Talley N J, Phillips S F, Bruce B, Twomey C K, Zinsmeister A R, Melton L J
Gastroenterology Research Unit, Mayo Clinic, Rochester, Minnesota.
Gastroenterology. 1990 Aug;99(2):327-33. doi: 10.1016/0016-5085(90)91012-u.
The importance of personality traits in nonulcer dyspepsia and irritable bowel syndrome is a controversial issue. We wished to assess the distribution of abnormal personality traits in nonulcer dyspepsia and the irritable bowel syndrome, define any relation among personality and symptoms, and determine whether personality factors discriminate among patients with functional, psychiatric, or organic gastrointestinal diseases. Patients with nonulcer dyspepsia (n = 31), irritable bowel syndrome (n = 67), organic gastrointestinal disease (n = 64), somatoform disorder (n = 36) and healthy controls (n = 128) were studied. Before diagnostic evaluation by an independent physician, all patients completed the Minnesota Multiphasic Personality Inventory and a symptom questionnaire. Symptom scores for abdominal pain and the Manning criteria, which is considered to be diagnostic for the irritable bowel syndrome, were evaluated. Personality scales in patients with nonulcer dyspepsia, irritable bowel syndrome, and organic disease were very similar. However, patients in the other groups differed from somatoform disorder on nearly all scales. In nonulcer dyspepsia, irritable bowel syndrome, and organic disease, hypochondriasis weakly correlated with pain. Subgroups of irritable bowel syndrome patients with predominant constipation and those with predominant diarrhea had similar personality traits, although hypomania was minimally increased in constipation. Patients who fulfilled the Manning criteria for irritable bowel syndrome had more psychological distress than those who did not. The Minnesota Multiphasic Personality Inventory correctly classified somatoform disorder and health 81% and 75% of the time, respectively, but it classified nonulcer dyspepsia and irritable bowel syndrome correctly in only 32% and 34% of cases. Our results suggest that psychopathology may not be the major explanation for functional gastrointestinal disorders.
人格特质在非溃疡性消化不良和肠易激综合征中的重要性是一个有争议的问题。我们希望评估非溃疡性消化不良和肠易激综合征中异常人格特质的分布，确定人格与症状之间的任何关系，并确定人格因素是否能区分功能性、精神性或器质性胃肠道疾病患者。对非溃疡性消化不良患者（n = 31）、肠易激综合征患者（n = 67）、器质性胃肠道疾病患者（n = 64）、躯体形式障碍患者（n = 36）和健康对照者（n = 128）进行了研究。在由独立医生进行诊断评估之前，所有患者均完成了明尼苏达多相人格调查表和一份症状问卷。对腹痛症状评分以及被认为可诊断肠易激综合征的曼宁标准进行了评估。非溃疡性消化不良、肠易激综合征和器质性疾病患者的人格量表非常相似。然而，其他组的患者在几乎所有量表上均与躯体形式障碍患者不同。在非溃疡性消化不良、肠易激综合征和器质性疾病中，疑病与疼痛呈弱相关。以便秘为主的肠易激综合征患者亚组和以腹泻为主的患者亚组具有相似的人格特质，尽管便秘患者的轻躁狂略有增加。符合肠易激综合征曼宁标准的患者比不符合该标准的患者有更多的心理困扰。明尼苏达多相人格调查表分别有81%和75%的时间能正确分类躯体形式障碍和健康状况，但对非溃疡性消化不良和肠易激综合征的正确分类率仅分别为32%和34%。我们的结果表明，精神病理学可能不是功能性胃肠道疾病的主要解释。
