Creed Francis, Ratcliffe Joy, Fernandes Lakshmi, Palmer Stephen, Rigby Christine, Tomenson Barbara, Guthrie Elspeth, Read Nicholas, Thompson David G
School of Psychiatry and Behavioural Science, University of Manchester, Oxford Road, Manchester M13 9WL, UK.
Br J Psychiatry. 2005 Jun;186:507-15. doi: 10.1192/bjp.186.6.507.
Irritable bowel syndrome often leads to impaired functioning.
To assess the contribution of psychiatric disorders to impaired outcome in severe irritable bowel syndrome.
Patients with severe irritable bowel syndrome entering a psychological treatment trial (n=257) were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry. Outcomes were number of days of restricted activity, role limitation (physical) score of the Short Form Health Survey and costs.
At baseline, depressive disorder (29% of patients), panic (12%) and neurasthenia (35%) were associated with impairment; number of psychiatric disorders was associated in a dose-response fashion (P=0.005). At follow-up, depressive disorder and neurasthenia were associated with role limitation score. Improved depression was associated with improved role functioning.
Depressive, panic and neurasthenic disorders contribute to poor outcomes in severe irritable bowel syndrome, and appropriate treatment should be available to these patients.
肠易激综合征常导致功能受损。
评估精神障碍对重度肠易激综合征不良结局的影响。
采用神经精神病学临床评估量表对进入心理治疗试验的重度肠易激综合征患者（n = 257）进行访谈。结局指标包括活动受限天数、简短健康调查问卷的角色限制（身体方面）得分及费用。
在基线时，抑郁症（29%的患者）、惊恐障碍（12%）和神经衰弱（35%）与功能受损相关；精神障碍的数量呈剂量反应关系（P = 0.005）。在随访时，抑郁症和神经衰弱与角色限制得分相关。抑郁症状改善与角色功能改善相关。
抑郁、惊恐和神经衰弱性障碍导致重度肠易激综合征预后不良，应为这些患者提供适当治疗。
