Background and Aims: Anger has been linked to irritable bowel syndrome (IBS), but the mechanism underlying this relationship is still unknown. This cross-sectional study explores the possibility that anger mediates the relationship between pain severity and depression in IBS patients.

Methods: The sample included 70 consecutively evaluated patients who met Rome III criteria for IBS diagnosis and 55 healthy controls. All participants completed measures of depression, pain, state and trait anger, and anger expression style.

Results: Using a mediational model involving a series of linear regressions we found that trait anger and anger expression index partially mediated the association between depression and abdominal pain severity. The IBS patients with significant pain reported higher depressive symptoms; these results could be partially explained by their tendency to experience angry feelings generated by pain.

Conclusions: The relation between pain and depression is not a direct and linear one, but works partly through patients’ tendency to become angry and through anger expression style regarding their pain.


anger, chronic pain, depression, irritable bowel syndrome