Published online Jul 28, 2016. doi: 10.3748/wjg.v22.i28.6402
Peer-review started: March 27, 2016
First decision: May 12, 2016
Revised: May 26, 2016
Accepted: June 15, 2016
Article in press: June 15, 2016
Published online: July 28, 2016
The review focuses on those personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness), constructs (alexithymia and distressed - Type D personality) and emotional patterns (negative and positive) that are of particular concern in health psychology, with the aim to highlight their potential role on the pathogenesis, onset, symptom clusters, clinical course, and outcome of irritable bowel syndrome (IBS). Personality traits and emotional patterns play key roles in affecting autonomic, immune, inflammatory, and endocrine functions, thus contributing not only to IBS clinical expression and symptomatic burden, but also to disease physiopathology. In this sense, psychological treatments should address those personality traits and emotional features that are constitutive of, and integral to IBS. The biopsychosocial model of illness applied to IBS acknowledges the interaction between biological, psychological, environmental, and social factors in relation to pain and functional disability. A holistic approach to IBS should take into account the heterogeneous nature of the disorder, and differentiate treatments for different types of IBS, also considering the marked individual differences in prevalent personality traits and emotional patterns. Beyond medications, and lifestyle/dietary interventions, psychological and educational treatments may provide the optimal chance of addressing clinical symptoms, comorbid conditions, and quality of life in IBS patients.
Core tip: The complex nature of irritable bowel syndrome (IBS) requires a multidisciplinary approach from different fields of scientific knowledge. This review examines the contribution of personality traits and emotional patterns to pathophysiology, clinical expression, and outcome of IBS. Several personality traits and constructs, such as neuroticism, conscientiousness, and alexithymia, are closely associated with IBS. Negative emotions, which are probably more entangled with neurobiological substrates, seem to have a key role in the brain-gut axis dysfunction which characterizes IBS. Based on the reviewed evidence, effective treatments for IBS should also address personality traits and emotions to improve outcomes in IBS patients.