Association between Stress, Anxiety, Depression, and Irritable Bowel Syndrome among Students in a Palestinian University: A Cross-Sectional Study رسالة ماجستير

Abstract

Background: Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders (FGIDs) that are reported among university students and is linked to several physiological and psychological factors. Purpose: The current study aims to investigate the pattern of IBS and depression, anxiety, and stress (DAS) and the association between them among Palestinian university students. Methods: The study utilized a cross-sectional quantitative analytical design, in which a convenience sampling of 372 university students from 13 colleges at Arab American University of Palestine (AAUP) were recruited and filled a self-administered questionnaire containing Rome IV criteria for IBS diagnosis and Depression, Anxiety and Stress Scale (DASS-21) instruments, and were analyzed using SPSS version 27.0. Results: 51.3% of participants were male, with a mean age of 22.6 ± 4.4 years old. Most were from medical and health sciences colleges, predominantly nursing (40.9%). A majority had no family history of IBS (73.7%). Using Rome IV criteria, the Mean IBS score was 10.96 ± 9.4, with IBS-Undefined being the most common subtype (38.7%), followed by IBS-mixed (23.0%) and IBS-constipation (22.3%). Approximately one-third showed normal levels of depression (34.7%), anxiety (30.1%), vi and stress (37.9%). Significant findings included higher IBS scores among females, older students, those with a positive family history of IBS, higher caffeine consumption, and sleep disturbances (p < 0.05). Anxiety (B = 0.463, p < 0.001) and stress (B = 0.365, p<0.001) predicted IBS scores, with significant inter-correlations among stress, anxiety, depression, and irritable bowel syndrome scores (p < 0.001). Conclusion: The current study has several points that are congruent with other international and Arabic studies in relation to most of the factors associated with IBS among university students, especially in terms of psychological factors. Further studies on a larger sample containing multiple educational institutions in Palestine are recommended.