Greater intolerance to uncertainty predicts poorer quality of life in adults with cyclic vomiting syndrome

• Published in: Neurogastroenterology and motility Vol. 33; no. 12; pp. e14159 - n/a
• Main Authors: Levinthal, David J., Romutis, Stephanie, Rajalaban, Ajai, Kumar, Vishnu C. S., Feldman, Robert, Althouse, Andrew D., Venkatesan, Thangam
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.12.2021
• Subjects: Adolescent; Adult; Adults; Aged; Anxiety; Anxiety - psychology; Cognitive ability; cyclic vomiting syndrome; Female; Health care; Health services utilization; healthcare utilization; Humans; Intolerance; intolerance to uncertainty; Male; Middle Aged; Nausea; Patients; Quality of life; Quality of Life - psychology; Uncertainty; Vomiting; Vomiting - psychology; Young Adult; anxiety; healthcare utilization; quality of life; cyclic vomiting syndrome; intolerance to uncertainty
• ISSN: 1350-1925; 1365-2982
• DOI: 10.1111/nmo.14159

ABSTRACT Background Cyclic vomiting syndrome (CVS) is an idiopathic disorder of gut‐brain interaction characterized by recurrent bouts of nausea and vomiting. Although CVS negatively impacts quality of life (QOL), the determinants of impaired QOL among adult CVS sufferers are not fully understood. The unpredictability of CVS attacks may generate anticipatory anxiety and worsen quality of life in a substantial proportion of patients with CVS. Intolerance to uncertainty (IU) is a cognitive trait in which individuals experience distress when faced with unpredictable situations, particularly those with potentially negative consequences. Higher trait IU is a well‐established vulnerability factor linked to the development of multiple psychiatric conditions, including anxiety. However, the extent to which higher IU is associated with impaired QOL in adults with CVS is not known. Methods To explore this issue, we surveyed 118 adult CVS patients and obtained demographic information, clinical features, reported healthcare utilization, and standardized assessments of IU, anxiety and panic, and QOL. Key Results Adult CVS patients with higher IU did not report a greater frequency of CVS attacks or overall CVS‐related healthcare utilization than those with lower IU. Yet, this group demonstrated substantially poorer physical and mental health‐related QOL and higher rates of anxiety‐spectrum disorders. Conclusions & Inferences Higher degrees of IU are associated with increased anxiety and reduced QOL in patients with CVS. IU is a malleable cognitive trait that can be targeted by cognitive behavioral therapy (CBT). Our results suggest that some CVS patients may benefit from non‐pharmacologic therapies such as CBT. Higher levels of the the cognitive trait 'intolerance to uncertainty' are associated with greater rates of anxiety and poorer quality of life in adult patients with CVS.