Irritable bowel syndrome is manifested together with depressive disorders approximately 2 times more often than with neurotic disorders. Long-lasting (more than 2 years) endogenous depressions prevail: the periodic depressive states occurring autochtonously (with no direct connection with psychotraumatic events), are, as a rule, of light and mild severity.
Among clinical signs of depression the greatest role is played by the so-called somatic symptoms of depression with the prevalence of disorders of the digestive system. At the same time symptoms of gastrointestinal disorders typical of irritable bowel syndrome – constipations, abdominal pains, etc. – come out as the common symptoms of depression and pathology of the digestive system along with reduction of appetite (depressive anorexia), sensation of unpleasant taste, bitterness or dryness in the mouth. Also a significant decrease of body weight and sleeping disorders are marked.
In contrast to patients with neurotic disorders patients with depression abdominal pains are characterized as monotonous and only in single instances are accompanied by pathological corporal sensations of extra-abdominal localization. Pains are usually nagging and aching and only incidentally there are sharp spastic algic sensations. Patients characterize pains as burdensome, “torturing” and “exhausting”. Abdominal pains have constant localization and keep during the whole period of wakefulness. Intensity of pains varies seldom, mainly depending on the daily rhythm of intensity of depressive symptoms (usually in the morning and less often in the evening time).
Diagnostics of such depressions, generally referred to as somatized depressions, demand careful clinical inspection, as the main symptoms of endogen depressions – depressive mood, ideas of inferiority, feeling of fault, pessimistic estimation of one’s position in the world around – remain as though on the background. Qualification of depression in this case should be based on separate, but the most significant symptoms: actually depressive mood (persistent depression, despirit, feeling of melancholy), a pathological daily rhythm, self-accusation, suicidal ideas, periodicity of semiology, remittent clinical course.