FA lot of research has pointed out that irritable bowel syndrome (IBS) is a multifactorial illness involving visceral hypersensitivity, alteration of communication between the enteric nervous system (ENS) and central nervous system (CNS), increased intestinal permeability, minimal intestinal inflammation, and altered intestinal microflora. Psychological, social, and genetic factors appear to be important in the development of IBS symptomatology through several mechanisms. This chapter addresses the relationships between irritable bowel syndrome (IBS) and psychiatric comorbidities. The aim of this chapter is to provide an overview of explanatory hypothesis and to describe a variety of approaches which integrate the vast research data about IBS and psychiatric comorbidities, including genetic, brain imaging, and neuropsychological findings. The section of this chapter which overlooks the psychotropic treatment reviews the comparative efficacy of various drugs.
Part of the book: Irritable Bowel Syndrome
The hepatitis C virus is a blood-borne virus with a direct cytopathic action. Chronic hepatitis C is a prevalent and costly disease. Studies have shown that it is a significant overlap between hepatitis C virus and mental disorders and that a substantial number of patients infected are suffering from mood disturbances and neurocognitive impairment. Recently, the neurocognitive impairments (attention, memory, and executive function alterations) were recognized as being independent of liver fibrosis and representing the direct effect of hepatitis C virus on neurons. However, until now impairments in neurocognition are not associated with viral replication or overall viral burden. Moreover, interferon alpha is still used to treat patients with hepatitis C. According to various researchers, 30–70% will develop significant psychiatric symptoms, leading to a premature discontinuation of therapy or noncompliance and worsening of quality of life. Several potential mechanisms may be implicated in the onset of a depressive episode following interferon alpha, the most important being the activation of immune-inflammatory pathways. This chapter will present the complex and striking relationships between hepatitis C virus infection and central nervous system symptoms. A variety of approaches, which integrate the extensive research data (including molecular, brain imaging, and neuropsychological findings), will be discussed.
Part of the book: Liver Research and Clinical Management