Miller A R, North C S, Clouse R E, Wetzel R D, Spitznagel E L, Alpers D H
Department of Psychiatry, Washington University, St Louis, Missouri, USA.
Ann Clin Psychiatry. 2001 Mar;13(1):25-30. doi: 10.1023/a:1009060731057.
Irritable bowel syndrome (IBS) and somatization disorder (SD) are defined by nonobjective symptoms that overlap considerably. Psychiatric symptoms associated with IBS may originate from SD in IBS patients. Previous studies of IBS have not considered SD separately from IBS.
This study explored psychiatric symptoms and illness behavior in IBS in relation to SD. A total of 50 outpatients with IBS or ulcerative colitis (UC) were evaluated with the Diagnostic Interview Schedule and Illness Behavior Questionnaire.
Definite or probable SD was diagnosed in no UC patients and in 42% of IBS patients (confirmed in 25% and lacking one symptom in another 17%). IBS patients with probable or definite SD, but not those without SD, reported more psychiatric symptoms and abnormal illness behaviors than did UC patients. SD accounted for the association of psychiatric symptoms with IBS.
In this university-based office setting, the association of psychiatric features with IBS appears heterogeneous predicated on whether SD is present. Future studies of functional bowel diseases should distinguish between patients with and without SD to clarify its relationship to these disorders. Clinicians should consider whether patients with functional disorders have SD, a diagnosis that indicates specific clinical management strategies.
肠易激综合征（IBS）和躯体化障碍（SD）由大量重叠的非客观症状所定义。与IBS相关的精神症状可能源于IBS患者的SD。既往对IBS的研究未将SD与IBS分开考虑。
本研究探讨了IBS中与SD相关的精神症状和疾病行为。共有50例IBS或溃疡性结肠炎（UC）门诊患者接受了诊断性访谈表和疾病行为问卷评估。
UC患者中未诊断出明确或可能的SD，而IBS患者中有42%被诊断出（25%确诊，另有17%缺少一项症状）。与UC患者相比，可能或明确患有SD的IBS患者报告了更多的精神症状和异常疾病行为，而无SD的IBS患者则不然。SD解释了精神症状与IBS之间的关联。
在这个基于大学的门诊环境中，精神特征与IBS之间的关联似乎因是否存在SD而异。未来对功能性肠病的研究应区分有无SD的患者，以阐明其与这些疾病的关系。临床医生应考虑功能性障碍患者是否患有SD，这一诊断表明了特定的临床管理策略。
