Category: Functional Bowel Disease

P0343 - Majority of Patients With Irritable Bowel Syndrome Do Not Have Comorbid Borderline Personality Disorder

Sunday, October 7
3:30 PM – 7:00 PM

Category: Functional Bowel Disease       

Janice Cho, MD1, Brian Palmer, MD, MPH2, Jean Fox, MD1

1Mayo Clinic, Rochester, MN; 2Mayo Clinic, Minneapolis, MN

Introduction: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain related to defecation, change in stool frequency, or change in stool form. Borderline personality disorder (BPD) is a psychiatric disorder characterized by instability in relationships, behavior, self-image, and mood, which can result in functional impairments. Somatic complaints are common in patients with BPD. Poor outcomes in IBS have been linked to anxiety and depression, but its relationship to BPD is less well defined.

Methods: Patients living in Olmsted County who were seen at Mayo Clinic in Rochester, MN from 1985 to November 2017 were identified. The study was limited to Olmsted County to limit bias from the referral nature of the Mayo Clinic practice. ICD9 and ICD10 codes for borderline personality disorder and irritable bowel syndrome were used for database query. Prevalence rates for each disorder were calculated.

Results: From January 1985 to November 2017, 1641 patients from Olmsted County, MN were diagnosed with borderline personality disorder. The median age at BPD diagnosis was 30 years (interquartile range [IQR] of 22 to 40 years). 78% of patients with BPD were female. 135 patients were excluded from analysis due to lack of research consent. Of the patients diagnosed with BPD, 205 patients also had a concurrent diagnosis of irritable bowel syndrome (12.5%).

In total, 6686 unique patients had the diagnosis of irritable bowel syndrome from 1985 to November 2017. The median age at IBS diagnosis was 45 years (IQR of 32 to 63 years). 74% of patients with IBS were female. 509 patients were excluded from analysis due to lack of research consent. Of the 6686 patients with IBS, 205 patients had a concurrent diagnosis of BPD (3.1%).

Discussion: The prevalence of IBS in North America is common with most prevalence estimates ranging from 10% to 15%. The fact that IBS is similarly common (12.5%) in the BPD patient population is consistent with the limited literature on the topic and suggests that clinicians treating BPD should be aware of IBS symptoms and be able to use them in making a diagnosis. Somewhat surprisingly to us, the prevalence of BPD in the IBS population is at or only very slightly above the population prevalence of the disorder (variably 2-3%). This suggests that while attention to psychiatric symptoms in IBS remains important and appropriate, the vast majority of IBS patients do not have comorbid borderline personality disorder.

Disclosures: Does Not Disclose

Janice Cho indicated no relevant financial relationships.
Brian Palmer indicated no relevant financial relationships.
Jean Fox indicated no relevant financial relationships.

Citation: Janice Cho, MD; Brian Palmer, MD, MPH; Jean Fox, MD. MAJORITY OF PATIENTS WITH IRRITABLE BOWEL SYNDROME DO NOT HAVE COMORBID BORDERLINE PERSONALITY DISORDER. Program No. P0343. ACG 2018 Annual Scientific Meeting Abstracts. Philadelphia, Pennsylvania: American College of Gastroenterology.

Janice Cho

Mayo Clinic
Rochester, Minnesota