Irritable bowel syndrome (IBS) appears to have a bidirectional interaction with both depressive and anxiety-related complaints. However, it remains unclear how exactly the psychological complaints, at the individual level, are related to somatic symptoms on a daily basis. This single case study investigates how somatic and psychological variables are temporally related in a patient with irritable bowel syndrome. The patient was a woman in her mid-twenties with an IBS diagnosis. She reported frequent soft bowel movements (5–6 times per day), as well as flatulence and abdominal pain. She resembled a typical IBS patient; however, a marked feature of the patient was her high motivation for psychosomatic treatment as well as her willingness to try new strategies regarding the management of her symptoms. As an innovative approach this single case study used a longitudinal, observational, time series design. The patient answered questions regarding somatic and psychological variables daily over a period of twelve weeks with an online diary. The diary data was analysed using an autoregressive (VAR) modeling approach. Time series analyses showed that in most variables, strong same-day correlations between somatic (abdominal pain, daily impairment) and psychological time series (including coping strategies) were present. The day-lagged relationships indicated that higher values in abdominal pain on one day were predictive of higher values in the psychological variables on the following day (e.g. nervousness, tension, catastrophizing, hopelessness). The use of positive thinking as a coping strategy was helpful in reducing the pain on the following days. In the presented case we found a high correlation between variables, with somatic symptoms temporally preceding psychological variables. In addition, for this patient, the use of positive thoughts as a coping strategy was helpful in reducing pain.

中文翻译：

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肠易激综合征患者的疼痛和心理：先有鸡还是先有蛋？时间序列案例报告

肠易激综合症（IBS）似乎与抑郁和焦虑相关的主诉存在双向相互作用。然而，目前尚不清楚个人层面的心理不适与日常躯体症状到底有何关系。这个单一案例研究调查了肠易激综合征患者的躯体和心理变量如何在时间上相关。患者是一名二十多岁的女性，患有肠易激综合症（IBS）。她报告经常软便（每天 5-6 次），以及胀气和腹痛。她就像一个典型的肠易激综合症患者。然而，该患者的一个显着特征是她对心身治疗的高度积极性以及她愿意尝试新的症状管理策略。作为一种创新方法，该单一案例研究采用了纵向、观察性时间序列设计。在十二周的时间里，患者每天通过在线日记回答有关躯体和心理变量的问题。使用自回归（VAR）建模方法对日记数据进行分析。时间序列分析表明，在大多数变量中，躯体（腹痛、日常损伤）和心理时间序列（包括应对策略）之间存在很强的同日相关性。日滞后关系表明，一天腹痛的较高值预示着第二天心理变量的较高值（例如紧张、紧张、灾难性、绝望）。使用积极的思维作为应对策略有助于减轻接下来几天的痛苦。在本案例中，我们发现变量之间存在高度相关性，躯体症状在时间上先于心理变量。此外，对于该患者来说，使用积极的想法作为应对策略有助于减轻疼痛。