Levy Rona L, Olden Kevin W, Naliboff Bruce D, Bradley Laurence A, Francisconi Carlos, Drossman Douglas A, Creed Francis
University of Washington, Seattle, Washington 98105, USA.
Gastroenterology. 2006 Apr;130(5):1447-58. doi: 10.1053/j.gastro.2005.11.057.
This report reviews recent research on the psychosocial aspects of the functional gastrointestinal disorders (FGIDs). A review and evaluation of existing literature was conducted by a multidisciplinary committee of experts in this field. This report is a synopsis of a chapter published in the Rome III book. The committee reached consensus in finding considerable evidence supporting the association between psychological distress, childhood trauma and recent environmental stress, and several of the FGIDs but noted that this association is not specific to FGIDs. There is also considerable evidence that psychosocial variables are important determinants of the outcomes of global well-being, health-related quality of life, and health care seeking. In line with these descriptive findings, there is now increasing evidence that a number of psychological treatments and antidepressants are helpful in reducing symptoms and other consequences of the FGIDs in children and adults. The FGIDs are a result of complex interactions between biological, psychological, and social factors, and they can only be treated satisfactorily when all these factors are considered and addressed. Therefore, knowledge about the psychosocial aspects of FGIDs is fundamental and critical to the understanding, assessment, and treatment of these disorders. More extensive physician training is needed if these aspects of treatment are to be used effectively and widely in clinical practice.
本报告回顾了近期关于功能性胃肠疾病（FGIDs）心理社会方面的研究。该领域的多学科专家委员会对现有文献进行了综述和评估。本报告是《罗马III》一书中某章节的概要。委员会达成共识，发现有大量证据支持心理困扰、童年创伤和近期环境压力与多种FGIDs之间存在关联，但指出这种关联并非FGIDs所特有。也有大量证据表明，心理社会变量是总体幸福感、健康相关生活质量和就医行为等结果的重要决定因素。与这些描述性研究结果一致，现在越来越多的证据表明，一些心理治疗方法和抗抑郁药物有助于减轻儿童和成人FGIDs的症状及其他后果。FGIDs是生物、心理和社会因素之间复杂相互作用的结果，只有在考虑并解决所有这些因素时，才能得到令人满意的治疗。因此，了解FGIDs的心理社会方面对于理解、评估和治疗这些疾病至关重要。如果要在临床实践中有效且广泛地运用治疗的这些方面，就需要对医生进行更广泛的培训。
