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Neuropsychological function is related to irritable bowel syndrome in women with premenstrual syndrome and dysmenorrhea

  • General Gynecology
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Abstract

Background

There is increasing evidence demonstrating the co-occurrence of primary dysmenorrhea (PD), premenstrual syndrome (PMS), and irritable bowel syndrome (IBS) in women. This study aimed to investigate whether women who have symptoms of IBS in addition to PD and PMS also report more severe or frequent menstruation-associated symptoms and psychological complications compared to women with PD and PMS alone.

Methods

The study group included 182 female University students aged 18–25 years. IBS was diagnosed using the Rome III criteria. The severity of PMS and PD was determined using a 10-point visual analog scale and PSST (Premenstrual Syndrome Screening Tool), respectively. Neuropsychological functions including cognitive function, depression score, anxiety score, stress, insomnia, daytime sleepiness, quality of life and personality were assessed using standard questionnaires.

Results

Of the 182 young females, 31 (17.0%) had IBS. Average days of bleeding during the menstrual cycle and mean pain severity on the PSST scale were significantly greater in the group with IBS compared to the non-IBS group (p < 0.01). The non-IBS individuals scored more favorably than the women with IBS with respect to severity of depression, insomnia, daytime sleepiness (p < 0.05). The PSST scores were significantly correlated with scores for depression (r = 0.29; p < 0.001), anxiety (r = 0.28; p < 0.001), stress (r = 0.32; p < 0.001), insomnia (r = 0.34; p < 0.001) and daytime sleepiness (r = 0.31; p < 0.001); while, they were negatively correlated with cognitive abilities (r = − 0.20; p = 0.006) and quality of life (r = − 0.42; p < 0.001). Linear regression analysis showed that the PSST scores were possibly significant factors in determining the scores for depression, anxiety, stress, quality of life, insomnia and daytime sleepiness (p < 0.05).

Conclusion

IBS is related to psychological comorbidities, in particular depression, sleep problems and menstrual-associated disorders. IBS may exacerbate the features of PMS which should be taken into account in the management of PMS.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Longstreth GF et al (2006) Functional bowel disorders. Gastroenterology 130(5):1480–1491

    PubMed  Google Scholar 

  2. Canavan C, West J, Card T (2014) The epidemiology of irritable bowel syndrome. Clin Epidemiol 6:71

    PubMed  PubMed Central  Google Scholar 

  3. Jahangiri P et al (2012) Irritable bowel syndrome in Iran: SEPAHAN systematic review No. 1. International journal of preventive medicine 3(Suppl 1):S1

    PubMed  PubMed Central  Google Scholar 

  4. Vahedi H et al (2010) Irritable bowel syndrome: a review article. Middle East J Dig Dis 2(2):66

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Mayer EA et al (2009) Brain imaging approaches to the study of functional GI disorders: a Rome working team report. Neurogastroenterol Motil 21(6):579–596

    CAS  PubMed  Google Scholar 

  6. Elsenbruch S (2011) Abdominal pain in Irritable Bowel Syndrome: a review of putative psychological, neural and neuro-immune mechanisms. Brain Behav Immun 25(3):386–394

    CAS  PubMed  Google Scholar 

  7. Atkinson W et al (2004) Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial. Gut 53(10):1459–1464

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Barbara G et al (2011) The immune system in irritable bowel syndrome. J Neurogastroenterol Motil 17(4):349

    PubMed  PubMed Central  Google Scholar 

  9. Camilleri M, Lasch K, Zhou W (2012) Irritable bowel syndrome: methods, mechanisms, and pathophysiology. The confluence of increased permeability, inflammation, and pain in irritable bowel syndrome. Am J Physiol-Gastrointest Liver Physiol 303(7):775–785

    Google Scholar 

  10. Philpott H, Gibson P, Thien F (2011) Irritable bowel syndrome-an inflammatory disease involving mast cells. Asia Pac Allergy 1(1):36–42

    PubMed  PubMed Central  Google Scholar 

  11. Ringel Y, Ringel-Kulka T (2015) The intestinal microbiota and irritable bowel syndrome. J Clin Gastroenterol 49:S56–S59

    CAS  PubMed  Google Scholar 

  12. Walker EA et al (1992) Comorbidity of gastrointestinal complaints, depression, and anxiety in the Epidemiologic Catchment Area (ECA) Study. Am J Med 92(1):S26–S30

    Google Scholar 

  13. Drossman DA (1999) Do psychosocial factors define symptom severity and patient status in irritable bowel syndrome? Am J Med 107(5):41–50

    Google Scholar 

  14. Elsaied HF et al (2017) A study of sociodemographic factors and anxiety: depressive disorders among irritable bowel syndrome patients. Egypt J Psychiatry 38(2):97

    Google Scholar 

  15. Tougas G (2000) The autonomic nervous system in functional bowel disorders. Gut 47(Suppl 4):478–480

    Google Scholar 

  16. Houghton L et al (2002) The menstrual cycle affects rectal sensitivity in patients with irritable bowel syndrome but not healthy volunteers. Gut 50(4):471–474

    CAS  PubMed  PubMed Central  Google Scholar 

  17. McPherson ME, Korfine L (2004) Menstruation across time: menarche, menstrual attitudes, experiences, and behaviors. Women’s Health Issues 14(6):193–200

    PubMed  Google Scholar 

  18. Iacovides S, Avidon I, Baker FC (2015) What we know about primary dysmenorrhea today: a critical review. Hum Reprod Update 21(6):762–778

    CAS  PubMed  Google Scholar 

  19. Campbell MA, McGrath PJ (1997) Use of medication by adolescents for the management of menstrual discomfort. Arch Pediatr Adolesc Med 151(9):905–913

    CAS  PubMed  Google Scholar 

  20. Sternfeld B et al (2002) Severity of premenstrual symptoms in a health maintenance organization population. Obstet Gynecol 99(6):1014–1024

    PubMed  Google Scholar 

  21. Yang M et al (2008) Burden of premenstrual dysphoric disorder on health-related quality of life. J Women’s Health 17(1):113–121

    Google Scholar 

  22. Bahrami A et al (2018) High dose vitamin D supplementation can improve menstrual problems, dysmenorrhea, and premenstrual syndrome in adolescents. Gynecol Endocrinol 34(8):659–663

    CAS  PubMed  Google Scholar 

  23. Mishell JD (2005) Premenstrual disorders: epidemiology and disease burden. Am J Manag Care 11(16 Suppl):S473–S479

    PubMed  Google Scholar 

  24. Bahrami A et al (2018) Menstrual disorders and premenstrual symptoms in adolescents: prevalence and relationship to serum calcium and vitamin D concentrations. J Obstet Gynaecol 38(7):989–995

    CAS  PubMed  Google Scholar 

  25. Heitkemper MM et al (2003) Symptoms across the menstrual cycle in women with irritable bowel syndrome. Am J Gastroenterol 98(2):420–430

    PubMed  Google Scholar 

  26. Bahrami A et al (2019) The association of trace elements with premenstrual syndrome, dysmenorrhea and irritable bowel syndrome in adolescents. Eur J Obstetr Gynecol Reprod Biol 233:114–119

    CAS  Google Scholar 

  27. Awed H, El-Saidy T, Amro T (2013) The use of fresh Ginger herbs as a home remedy to relieve primary dysmenorrhea. J Res Nurs Midwifery 2(8):104–113

    Google Scholar 

  28. Osayande AS, Mehulic S (2014) Diagnosis and initial management of dysmenorrhea. Am Fam Phys 89(5):341–346

    Google Scholar 

  29. Steiner M, Macdougall M, Brown E (2003) The premenstrual symptoms screening tool (PSST) for clinicians. Arch Women’s Mental Health 6(3):203–209

    CAS  Google Scholar 

  30. Siahbazi S et al (2011) Translation and psychometric properties of the Iranian version of the Premenstrual Symptoms Screening Tool (PSST). Payesh (Health Monitor) 10(4):421–427

    Google Scholar 

  31. Agarwal A, Venkat A (2009) Questionnaire study on menstrual disorders in adolescent girls in Singapore. J Pediatr Adolesc Gynecol 22(6):365–371

    PubMed  Google Scholar 

  32. Sorouri M et al (2010) Functional bowel disorders in Iranian population using Rome III criteria. Saudi J Gastroenterol: Off J Saudi Gastroenterol Assoc 16(3):154

    Google Scholar 

  33. Nejati V (2013) Cognitive abilities questionnaire: development and evaluation of psychometric properties. Adv Cognit Sci 15(2):11–19

    Google Scholar 

  34. Bahrami A et al (2019) the association between neuropsychological function with serum vitamins A, D, and E and hs-CRP concentrations. J Mol Neurosci 68(2):243–250

    CAS  PubMed  Google Scholar 

  35. Henry JD, Crawford JR (2005) The short-form version of the Depression Anxiety Stress Scales (DASS-21): construct validity and normative data in a large non-clinical sample. Br J Clin Psychol 44(2):227–239

    PubMed  Google Scholar 

  36. Sahebi A, Asghari MJ, Salari R (2005) Validation of depression anxiety and stress scale (DASS-21) for an Iranian population (Persian). Iranian Psychol 4(1):299–313

    Google Scholar 

  37. Yazdi Z et al (2012) Validity and reliability of the Iranian version of the insomnia severity index. Malay J Med Sci 19(4):31

    Google Scholar 

  38. Haghighi KS et al (2013) The Epworth sleepiness scale: translation and validation study of the Iranian version. Sleep Breath 17(1):419–426

    Google Scholar 

  39. Ware JE et al (2002) SF-12v2™: how to score version 2 of the SF-12® health survey. QualityMetric Inc., & Health Assessment Lab, Lincoln, RI, & Boston, MA, pp 3–8

    Google Scholar 

  40. Montazeri A et al (2009) The Iranian version of 12-item Short Form Health Survey (SF-12): factor structure, internal consistency and construct validity. BMC Public Health 9(1):341

    PubMed  PubMed Central  Google Scholar 

  41. Mousaviraja A et al (2014) Personality type and drug abuse among Iranian young adults: a comparative study. Life Sci J 11(4s):251–256

    Google Scholar 

  42. Friedman M (1996) Type A behavior: its diagnosis and treatment. Springer Science & Business Media, New York

    Google Scholar 

  43. Friedman M, Rosenman RH (1974) Type A behavior and your heart. A. Knopf, New York

    Google Scholar 

  44. Sanjoori H, Asgari P (2016) A comparative analysis of self-actualization, risk taking, accountability and happiness among students with A/B personality types in Islamic Azad University of Ahvaz. Int J Hum Cult Stud, 757-768. ISSN 2356-5926

  45. Whitehead WE, Palsson O, Jones KR (2002) Systematic review of the comorbidity of irritable bowel syndrome with other disorders: what are the causes and implications? Gastroenterology 122(4):1140–1156

    PubMed  Google Scholar 

  46. Olafsdottir LB et al (2012) Natural history of irritable bowel syndrome in women and dysmenorrhea: a 10-year follow-up study. Gastroenterol Res Pract 2012:534204

    PubMed  PubMed Central  Google Scholar 

  47. Jackson N et al (1994) Does the menstrual cycle affect anorectal physiology? Dig Dis Sci 39(12):2607–2611

    CAS  PubMed  Google Scholar 

  48. Altman G et al (2006) Increased symptoms in female IBS patients with dysmenorrhea and PMS. Gastroenterol Nurs 29(1):4–11

    PubMed  Google Scholar 

  49. Muscatello MRA et al (2016) Personality traits and emotional patterns in irritable bowel syndrome. World J Gastroenterol 22(28):6402

    PubMed  PubMed Central  Google Scholar 

  50. Elaziz HMA et al (2019) Psychosocial aspects and personality dimensions among a sample of patients with irritable bowel syndrome. Egypt J Psychiatry 40(3):147

    Google Scholar 

  51. Farnam A et al (2007) Personality factors and profiles in variants of irritable bowel syndrome. World J Gastroenterol 13(47):6414

    PubMed  PubMed Central  Google Scholar 

  52. Ranasinghe N et al (2018) Functional gastrointestinal diseases and psychological maladjustment, personality traits and quality of life. BMC Gastroenterol 18(1):33

    PubMed  PubMed Central  Google Scholar 

  53. Cho HS et al (2011) Anxiety, depression and quality of life in patients with irritable bowel syndrome. Gut Liver 5(1):29

    PubMed  PubMed Central  Google Scholar 

  54. Lee YT et al (2015) Risk of psychiatric disorders following irritable bowel syndrome: a nationwide population-based cohort study. PLoS ONE 10(7):e0133283

    PubMed  PubMed Central  Google Scholar 

  55. Drossman DA et al (2002) AGA technical review on irritable bowel syndrome. Gastroenterology 123(6):2108–2131

    PubMed  Google Scholar 

  56. Guthrie E et al (2004) Changes in tolerance to rectal distension correlate with changes in psychological state in patients with severe irritable bowel syndrome. Psychosom Med 66(4):578–582

    PubMed  Google Scholar 

  57. Abdulahad S et al (2019) Irritable bowel syndrome, immune fitness, and insomnia: results from an online survey among people reporting sleep complaints. Sleep Vigil 3(2):121–129

    Google Scholar 

  58. Jarrett M et al (2000) Sleep disturbance influences gastrointestinal symptoms in women with irritable bowel syndrome. Dig Dis Sci 45(5):952–959

    CAS  PubMed  Google Scholar 

  59. Kim SY et al (2018) Self-reported sleep impairment in functional dyspepsia and irritable bowel syndrome. J Neurogastroenterol Motil 24(2):280

    PubMed  PubMed Central  Google Scholar 

  60. Edinger JD et al (2000) Insomnia and the eye of the beholder: are there clinical markers of objective sleep disturbances among adults with and without insomnia complaints? J Consult Clin Psychol 68(4):586–593

    CAS  PubMed  Google Scholar 

  61. Wang B, Duan R, Duan L (2018) Prevalence of sleep disorder in irritable bowel syndrome: a systematic review with meta-analysis. Saudi J Gastroenterol: Off J Saudi Gastroenterol Assoc 24(3):141

    Google Scholar 

  62. Lee SK et al (2017) The association between irritable bowel syndrome and the coexistence of depression and insomnia. J Psychosom Res 93:1–5

    PubMed  Google Scholar 

  63. Balikji S et al (2018) The association of insomnia, perceived immune functioning, and irritable bowel syndrome complaints. J Clin Med 7(9):238

    PubMed Central  Google Scholar 

  64. Miglis MG (2016) Autonomic dysfunction in primary sleep disorders. Sleep Med 19:40–49

    PubMed  Google Scholar 

  65. Tobaldini E et al (2017) Sleep, sleep deprivation, autonomic nervous system and cardiovascular diseases. Neurosci Biobehav Rev 74:321–329

    PubMed  Google Scholar 

  66. Everson CA, Toth LA (2000) Systemic bacterial invasion induced by sleep deprivation. Am J Physiol-Regulat Integr Comp Physiol 278(4):R905–R916

    CAS  Google Scholar 

  67. Bøyum A et al (1996) The effect of strenuous exercise, calorie deficiency and sleep deprivation on white blood cells, plasma immunoglobulins and cytokines. Scand J Immunol 43(2):228–235

    PubMed  Google Scholar 

  68. Berrill J et al (2013) An observational study of cognitive function in patients with irritable bowel syndrome and inflammatory bowel disease. Neurogastroenterol Motil 25(11):918-e704

    PubMed  Google Scholar 

  69. Kennedy P et al (2014) Cognitive performance in irritable bowel syndrome: evidence of a stress-related impairment in visuospatial memory. Psychol Med 44(7):1553–1566

    CAS  PubMed  Google Scholar 

  70. Attree EA et al (2003) Cognitive function in people with chronic illness: inflammatory bowel disease and irritable bowel syndrome. Appl Neuropsychol 10(2):96–104

    PubMed  Google Scholar 

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Acknowledgments

We are grateful to all study participants. This work was supported by Birjand University of Medical Science (BUMS), Iran.

Funding

This study was supported by grants [grant nu#5109(Afsane Bahrami)] from Birjand University of Medical Sciences, Birjand, Iran.

Author information

Author notes

  1. Malaksima Ayadilord and Sara Mahmoudzadeh have equally contributed as first author.

Authors and Affiliations

  1. Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran

    Malaksima Ayadilord, Sara Mahmoudzadeh, Masoumeh Askari, Hadis Rezapour, Mansoore Saharkhiz, Arefeh Abbaszadeh & Samira Karbasi

  2. Department of Immunology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran

    Malaksima Ayadilord, Sara Mahmoudzadeh, Hadis Rezapour & Mansoore Saharkhiz

  3. Department of Psychology, University of Birjand, Birjand, Iran

    Zahra Sadat Hoseini

  4. Department of Anatomical Sciences, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran

    Masoumeh Askari

  5. Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran

    Samira Karbasi, Nasrin Zandi Dashtebayaze & Afsane Bahrami

  6. Division of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex, BN1 9PH, UK

    Gordon A. Ferns

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  1. Malaksima Ayadilord
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  11. Afsane Bahrami
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Contributions

AB performed all analyses and drafted the manuscript. AB, SK, MA and SM coordinated the fieldwork of the study. MS, AA, MA, NZ and HR provided methodological feedback. AB, ZH, and GF supervised the overall research project and helped to draft the manuscript. All of the authors have read and confirmed the final manuscript. All authors state that they have no conflicts of interest.

Corresponding author

Correspondence to Afsane Bahrami.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

Ethical approval was obtained from the Birjand University of Medical Sciences and informed written consent was completed by all participants (code:IR.BUMS.REC.1398.160).

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Informed consent was obtained from all individual participants included in the study.

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Ayadilord, M., Mahmoudzadeh, S., Hoseini, Z.S. et al. Neuropsychological function is related to irritable bowel syndrome in women with premenstrual syndrome and dysmenorrhea. Arch Gynecol Obstet 302, 915–923 (2020). https://doi.org/10.1007/s00404-020-05659-3

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