• Irritable bowel syndrome
• Treatment
• Comorbidities
• Psychiatric disorders

Irritable Bowel Syndrome (IBS) is the most common functional gastrointestinal (GI)
disorder observed in patients who visit general practitioners for GI­related complaints. A
high prevalence of psychiatric comorbidities, particularly anxiety and depressive
disorders, has been reported in patients with IBS, suggesting that this association should
always be considered in this setting.
In order to better define the relationship between IBS and psychiatric disorders, one
hundred and fifty subjects with diagnosis of IBS and relative sub­classification
(constipated, diarrhea and alternating bowel) were assessed for gastrointestinal and
mental functioning at the Gastroenterological Department of University of Pisa.
Over half of the subjects in the sample (56%) showed “psychopathological features”
(term that covers both Axis I diagnosis both previous or current drug / psychological
treatment). In this group GI symptoms severity was higher and quality of life more
unsatisfactory than in the group without any psychiatric implications (44%).
Second objective of the study was to examine the efficacy of SSRI (paroxetine) in IBS
patients. With the limit due to small sample size of IBS patients suitable for treatment
paroxetine showed a significant improvement not only at psychiatric but also at GI
evaluations. Moreover, efficacy on abdominal symptoms was independent by the
presence of psychopathological features or by quality of life and satisfaction.
Consequently this study emphasizes the importance of the assessment of all IBS subjects
for clear or subclinical psychiatric comorbidities that are suggestive to correlate with the
severity of GI symptoms and functional impairment.