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肠易激综合征和炎症性肠病中的抑郁与焦虑症状、功能失调性态度及社会因素

Depressive and anxiety symptoms, dysfunctional attitudes and social aspects in irritable bowel syndrome and inflammatory bowel disease.

作者信息

Kovács Zoltán, Kovács Ferenc

机构信息

Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.

出版信息

Int J Psychiatry Med. 2007;37(3):245-55. doi: 10.2190/PM.37.3.a.

Abstract

OBJECTIVE

Biopsychosocial models for both organic and functional gastrointestinal (GI) disorders have been described in the recent literature. The objective of this study was to give further data to this model by assessing stressful life events, social support, psychopathological symptoms, and dysfunctional attitudes in irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) and healthy subjects.

METHOD

Age- and gender-matched IBS and IBD patients presenting at a tertiary care gastroenterological center completed self-reported questionnaires on stressful life events, social support, depressive and anxiety symptoms and dysfunctional attitudes. For comparative purposes, data from an age- and gender-matched healthy control group were obtained.

RESULTS

No significant differences were found between the groups regarding stressful life events and social support. Both patient groups had higher depressive and anxiety symptoms compared to healthy subjects, and IBS patients had higher depressive scores compared to IBD patients. IBS patients had more dysfunctional attitudes compared to both IBD and healthy subjects, while IBD and healthy subjects did not differ on dysfunctional attitudes.

CONCLUSIONS

GI patient status is associated with depressive and anxiety symptoms, in addition IBS patients have more severe depressive symptoms and depressogenic dysfunctional attitudes. The fact that functional GI patients are characterized by more severe psychological, but not social parameters, supports the hypothesis that IBS might be related to the range of depressive disorders.

摘要

目的

近期文献中已描述了针对器质性和功能性胃肠(GI)疾病的生物心理社会模型。本研究的目的是通过评估应激性生活事件、社会支持、心理病理症状以及肠易激综合征(IBS)、炎症性肠病(IBD)患者和健康受试者的功能失调态度,为该模型提供更多数据。

方法

在一家三级医疗胃肠病中心就诊的年龄和性别匹配的IBS和IBD患者完成了关于应激性生活事件、社会支持、抑郁和焦虑症状以及功能失调态度的自我报告问卷。为作比较,获取了年龄和性别匹配的健康对照组的数据。

结果

在应激性生活事件和社会支持方面,各组之间未发现显著差异。与健康受试者相比,两个患者组的抑郁和焦虑症状均更严重,且IBS患者的抑郁得分高于IBD患者。与IBD患者和健康受试者相比,IBS患者有更多功能失调态度,而IBD患者和健康受试者在功能失调态度方面无差异。

结论

胃肠疾病患者状态与抑郁和焦虑症状相关,此外,IBS患者有更严重的抑郁症状和致抑郁的功能失调态度。功能性胃肠疾病患者以更严重的心理而非社会参数为特征,这一事实支持了IBS可能与一系列抑郁症相关的假说。

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