms the faster was the response. No correlations between clinical symptomatology or subject demographics and the Go/Nogo task were observed. It was demonstrated that OCD subjects exhibit deficits in behavioural and cognitive inhibition, which together may underlie the repetitive symptomatic behaviours of the disorder, such as compulsions and obsessions.

Adolescent↗
PubMed2002

Epidemiology and health care seeking in the functional GI disorders: a population-based study.

OBJECTIVES: Functional GI disorders (FGIDs) are common in clinical practice, but little is known about the epidemiology of these disorders in the general population. We aimed to determine the prevalence, association with psychological morbidity, and health care seeking behavior of FGIDs in the population. METHODS: A random sample of subjects (n = 4500) aged > or = 18 yr and representative of the Australian population were mailed a validated questionnaire. For these subjects we measured all Rome I GI symptoms and physician visits over the past 12 months, as well as neuroticism, anxiety, depression, and somatic distress. RESULTS: The response rate for the study was 72%. The prevalence of any FGID was 34.6%, and 62.1% of these subjects had consulted a physician. There was considerable overlap of the FGIDs (19.2% had more than two disorders). Independent predictors for an FGID diagnosis were neuroticism, somatic distress, anxiety, bowel habit disturbance, abdominal pain frequency, and increasing age. However, psychological morbidity did not independently discriminate between consulters and nonconsulters with an FGID. CONCLUSIONS: More than one third of the general population have one or more FGIDs. There seems to be a modest link between psychological morbidity and FGIDs, although other unknown factors seem to be more important in explaining health care seeking for these disorders.

Adolescent↗
PubMedDate not supplied

Executive functions in obsessive-compulsive disorder: state or trait deficits?

OBJECTIVE: Despite the neuropsychology literature providing reliable evidence of impaired executive functions in obsessive-compulsive disorder (OCD), to date it has not been determined whether these deficits are trait-related (independent of symptomatology) or state-dependent (dependent on symptomatology). The current research examines the executive functions in OCD in a comprehensive manner and, for the first time, assesses the stability of these deficits over the developmental course of the disorder. METHOD: Using a cross-sectional design, Study 1 examined the executive functions (set shifting, inhibition, planning, verbal fluency and working memory) in 60 subjects (20 actively Symptomatic OCD, 20 Remitted OCD and 20 Panic Disorder). Using a longitudinal design, Study 2 reassessed a subsample of OCD subjects (participants in Study 1) once they reached remitted status. RESULTS: Study 1 found that the OCD groups exhibited deficits in set shifting and inhibition relative to Panic Disorder controls; however, no deficits were observed in planning, verbal fluency or working memory. There were no differences found between the Symptomatic and Remitted OCD groups on any of the executive function measures. Study 2 found that the identified executive function deficits in individuals were stable over time and remained unchanged despite symptom remittance. CONCLUSION: Current results confirm the presence of specific executive function deficits in OCD, and indicate that these deficits are trait-like in nature.

Adult↗