Drossman D A
Département de Médecine et Psychiatrie, Université de Caroline du Nord, Chapel Hill, NC 27599.
Gastroenterol Clin Biol. 1990;14(5 ( Pt 2)):49C-53C.
The study of the psychologic profile of patients with the irritable bowel syndrome (IBS) has shown that psychologic aggression, personality abnormalities, psychiatric diagnostics and pathologic behaviour patterns are more frequently encountered than in normal subjects or those with other disease. Moreover, patients with IBS often relate psychological events experienced in infancy such as a lost child, divorce of parents, or sexual abuse which can affect their future and particularly their manner of seeking medical advice. As it is known that only between 23 and 38 per cent of patients with IBS seek medical advice, it is also important to know whether these psychologic characteristics are true for all subjects with these symptoms or if they are found in a particular subgroup of patients who seek medical advice because, in fact, they are really ill. Multivariate analysis was used to evaluate the medical and psychologic status of 72 patients with IBS, 82 patients with symptoms suggestive of IBS but who did not seek medical advice, and 84 normal subjects. With regard to semeiologic differences according to whether patients sought medical advice or not, there were more subjects in the first group who complained of diarrhea and pain. Moreover, there were more patients with personality abnormalities, pathologic behaviour patterns, and a lower sensitivity to stress in subjects with IBS seeking medical advice than in those with symptoms who did not seek advice (p less than 0.001) or normal subjects (p less than 0.001). There were no significant differences between the subjects with symptoms but who do not seek medical advice and the normal subjects (p = 0.21).(ABSTRACT TRUNCATED AT 250 WORDS)
对肠易激综合征(IBS)患者心理特征的研究表明,与正常受试者或患有其他疾病的人相比,心理攻击、人格异常、精神诊断和病理行为模式在IBS患者中更为常见。此外,IBS患者常提及婴儿期经历的心理事件,如失去孩子、父母离异或性虐待,这些事件会影响他们的未来,尤其是他们寻求医疗建议的方式。众所周知,只有23%至38%的IBS患者会寻求医疗建议,了解这些心理特征是否适用于所有有这些症状的受试者,或者是否只存在于寻求医疗建议的特定亚组患者中也很重要,因为实际上他们确实患病了。采用多变量分析评估了72例IBS患者、82例有IBS症状但未寻求医疗建议的患者以及84名正常受试者的医疗和心理状况。关于根据患者是否寻求医疗建议的症状学差异,第一组中抱怨腹泻和疼痛的受试者更多。此外,与未寻求建议的有症状受试者(p<0.001)或正常受试者(p<0.001)相比,寻求医疗建议的IBS受试者中人格异常、病理行为模式更多,对压力的敏感性更低。有症状但未寻求医疗建议的受试者与正常受试者之间无显著差异(p = 0.21)。(摘要截断于250字)