Barts and the London NHS Trust, Royal London Hospital, London, UK.
Dig Dis. 2009;27 Suppl 1:76-9. doi: 10.1159/000268124. Epub 2010 Mar 4.
There is increasing evidence that psychological stress and associated mood disorders are linked with, and can adversely affect the course of inflammatory bowel disease (IBD). Of 11 longitudinal studies of the effects of stress or depression on the course of IBD, most suggested that stress worsened IBD, the rest giving either negative or inconclusive results. If stress does have an adverse effect on the natural history of IBD, then measures which reduce stress should help symptoms and activity of IBD. Unfortunately, because of methodological difficulties inherent in undertaking appropriately targeted and blinded trials, good data about the effects on IBD of interventions aimed to ameliorate stress and mood disorders are limited. Emerging trial evidence supports the suggestion that psychologically orientated therapy may ameliorate IBD-associated mood disorders, but there is no strong data yet to indicate that stress management has a beneficial effect on the activity or course of IBD. More rigorous assessments are needed of the relation between psychological state and activity of IBD, and of the potential benefits of stress-reducing measures in IBD.
越来越多的证据表明，心理压力和相关的情绪障碍与炎症性肠病（IBD）的发生有关，并可能对其病程产生不利影响。在 11 项关于压力或抑郁对 IBD 病程影响的纵向研究中，大多数研究表明压力会使 IBD 恶化，其余研究则得出了负面或不确定的结果。如果压力确实对 IBD 的自然病程有不良影响，那么减轻压力的措施应该有助于缓解 IBD 的症状和活动。不幸的是，由于在进行有针对性和盲法试验方面存在固有的方法学困难，关于旨在改善压力和情绪障碍的干预措施对 IBD 影响的良好数据有限。新兴的试验证据支持这样一种观点，即心理导向疗法可能改善与 IBD 相关的情绪障碍，但目前尚无强有力的数据表明压力管理对 IBD 的活动或病程有有益的影响。需要更严格地评估心理状态与 IBD 活动之间的关系，以及减轻压力措施在 IBD 中的潜在益处。
