Haug T Tangen, Mykletun A, Dahl A A
Dept. of Psychiatry, Haukeland Hospital, University of Bergen, Norway.
Scand J Gastroenterol. 2002 Mar;37(3):294-8. doi: 10.1080/003655202317284192.
In clinical studies there is a strong relationship between gastrointestinal symptoms, anxiety and depression. The results may be biased, however, since anxiety and depression will influence the decision to consult a doctor. The aim of this study was to investigate the relationship between these symptoms in the population.
In the Health Study of Nord-Trøndelag County of Norway (HUNT) a questionnaire concerning physical and mental health, demographic and life-style factors was sent to all inhabitants aged 20 years and above (a total of 94,197 persons). Valid questionnaires were returned by 62,651 persons (66.5%). Presence of nausea, heartburn, diarrhoea and constipation during the last year was self-reported. Anxiety disorders and depression were based on self-ratings of the Hospital Anxiety and Depression Scale (HADS).
48% of the population reported one or more of the four gastrointestinal symptoms. Based on the HADS ratings, 15.3% of the population had an anxiety disorder and 10.4% a depression. Anxiety disorder was most strongly associated with nausea (OR 3.42). Anxiety was also associated with heartburn, diarrhoea and constipation, but weaker than with nausea. Depression was less strongly associated with the four gastrointestinal symptoms. Demographic factors, life-style factors and extra-gastrointestinal complaints could not explain the effect of anxiety disorders and depression on these gastrointestinal symptoms.
In this population study there was a strong relationship between gastrointestinal symptoms, anxiety disorders and depression. These findings suggest that mental disorders in patients with gastrointestinal symptoms are not merely a consequence of selection bias in patient materials but connected to the symptoms themselves.
在临床研究中，胃肠道症状、焦虑和抑郁之间存在密切关系。然而，由于焦虑和抑郁会影响就医决定，研究结果可能存在偏差。本研究旨在调查这些症状在人群中的关系。
在挪威北特伦德拉格郡健康研究（HUNT）中，向所有20岁及以上居民（共94,197人）发送了一份关于身心健康、人口统计学和生活方式因素的问卷。62,651人（66.5%）返回了有效问卷。通过自我报告了解过去一年中是否存在恶心、烧心、腹泻和便秘症状。焦虑症和抑郁症基于医院焦虑抑郁量表（HADS）的自我评分。
48%的人群报告了四种胃肠道症状中的一种或多种。根据HADS评分，15.3%的人群患有焦虑症，10.4%患有抑郁症。焦虑症与恶心的关联最为强烈（比值比3.42）。焦虑也与烧心、腹泻和便秘有关，但比与恶心的关联弱。抑郁症与这四种胃肠道症状的关联较弱。人口统计学因素、生活方式因素和胃肠道外的不适无法解释焦虑症和抑郁症对这些胃肠道症状的影响。
在这项人群研究中，胃肠道症状、焦虑症和抑郁症之间存在密切关系。这些发现表明，胃肠道症状患者的精神障碍不仅仅是患者资料选择偏差的结果，而是与症状本身有关。
