{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:30:21Z","timestamp":1792002621873,"version":"4.4.0"},"reference-count":33,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"accepted":{"date-parts":[[1998,2,4]]},"published-print":{"date-parts":[[1998,8,1]]},"abstract":"<jats:p>\n                  <jats:italic>Background<\/jats:italic>\u2014Life stress contributes to symptom onset and exacerbation in the majority of patients with irritable bowel syndrome (IBS) and functional dyspepsia (FD); research evidence is conflicting, however, as to the strength of these effects.<\/jats:p>\n               <jats:p>\n                  <jats:italic>Aims<\/jats:italic>\u2014To test prospectively the relation of chronic life stress threat to subsequent symptom intensity over time.<\/jats:p>\n               <jats:p>\n                  <jats:italic>Patients<\/jats:italic>\u2014One hundred and seventeen consecutive outpatients satisfying the modified Rome criteria for IBS (66% with one or more concurrent FD syndromes) participated.<\/jats:p>\n               <jats:p>\n                  <jats:italic>Methods<\/jats:italic>\u2014The life stress and symptom intensity measures were determined from interview data collected independently at entry, and at six and 16 months; these measures assessed the potency of chronic life stress threat during the prior six months or more, and the severity and frequency of IBS and FD symptoms during the following two weeks.<\/jats:p>\n               <jats:p>\n                  <jats:italic>Results<\/jats:italic>\u2014Chronic life stress threat was a powerful predictor of subsequent symptom intensity, explaining 97% of the variance on this measure over 16 months. No patient exposed to even one chronic highly threatening stressor improved clinically (by 50%) over the 16 months; all patients who improved did so in the absence of such a stressor.<\/jats:p>\n               <jats:p>\n                  <jats:italic>Conclusion<\/jats:italic>\u2014The level of chronic life stress threat predicts the clinical outcome in most patients with IBS\/FD.<\/jats:p>","DOI":"10.1136\/gut.43.2.256","type":"journal-article","created":{"date-parts":[[2010,6,30]],"date-time":"2010-06-30T12:46:12Z","timestamp":1277901972000},"page":"256-261","source":"Crossref","is-referenced-by-count":317,"title":["Level of chronic life stress predicts clinical outcome in irritable bowel syndrome"],"prefix":"10.1136","volume":"43","author":[{"given":"E J","family":"Bennett","sequence":"first","affiliation":[{"name":"aDepartment of Gastroenterology, Royal North Shore Hospital, Sydney, Australia, \n\nbDepartment of Medicine, Royal North Shore Hospital, Sydney, Australia, \n\ncDepartment of Psychological Medicine, Royal North Shore Hospital, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C C","family":"Tennant","sequence":"additional","affiliation":[{"name":"aDepartment of Gastroenterology, Royal North Shore Hospital, Sydney, Australia, \n\nbDepartment of Medicine, Royal North Shore Hospital, Sydney, Australia, \n\ncDepartment of Psychological Medicine, Royal North Shore Hospital, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Piesse","sequence":"additional","affiliation":[{"name":"aDepartment of Gastroenterology, Royal North Shore Hospital, Sydney, Australia, \n\nbDepartment of Medicine, Royal North Shore Hospital, Sydney, Australia, \n\ncDepartment of Psychological Medicine, Royal North Shore Hospital, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C-A","family":"Badcock","sequence":"additional","affiliation":[{"name":"aDepartment of Gastroenterology, Royal North Shore Hospital, Sydney, Australia, \n\nbDepartment of Medicine, Royal North Shore Hospital, Sydney, Australia, \n\ncDepartment of Psychological Medicine, Royal North Shore Hospital, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J E","family":"Kellow","sequence":"additional","affiliation":[{"name":"aDepartment of Gastroenterology, Royal North Shore Hospital, Sydney, Australia, \n\nbDepartment of Medicine, Royal North Shore Hospital, Sydney, Australia, \n\ncDepartment of Psychological Medicine, Royal North Shore Hospital, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1998,8,1]]},"reference":[{"key":"2025090723412265000_43.2.256.1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(84)90073-4"},{"key":"2025090723412265000_43.2.256.2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(91)90052-P"},{"key":"2025090723412265000_43.2.256.3","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(86)90079-6"},{"key":"2025090723412265000_43.2.256.4","first-page":"307","article-title":"The irritable colon syndrome: a study of the clinical features, predisposing causes, and prognosis in 130 cases.","volume":"31","author":"Chaudhary","year":"1962","journal-title":"Q J Med"},{"key":"2025090723412265000_43.2.256.5","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/0016-5085(91)90215-7","article-title":"A controlled trial of psychological treatment for the irritable bowel syndrome.","volume":"100","author":"Guthrie","year":"1991","journal-title":"Gastroenterology"},{"key":"2025090723412265000_43.2.256.6","doi-asserted-by":"publisher","DOI":"10.1159\/000010277"},{"key":"2025090723412265000_43.2.256.7","unstructured":"Rumsay N (1991) Group stress management programmes v pharmacological treatment in the treatment of the irritable bowel syndrome. in Towards confident management of irritable bowel syndrome. eds Heaton KW Creed F Goeting NIM (Duphar, Lyme Regis), pp 33\u201339."},{"key":"2025090723412265000_43.2.256.8","doi-asserted-by":"publisher","DOI":"10.1136\/gut.42.3.414"},{"key":"2025090723412265000_43.2.256.9","unstructured":"Drossman DA (1996) Psychosocial aspects of the functional gastrointestinal disorders. Neurogastroenterology. ed Corazziari E (de Gruyter, Berlin, New York)."},{"key":"2025090723412265000_43.2.256.10","doi-asserted-by":"publisher","DOI":"10.1037\/0278-6133.13.2.99"},{"key":"2025090723412265000_43.2.256.11","unstructured":"Drossman DA (1994) The functional gastrointestinal disorders: diagnosis, pathophysiology, and treatment. (Little, Brown & Co, Boston)."},{"key":"2025090723412265000_43.2.256.12","unstructured":"Brown GW Harris TO (1978) Social origins of depression: a study of psychiatric disorder in women. (Tavistock, London)."},{"key":"2025090723412265000_43.2.256.13","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1017\/S0033291700032086","article-title":"The contextual threat of life events: the concept and its reliability.","volume":"9","author":"Tennant","year":"1979","journal-title":"Psychol Med"},{"key":"2025090723412265000_43.2.256.14","doi-asserted-by":"publisher","DOI":"10.1177\/014662167700100306"},{"key":"2025090723412265000_43.2.256.15","doi-asserted-by":"crossref","unstructured":"Spielberger CD Gorsuch RL Lushene R (1983) Manual for the State-Trait Anxiety Inventory STAI (Form Y). (Consulting Psych Press, Palo Alto).","DOI":"10.1037\/t06496-000"},{"key":"2025090723412265000_43.2.256.16","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(86)90005-1"},{"key":"2025090723412265000_43.2.256.17","unstructured":"Spielberger CD Jacobs G Russell S (1983) Assessment of anger: the State-Trait Anger Scale. Advances in personality assessment. eds Butcher JN Spielberger CP (LEA, Hillsdale, NY), 2."},{"key":"2025090723412265000_43.2.256.18","doi-asserted-by":"crossref","unstructured":"Pilowsky I Spence ND (1983) Manual for the illness behaviour questionnaire (IBQ). 2nd edn. (University of Adelaide, Adelaide).","DOI":"10.1037\/t04209-000"},{"key":"2025090723412265000_43.2.256.19","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(69)91755-3"},{"key":"2025090723412265000_43.2.256.20","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1093\/oxfordjournals.aje.a116483","article-title":"Onset and disappearance of gastrointestinal symptoms and functional gastrointestinal disorders.","volume":"136","author":"Talley","year":"1992","journal-title":"Am J Epidemiol"},{"key":"2025090723412265000_43.2.256.21","first-page":"A26","article-title":"Evidence that the irritable bowel syndrome and functional dyspepsia are a single disorder: a longitudinal population-based study [abstract].","volume":"110","author":"Locke","year":"1996","journal-title":"Gastroenterology"},{"key":"2025090723412265000_43.2.256.22","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(95)90373-9"},{"key":"2025090723412265000_43.2.256.23","doi-asserted-by":"publisher","DOI":"10.1136\/gut.33.6.825"},{"key":"2025090723412265000_43.2.256.24","first-page":"292","article-title":"The perception of life events and daily stress in nonulcer dyspepsia.","volume":"86","author":"Hui","year":"1991","journal-title":"Am J Gastroenterol"},{"key":"2025090723412265000_43.2.256.25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1991.tb01416.x"},{"key":"2025090723412265000_43.2.256.26","doi-asserted-by":"crossref","first-page":"524","DOI":"10.3109\/00365529509089784","article-title":"Life events and stress in patients with dyspepsia compared with patients with duodenal ulcer and healthy controls.","volume":"30","author":"Haug","year":"1995","journal-title":"Scand J Gastroenterol"},{"key":"2025090723412265000_43.2.256.27","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1136\/gut.27.2.127","article-title":"Major life event stress and dyspepsia of unknown cause: a case control study.","volume":"27","author":"Talley","year":"1986","journal-title":"Gut"},{"key":"2025090723412265000_43.2.256.28","doi-asserted-by":"crossref","first-page":"268","DOI":"10.3109\/00365528709078590","article-title":"A prospective study of social factors and major life event stress in patients with dyspepsia of unknown cause.","volume":"22","author":"Talley","year":"1987","journal-title":"Scand J Gastroenterol"},{"key":"2025090723412265000_43.2.256.29","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/S0016-5085(88)80017-9","article-title":"Psychosocial factors in the irritable bowel syndrome: a multivariate study of patients and nonpatients with irritable bowel syndrome.","volume":"95","author":"Drossman","year":"1988","journal-title":"Gastroenterology"},{"key":"2025090723412265000_43.2.256.30","doi-asserted-by":"publisher","DOI":"10.1037\/0278-6133.13.2.103"},{"key":"2025090723412265000_43.2.256.31","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(95)00016-X"},{"key":"2025090723412265000_43.2.256.32","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1159\/000288657","article-title":"Psychosocial factors in gastrointestinal illness.","volume":"59","author":"Cassileth","year":"1993","journal-title":"Psychother Psychosom"},{"key":"2025090723412265000_43.2.256.33","doi-asserted-by":"publisher","DOI":"10.1037\/\/0003-066X.50.2.106"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.43.2.256","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T06:41:29Z","timestamp":1757313689000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.43.2.256"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,8,1]]},"references-count":33,"journal-issue":{"issue":"2","published-online":{"date-parts":[[1998,8,1]]},"published-print":{"date-parts":[[1998,8,1]]}},"alternative-id":["10.1136\/gut.43.2.256"],"URL":"https:\/\/doi.org\/10.1136\/gut.43.2.256","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,8,1]]}}}