Norwegian Institute of Public Health, Division of Mental Heath, Oslo, Norway.
BMC Gastroenterol. 2010 Aug 5;10:88. doi: 10.1186/1471-230X-10-88.
Irritable bowel syndrome (IBS) is commonly regarded as a functional disorder, and is hypothesized to be associated with anxiety and depression. This evidence mainly rests on population-based studies utilising self-report screening instruments for psychopathology. Other studies applying structured clinical interviews are generally based on small clinical samples, which are vulnerable to biases. The extant evidence base for an association between IBS and psychopathology is hence not conclusive. The aim of this study was therefore to re-examine the hypothesis using population-based data and psychiatric morbidity established with a structured clinical interview.
Data were derived from a population-based epidemiological study (n = 1077). Anxiety and mood disorders were established using the Structured Clinical Interview for DSM-IV-TR (SCID-I/NP) and the General Health Questionnaire (GHQ-12). Current and lifetime IBS was self-reported. Hypertension and diabetes were employed as comparison groups as they are expected to be unrelated to mental health.
Current IBS (n = 69, 6.4%) was associated with an increased likelihood of current mood and/or anxiety disorders (OR = 2.62, 95%CI 1.49 - 4.60). Half the population reporting a lifetime IBS diagnosis also had a lifetime mood or anxiety disorder. Exploratory analyses demonstrated an increased prevalence of IBS across most common anxiety and mood disorders, the exception being bipolar disorder. The association with IBS and symptoms load (GHQ-12) followed a curved dose response pattern. In contrast, hypertension and diabetes were consistently unrelated to psychiatric morbidity.
IBS is significantly associated with anxiety and mood disorders. This study provides indicative evidence for IBS as a disorder with a psychosomatic aspect.
肠易激综合征（IBS）通常被认为是一种功能障碍，据推测与焦虑和抑郁有关。这一证据主要基于利用精神病理学自评筛查工具的基于人群的研究。其他应用结构化临床访谈的研究通常基于小型临床样本，这些样本容易受到偏差的影响。因此，IBS 与精神病理学之间关联的现有证据基础并不确定。本研究旨在使用基于人群的数据和通过结构化临床访谈确定的精神疾病患病率来重新检验这一假说。
数据来自一项基于人群的流行病学研究（n=1077）。使用 DSM-IV-TR 结构化临床访谈（SCID-I/NP）和一般健康问卷（GHQ-12）确定焦虑和情绪障碍。当前和终身 IBS 采用自我报告的方式。高血压和糖尿病被用作对照组，因为它们预计与心理健康无关。
当前 IBS（n=69，6.4%）与当前情绪和/或焦虑障碍的可能性增加相关（OR=2.62，95%CI 1.49-4.60）。报告有终身 IBS 诊断的人群中有一半也有终身情绪或焦虑障碍。探索性分析表明，IBS 在大多数常见的焦虑和情绪障碍中普遍存在，双相情感障碍除外。IBS 与症状负荷（GHQ-12）之间的关联呈曲线剂量反应模式。相比之下，高血压和糖尿病与精神疾病患病率始终无关。
IBS 与焦虑和情绪障碍显著相关。本研究提供了 IBS 作为一种具有身心方面疾病的指示性证据。
