Gastrointestinal Cognition: Pain Catastrophizing in Irritable Bowel Syndrome, a Cross-Sectional Study in Mexico

Abstract

Introduction and Aims: Pain catastrophizing is more common in individuals with irritable bowel syndrome (IBS) than in healthy individuals. Despite this, its prevalence and impact in Latin American populations remain under-researched. Objective: To assess pain catastrophizing differences between IBS patients and healthy subjects. Materials and Methods: Cross-sectional study in which subjects with IBS and healthy individuals (HC) were recruited from our tertiary care center. IBS diagnosis was established based on the Rome IV criteria. All participants answered the pain catastrophizing scale (PCS), the hospital anxiety and depression scale (HAD), and the irritable bowel syndrome severity scoring system (IBS-SSS). Group comparisons employed the Student's t-test or Mann–Whitney U test, with Pearson's or Spearman's for correlations and logistic regression to assess IBS predictors. Results: A total of 920 participants (66.4% women) with a median age of 23 years (range: 18–60) met the inclusion criteria. IBS individuals had a higher prevalence of clinically significant pain catastrophizing compared to healthy subjects (22.5% vs. 11%, p < 0.0001). When classified by symptom intensity, 52.2% of IBS individuals with severe symptoms exhibited significant catastrophizing, compared to 25.3% with moderate symptoms and 14.7% with mild symptoms (p < 0.0001). Anxiety (OR 2.5, 95% CI 1.9–3.4, p < 0.0001), depression (OR 1.7, 95% CI 1.3–2.3, p < 0.0001), and catastrophizing (OR 2.3, 95% CI 1.6–3.3, p < 0.0001) were significantly associated with IBS. Conclusions: In Mexican individuals with IBS, pain catastrophizing is associated with more severe gastrointestinal symptoms and psychological distress. Comprehensive management of IBS in this population should involve addressing cognitive patterns in conjunction with conventional treatments.