Reviewer's report
Title:Psychopathological features of irritable bowel syndrome patients with and
without functional dyspepsia: a cross sectional study
Version: 1Date:20 July 2010
Reviewer: Laurie Keefer
Reviewer's report:
Thank you for the opportunity to review this paper. The manuscript is well-written
and the methodology and statistics are adequate. That said, the major concern I
have with this manuscript is that it does not really add significantly to what we
already know about the relations between FD, IBS and psychopathology.
Perhaps a larger sample size or the inclusion of several other psychological
questionnaires/interviews would make this previously reported observation more
definitive.
Major Compulsory Revisions
1. An estimate of power and a justification that the relatively small sample size is
adequate should be included
2. While differences were found between groups, they are not really clinically
significant-- scores on the SCL90R fell within the normal range for several
variables. I wonder whether a nonparametric statistic might be more useful, ie.
comparing functional v. dysfunctional SCL90 X group.
3. The authors conclude that the IBS+FD group have a greater severity of
psychopathology than IBS alone--however, they failed to control for other known
variables affecting this link including symptom severity and quality of life
impairment. While I realize that not all of the common questionnaires have been
validated in Italian, it still would have been appropriate to get a patient or
physician rating of symptom severity or functional impairment, etc.
4. It may have been more compelling to have included a group of FD patients
alone to tease out the "contribution" FD has to the association between IBS and
psychopathology.
Minor Essential Revisions
1. The authors should include in their discussion the potential limitation of having
>10% of their sample being referred from other gastroenterologists-- this implies
that the patients in this group were more distressed or refractory and may have
biased the results. This is particularly important because of the small sample
size.
2. Antidepressant therapies are commonly used in refractory functional gi
disorders-- what proportion of your patients were already using psychological
medications and how might this have affected the findings.
3. The authors should justify the breakdown of FD patients by subtype-- are there
theoretical reasons why these groups might be expected to differ? Also, why not
breakdown the IBS patients by subtype too then (IBS-D, IBS-C, etc.)? Again, a
larger sample may have been more useful in this regard.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Psychopathological features of irritable bowel syndrome patients with and
without functional dyspepsia: a cross sectional study
Version: 1Date:20 July 2010
Reviewer: Laurie Keefer
Reviewer's report:
Thank you for the opportunity to review this paper. The manuscript is well-written
and the methodology and statistics are adequate. That said, the major concern I
have with this manuscript is that it does not really add significantly to what we
already know about the relations between FD, IBS and psychopathology.
Perhaps a larger sample size or the inclusion of several other psychological
questionnaires/interviews would make this previously reported observation more
definitive.
Major Compulsory Revisions
1. An estimate of power and a justification that the relatively small sample size is
adequate should be included
2. While differences were found between groups, they are not really clinically
significant-- scores on the SCL90R fell within the normal range for several
variables. I wonder whether a nonparametric statistic might be more useful, ie.
comparing functional v. dysfunctional SCL90 X group.
3. The authors conclude that the IBS+FD group have a greater severity of
psychopathology than IBS alone--however, they failed to control for other known
variables affecting this link including symptom severity and quality of life
impairment. While I realize that not all of the common questionnaires have been
validated in Italian, it still would have been appropriate to get a patient or
physician rating of symptom severity or functional impairment, etc.
4. It may have been more compelling to have included a group of FD patients
alone to tease out the "contribution" FD has to the association between IBS and
psychopathology.
Minor Essential Revisions
1. The authors should include in their discussion the potential limitation of having
>10% of their sample being referred from other gastroenterologists-- this implies
that the patients in this group were more distressed or refractory and may have
biased the results. This is particularly important because of the small sample
size.
2. Antidepressant therapies are commonly used in refractory functional gi
disorders-- what proportion of your patients were already using psychological
medications and how might this have affected the findings.
3. The authors should justify the breakdown of FD patients by subtype-- are there
theoretical reasons why these groups might be expected to differ? Also, why not
breakdown the IBS patients by subtype too then (IBS-D, IBS-C, etc.)? Again, a
larger sample may have been more useful in this regard.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Psychopathological features of irritable bowel syndrome patients with and
without functional dyspepsia: a cross sectional study
Version: 1Date:20 July 2010
Reviewer: Laurie Keefer
Reviewer's report:
Thank you for the opportunity to review this paper. The manuscript is well-written
and the methodology and statistics are adequate. That said, the major concern I
have with this manuscript is that it does not really add significantly to what we
already know about the relations between FD, IBS and psychopathology.
Perhaps a larger sample size or the inclusion of several other psychological
questionnaires/interviews would make this previously reported observation more
definitive.
Major Compulsory Revisions
1. An estimate of power and a justification that the relatively small sample size is
adequate should be included
2. While differences were found between groups, they are not really clinically
significant-- scores on the SCL90R fell within the normal range for several
variables. I wonder whether a nonparametric statistic might be more useful, ie.
comparing functional v. dysfunctional SCL90 X group.
3. The authors conclude that the IBS+FD group have a greater severity of
psychopathology than IBS alone--however, they failed to control for other known
variables affecting this link including symptom severity and quality of life
impairment. While I realize that not all of the common questionnaires have been
validated in Italian, it still would have been appropriate to get a patient or
physician rating of symptom severity or functional impairment, etc.
4. It may have been more compelling to have included a group of FD patients
alone to tease out the "contribution" FD has to the association between IBS and
psychopathology.
Minor Essential Revisions
1. The authors should include in their discussion the potential limitation of having
>10% of their sample being referred from other gastroenterologists-- this implies
that the patients in this group were more distressed or refractory and may have
biased the results. This is particularly important because of the small sample
size.
2. Antidepressant therapies are commonly used in refractory functional gi
disorders-- what proportion of your patients were already using psychological
medications and how might this have affected the findings.
3. The authors should justify the breakdown of FD patients by subtype-- are there
theoretical reasons why these groups might be expected to differ? Also, why not
breakdown the IBS patients by subtype too then (IBS-D, IBS-C, etc.)? Again, a
larger sample may have been more useful in this regard.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
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