Objective We aimed to determine whether psychiatric disorders and psychological symptoms are associated with the irritable bowel syndrome, and whether childhood sexual abuse is reported more often by patients with irritable bowel syndrome, as these issues continue to be controversial. Design Prospectively, 32 symptomatic married outpatients with irritable bowel syndrome completed selected portions of the Structured Clinical Interview for DSM-III-R psychiatric diagnoses, a standardized interview for childhood abuse, and a series of self-report psychological symptom inventories. Controls comprised 20 currently symptomatic married outpatients who had undergone a partial colectomy or ileectomy for organic disease, the spouses of the patients with irritable bowel syndrome, and the spouses of the organic disease controls. Results Current psychiatric disorders were reported significantly more frequently by patients with irritable bowel syndrome compared with controls, although 69% of these patients were not affected. Childhood abuse was reported more frequently by patients with irritable bowel syndrome, but after adjusting for age and gender, a significant association with diagnostic group was not detected. However, psychiatric disorders were significantly more frequent in those with a history of childhood abuse. Self-report psychological symptom inventories did not discriminate between patients with the irritable bowel syndrome and controls. Conclusion Our findings suggest that while standardized psychiatric interviews give more information than self-report rating scales, psychopathology may not be the major explanation for at least a subset of patients with the irritable bowel syndrome.