San Francisco VA Medical Center, San Francisco, California; Department of Psychiatry, University of California, San Francisco, California.
Depress Anxiety. 2014 Feb;31(2):160-5. doi: 10.1002/da.22072. Epub 2013 Mar 14.
Gastrointestinal disorders (GIDs) represent a large public health burden, affecting an estimated 60-70 million Americans annually. Our goal was to examine the relationship between GID and the most common mental health disorders in a national group of newly returning veterans. We also evaluated gender differences in the association of mental health disorders and GID.
We utilized a retrospective, longitudinal cohort analysis of veterans' health records. Participants were 603,221 Iraq and Afghanistan veterans who were new users of VA healthcare from October 7, 2001 (start of the war in Afghanistan) to December 31, 2010.
The prevalence of GID in newly returning veterans was nearly 20%, and veterans with a mental health disorder were at least twice as likely to have a GID as those without mental health disorders. For women, the increased risk of all GIDs was greatest among those with depression. Among men, the increased risk of irritable bowel syndrome (IBS) was greatest among those with posttraumatic stress disorder. IBS was the GID most strongly associated with mental health conditions among both genders.
The large proportion of newly returning veterans with GIDs and comorbid mental health diagnoses is concerning. Successful detection and treatment of GIDs associated with mental health disorders will require integrated efforts from primary care and mental health.
胃肠道疾病（GIDs）是一个严重的公共卫生问题，每年影响约 6000 万至 7000 万美国人。我们的目标是在一个新返回的退伍军人的全国性群体中研究胃肠道疾病与最常见的心理健康障碍之间的关系。我们还评估了心理健康障碍与胃肠道疾病之间关联的性别差异。
我们利用退伍军人健康记录的回顾性、纵向队列分析。参与者为 603221 名伊拉克和阿富汗退伍军人，他们是 2001 年 10 月 7 日（阿富汗战争开始）至 2010 年 12 月 31 日期间新使用 VA 医疗保健的退伍军人。
新返回的退伍军人中胃肠道疾病的患病率接近 20%，患有心理健康障碍的退伍军人患有胃肠道疾病的可能性至少是没有心理健康障碍的退伍军人的两倍。对于女性，所有胃肠道疾病的风险增加最大的是患有抑郁症的人。对于男性，患有创伤后应激障碍的人患肠易激综合征（IBS）的风险增加最大。IBS 是男女两性中与心理健康状况最密切相关的胃肠道疾病。
患有胃肠道疾病和合并心理健康诊断的新返回退伍军人比例很高，令人担忧。成功发现和治疗与心理健康障碍相关的胃肠道疾病需要初级保健和心理健康的综合努力。
