Psychological factors: the defining features of quality of life in disorders of gut-brain interaction - a comparative exploratory analysis 2025 Groen+

[Andy]

Abstract​

Background and aims: Delineating key determinants of health-related quality of life (HrQoL) in patients with disorders of the gut-brain-interaction (DGBI) remains challenging due to complex interplay of socioeconomic, psychological, and clinical factors. This exploratory comparative study aimed to identify factors and latent patient-profiles associated with generic and condition-specific HrQoL across different DGBI.

Methods: Data from four clinical patient-cohorts were analyzed, including patients with functional dyspepsia ([FD], n=73), fecal incontinence ([FI], n=72), and irritable bowel syndrome ([IBS], n=419, 2 cohorts). Participants completed questionnaires on gastrointestinal (GI) symptoms, psychological factors, generic HrQoL (EQ-5D-5L), and condition-specific HrQoL. Finite mixture modeling identified latent clusters, and multivariate regression assessed factors associated with HrQoL-outcomes.

Results: In IBS and FD-patients, higher depression scores and GI-symptom severity were significantly associated with lower generic and condition-specific HrQoL (p <0.001). In both FI and IBS-cohorts, higher anxiety scores were associated with reduced HrQoL. Finite mixture modeling identified distinct latent clusters-two in FD and FI-cohorts, and three in IBS-cohort-primarily defined by psychological comorbidity. Latent clusters with higher anxiety and depression scores showed markedly lower HrQoL outcomes. In contrast, socioeconomic and lifestyle factors appeared less relevant. There were no significant associations between GI-symptom severity and HrQoL in FI.

Conclusion: Psychological comorbidity appears the most salient factor associated with HrQoL, which was uniformly seen across different DGBI, whereas GI-symptom severity was only associated with HrQoL in FD and patients with IBS, but not in patients with FI. Although causality between psychological factors and HrQoL cannot be ascertained, our findings underscore the importance of holistic DGBI-management that extends beyond symptom-control to encompass the full spectrum of patient-experience.

Open access

 

[rvallee]

Although causality between psychological factors and HrQoL cannot be ascertained, our findings underscore the importance of holistic DGBI-management that extends beyond symptom-control to encompass the full spectrum of patient-experience.

But they don't control the symptoms, so how would they know? And they notice how they can't make a causal claim, but they do it anyway, just with a dog whistle. Obviously if the symptoms were controlled the psychological distress apparent in questionnaires would vanish.

WTH is with this corrupt ideology? Seriously they don't ever bother making sense and just repeat the same affirmations. Even religion is usually less obviously dogmatic.

Plus, as if the questions on those anxiety and depression questionnaires are not themselves HrQoL.

 

[Sean]

What they said :

Although causality between psychological factors and HrQoL cannot be ascertained, our findings underscore the importance of holistic DGBI-management that extends beyond symptom-control to encompass the full spectrum of patient-experience.​

What they should have said:

As causality between psychological factors and HrQoL cannot be determined with this data, there are no recommendations that can be made for proactive disease-specific clinical management. Generic support and symptom-control remain the only practical options for now.​