Cognitive function in patients with irritable bowel syndrome: impairment is common and only weakly correlated with depression/anxiety and severity of gastrointestinal symptoms

Scand J Gastroenterol. 2023 Sep 20:1-9. doi: 10.1080/00365521.2023.2256916.Online ahead of print.


Julie Billing 1Birgitte Berentsen 2 3Arvid Lundervold 4 5Eline M R Hillestad 2 3Gülen A Lied 2 3Trygve Hausken 2 3Astri J Lundervold 1


Author information

1Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.

2Department of Clinical Medicine, University of Bergen, Bergen, Norway.

3National Center for Functional Gastrointestinal Disorders, Department of Medicine, Haukeland University Hospital, Bergen, Norway.

4Department of Biomedicine, University of Bergen, Bergen, Norway.

5Mohn Medical and Visualization Center, Department of Radiology, Haukeland University Hospital, Bergen, Norway.


Objective: To investigate cognitive function in patients with irritable bowel syndrome (IBS) and its relation to anxiety/depression and severity of gastrointestinal (GI) symptoms.

Methods: Patients with IBS (n = 65) and healthy controls (HCs, n = 37) performed the ten subtests of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Age-normed index scores of five cognitive domains (Immediate memory, Visuospatial function, Language function, Attention, Recall) and a total (Fullscale) score were derived from the performance. Emotional function was assessed using the Hospital Anxiety and Depression Scale (HADS), and the IBS Symptom Scoring System (IBS-SSS) was used to define the severity of GI symptoms.

Results: Patients with IBS reported significantly higher scores than the HC group on symptom measures of anxiety and depression, and significantly lower scores on the Immediate memory, Recall, and Fullscale RBANS indexes. Approximately 30% of the IBS patients obtained index scores at least one standard deviation below the population mean, and more than 50% scored above the screening threshold for an anxiety disorder. The severity of GI symptoms was significantly correlated with the severity level of anxiety symptoms (p=.006), but neither the severity level of emotional nor GI symptoms was significantly correlated with the RBANS index scores in the IBS group.

Conclusion: Cognitive and emotional function were more severely affected in patients with IBS than in HCs. The weak correlation between the two functional areas suggests that both should be assessed as part of a clinical examination of patients with IBS.

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