Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong.
Aliment Pharmacol Ther. 2009 Sep 15;30(6):643-51. doi: 10.1111/j.1365-2036.2009.04074.x. Epub 2009 Jun 23.
BACKGROUND: No previous study has examined the comorbidity of Irritable Bowel Syndrome (IBS) and Generalized Anxiety Disorder (GAD) in a general population using standardized diagnostic methods. AIM: To examine the prevalence, comorbidity and risk correlates of IBS and GAD in a general population. METHODS: A random community-based telephone survey was conducted. The questionnaire covered symptoms of IBS, GAD, core depressive symptoms, help-seeking behaviour and functional impairment on the Sheehan Disability Scale. RESULTS: A total of 2005 participants completed the interview. The current prevalence of IBS was 5.4% and the 12-month prevalence of GAD was 4%. GAD was five times more common among IBS respondents than non-IBS respondents (OR: 5.84, P < 0.001), whereas IBS was 4.7 times more common among GAD respondents than among non-GAD respondents (OR: 6.32, P < 0.001). Core depressive symptoms (OR: 6.25, P < 0.01) and education level (OR: 5.918, P = 0.021) were risk correlates of GAD among IBS respondents. Comorbid respondents were more impaired than respondents having either disorder alone, but were not more likely to seek professional help than IBS-only respondents. CONCLUSION: Irritable Bowel Syndrome and GAD comorbidity was common and added to impairment in the community. The strong association between psychiatric morbidity and IBS observed in referral centres was not a consequence of increased help-seeking behaviour.
背景:既往研究均未采用标准化诊断方法,在一般人群中调查肠易激综合征(IBS)与广泛性焦虑障碍(GAD)的共病情况。
目的:在一般人群中调查 IBS 和 GAD 的流行率、共病情况和风险相关因素。
方法:采用随机社区电话调查。调查问卷涵盖 IBS、GAD、核心抑郁症状、求医行为和 Sheehan 残疾量表上的功能障碍。
结果:共有 2005 名参与者完成了访谈。IBS 的当前患病率为 5.4%,GAD 的 12 个月患病率为 4%。与非 IBS 应答者相比,IBS 应答者中 GAD 更为常见(OR:5.84,P<0.001),而 GAD 应答者中 IBS 比非 GAD 应答者更为常见(OR:6.32,P<0.001)。核心抑郁症状(OR:6.25,P<0.01)和教育程度(OR:5.918,P=0.021)是 IBS 应答者中 GAD 的风险相关因素。共病应答者的功能障碍比仅患 IBS 或 GAD 的应答者更为严重,但与仅患 IBS 的应答者相比,他们寻求专业帮助的可能性并不更高。
结论:IBS 和 GAD 共病在社区中很常见,并加重了患者的功能障碍。在转诊中心观察到的精神疾病发病率与 IBS 之间的强关联并不是由于寻求帮助行为增加所致。
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