Miehsler Wolfgang, Weichselberger Martina, Offerlbauer-Ernst Anna, Dejaco Clemens, Reinisch Walter, Vogelsang Harald, Machold Klaus, Stamm Tanja, Gangl Alfred, Moser Gabriele
Department of Internal Medicine III, Division of Gastroenterology and Hepatology, University of Vienna, Austria.
Inflamm Bowel Dis. 2008 Sep;14(9):1273-80. doi: 10.1002/ibd.20462.
Psychological distress is frequent in inflammatory bowel disease (IBD). Whether there is a need for psychological interventions is unknown. This study investigated the quantity and quality of the need for psychological interventions in IBD as compared to rheumatoid arthritis (RA).
In all, 302 patients with IBD and 109 patients with RA answered the ADAPT questionnaire, assessing the need for psychosomatic support (physicians support) and for psychotherapy, the hospital anxiety and depression scale, the SF-36, a questionnaire on social support (SOZU-K22), and the Rating Form of IBD Patient Concerns (IBD patients only). Detailed biomedical data were also assessed.
Ninety-three patients with IBD (31%) expressed a need for psychological intervention compared to 14 patients with RA (13%; P < 0.001). Stepwise logistic regression analysis revealed that anxiety (odds ratio [OR] 3.6; 95% confidence interval [CI] 2.2-6.0; P < 0.001), age < or =44 years (OR 2.6; 95% CI 1.5-4.3; P < 0.001) and impaired social support (SOZU-K22 <4.20) (OR 2.0; 95% CI 1.2-3.3; P = 0.009) accounted for this difference. In IBD the need for psychosomatic (physicians) support was associated with worries and concerns about IBD and the need for psychotherapy was associated with worries and concerns about IBD, anxiety, impaired "social functioning" (SF-36), and short disease duration.
Patients with IBD express a higher need for psychological interventions than patients with RA due to greater psychosocial restrictions inherent in IBD. The need for psychological interventions was characterized by psychological factors, mainly worries about the disease and anxiety, rather than by medical variables
心理困扰在炎症性肠病（IBD）中很常见。是否需要心理干预尚不清楚。本研究调查了与类风湿关节炎（RA）相比，IBD患者心理干预需求的数量和质量。
共有302例IBD患者和109例RA患者回答了ADAPT问卷，评估对心身支持（医生支持）和心理治疗的需求、医院焦虑抑郁量表、SF-36、社会支持问卷（SOZU-K22）以及IBD患者关注评定表（仅适用于IBD患者）。还评估了详细的生物医学数据。
93例IBD患者（31%）表示需要心理干预，而RA患者为14例（13%；P<0.001）。逐步逻辑回归分析显示，焦虑（比值比[OR]3.6；95%置信区间[CI]2.2 - 6.0；P<0.001）、年龄≤44岁（OR 2.6；95%CI 1.5 - 4.3；P<0.001）和社会支持受损（SOZU-K22<4.20）（OR 2.0；95%CI 1.2 - 3.3；P = 0.009）导致了这种差异。在IBD中，对心身（医生）支持的需求与对IBD的担忧有关，而心理治疗的需求与对IBD的担忧、焦虑、“社会功能”受损（SF-36）以及病程短有关。
由于IBD固有的更大心理社会限制因素，IBD患者比RA患者对心理干预的需求更高。心理干预需求的特征是心理因素，主要是对疾病的担忧和焦虑，而非医学变量。
