Prasko Jan, Jelenova Daniela, Mihal Vladimir
Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University, University Hospital Olomouc, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2010 Dec;154(4):307-14. doi: 10.5507/bp.2010.046.
Despite holistic approach to psychosomatic medicine, gastroenterological disorders (GI) tend to be categorized broadly into "functional" and "organic". Major GI illnesses are Inflammatory bowel diseases (IBD) include ulcerative colitis and Crohn's disease. Both are chronic, with remissions and relapses over the years while irritable bowel syndrome (IBS) is a common, often disabling functional gastrointestinal disorder.
A literature review was performed using the National Library of Medicine PubMed database, including all resources within the period 1991-2008, additional references were found through bibliography reviews of relevant articles.
Psychological problems: Higher scores of neuroticism, depression, inhibition, and emotional instability, are typical for many patients with chronic diseases and nonspecific for chronic gastroenterological disorders. Patients with chronic gastrointestinal disorders have impaired health-related quality. Psychological treatments: There have been few adequate psychological treatment trials in IBD. These achieved lower demands for health care rather than a reduction of anxiety or depression. Psychotherapy with chronic gastrointestinal disorders could lead to improve the course of the disease, changing psychological factors such as depression and dysfunctional coping and improving the patient's quality of life.
There seem to be "risk patients" in whom psychosocial components have a bigger influence on the course of disease than in other patients; and those would probably benefit from psychotherapeutic treatment. Psychological treatments help patients manage the psychological distress which worsens bowel symptoms and quality of life.
尽管身心医学采用整体方法，但胃肠疾病（GI）往往大致分为“功能性”和“器质性”。主要的胃肠疾病包括炎症性肠病（IBD），其中有溃疡性结肠炎和克罗恩病。这两种疾病都是慢性的，多年来会有缓解期和复发期，而肠易激综合征（IBS）是一种常见的、往往会导致功能障碍的功能性胃肠疾病。
使用美国国立医学图书馆的PubMed数据库进行文献综述，涵盖1991年至2008年期间的所有资源，并通过对相关文章的参考文献综述找到其他参考文献。
心理问题：许多慢性病患者的神经质、抑郁、抑制和情绪不稳定得分较高，这并非慢性胃肠疾病所特有。慢性胃肠疾病患者的健康相关生活质量受损。心理治疗：针对炎症性肠病的充分心理治疗试验很少。这些试验降低了对医疗保健的需求，但并未减轻焦虑或抑郁。对慢性胃肠疾病进行心理治疗可能会改善疾病进程，改变诸如抑郁和功能失调应对等心理因素，并提高患者的生活质量。
似乎存在“风险患者”，其社会心理因素对疾病进程的影响比其他患者更大；这些患者可能会从心理治疗中受益。心理治疗有助于患者应对会加重肠道症状和生活质量的心理困扰。
