Université Paris V-René-Descartes, 15, rue de l'École-De-Médecine, 75270 Paris cedex 06, France.
Clin Res Hepatol Gastroenterol. 2013 Sep;37(4):422-30. doi: 10.1016/j.clinre.2012.10.011. Epub 2012 Dec 25.
Anxiety and depression are frequently present in patients with different types of functional gastrointestinal disorders (FGID), and seem to play a major part in both the perception of symptoms and the outcome of treatment.
The aim of the present study was therefore to evaluate levels of anxiety and depression in adult patients according to the extent and the type of FGID.
Three hundred and eighty-five consecutive patients (72% female) were evaluated. Each patient filled a standard clinical questionnaire based on diagnostic questions for uro-genital complaints and for FGID according to the Rome III criteria. In addition, they indicated on a 10-cm visual analog scale (VAS) the intensity of constipation, diarrhea, bloating, and abdominal pain, and stool description using the Bristol Stool Form Scale. Anxiety and depression were evaluated using Beck Depression Inventory and Anxiety State and Trait Anxiety Inventory.
In FGID patients, levels of depression, state and trait anxiety are higher in patients with several sites of complaint. Females are more depressed than males, regardless of the level of FGID. Females tend to react emotionally to stress with a lot of anxiety ("state" anxiety), as well as in the long run ("trait" anxiety). VAS parameters for constipation, bloating and abdominal pain were related to psychological scores in contrast to VAS diarrhea and stool form. In males, the extent of sites of FGID was strongly related to trait anxiety. In females, it was strongly related to depression.
Different types of FGID are associated with depression and anxiety according to the number of sites of complaints linked to gender and psychological parameters, as well as the magnitude of complaint expressed by the VAS.
焦虑和抑郁在患有不同类型功能性胃肠疾病(FGID)的患者中经常出现,并且似乎在症状的感知和治疗结果中都起着重要作用。
因此,本研究旨在根据 FGID 的程度和类型评估成年患者的焦虑和抑郁水平。
对 385 名连续患者(72%为女性)进行了评估。每位患者根据泌尿生殖系统疾病和 FGID 的诊断问题填写了一份标准临床问卷,符合罗马 III 标准。此外,他们还在 10 厘米的视觉模拟量表(VAS)上标记了便秘、腹泻、腹胀和腹痛的强度,以及使用布里斯托粪便形状量表描述粪便。使用贝克抑郁量表和焦虑状态与特质焦虑量表评估焦虑和抑郁。
在 FGID 患者中,有多个部位投诉的患者的抑郁、状态和特质焦虑水平更高。无论 FGID 水平如何,女性都比男性抑郁。女性往往会因压力而情绪激动,产生很多焦虑(“状态”焦虑),并且长期以来一直如此(“特质”焦虑)。与 VAS 腹泻和粪便形状相比,便秘、腹胀和腹痛的 VAS 参数与心理评分相关。在男性中,FGID 部位的程度与特质焦虑密切相关。在女性中,它与抑郁密切相关。
根据与性别和心理参数相关的投诉部位数量以及 VAS 表达的投诉程度,不同类型的 FGID 与抑郁和焦虑相关。