Momentary ecological assessment has shown relief in abdominal pain on treatment with escitalopram in irritable bowel syndrome (IBS) with comorbid panic disorder. Yet, little is known about symptom formation, like how psychological impacts physical symptoms, and vice versa, and regarding the effect of SSRI treatment on symptom formation.

A recent study investigated the variation in psychological and somatic symptoms over time in IBS patients with comorbid panic disorder and the effect of escitalopram treatment on them.

14 IBS patients with panic disorder rendered the data on escitalopram versus placebo. Multilevel time-lagged linear regression analysis was conducted at baseline, after three and six months, to construct symptom networks that represented coefficients between various affect and gastrointestinal items.

• Both groups showed an increase in Connectivity for up to 3 months. 
• Connectivity showed a decrease for placebo while an increase for escitalopram group between 3 and 6 months. 
• Additionally, the escitalopram network also showed a steep increase in node strength for negative affect nodes and vice versa for positive affect nodes. 
• Group symptom networks became increasingly dissimilar to each other over time.
• Anxious-anxious and enthusiastic-relaxed turned out to be substantially different between groups at 6 months.
• Anxious-anxious connection changed significantly in all analyses.

Thus, Escitalopram treatment changed the symptom networks in IBS patients with panic disorder. mood and physical symptoms enhance over time, while the connectivity between mood nodes altered, suggesting a healthier emotion regulation causing ease of physical symptoms.

Source: Journal of Psychosomatic Research. 2021;141. https://doi.org/10.1016/j.jpsychores.2020.110351.