Jones Michael P, Crowell Michael D, Olden Kevin W, Creed Francis
Feinberg School of Medicine, Northwestern University, Chicago, IL 60611-2908, USA.
Psychosomatics. 2007 Mar-Apr;48(2):93-102. doi: 10.1176/appi.psy.48.2.93.
Functional gastrointestinal disorders (FGID) are common conditions, with well-established diagnostic criteria. They are associated with impaired health-related quality of life and increased societal and healthcare costs. Their symptoms are probably related to altered 5-HT transmission and central processing of noxious visceral stimuli. Evaluation and treatment are best formulated using a biopsychosocial model that integrates gut function with psychosocial assessment. Psychological therapies may improve overall well-being and appear to help patients without significant psychiatric comorbidity. Antidepressants help comorbid anxiety and depressive disorders and have primary efficacy in improving the symptoms of FGID. Finally, there is a need for greater involvement of psychiatrists in both the evaluation and treatment of patients with FGID as well as the education and training of practitioners caring for these patients.
功能性胃肠疾病（FGID）很常见，有既定的诊断标准。它们与健康相关生活质量受损以及社会和医疗成本增加有关。其症状可能与5-羟色胺传递改变和有害内脏刺激的中枢处理有关。评估和治疗最好采用生物心理社会模型来制定，该模型将肠道功能与心理社会评估相结合。心理治疗可能会改善整体幸福感，并且似乎对没有明显精神疾病合并症的患者有帮助。抗抑郁药有助于治疗合并的焦虑和抑郁障碍，并且在改善FGID症状方面有主要疗效。最后，精神科医生需要更多地参与FGID患者的评估和治疗，以及对照顾这些患者的从业者的教育和培训。
