Shah Eric, Rezaie Ali, Riddle Mark, Pimentel Mark
GI Motility Program Cedars-Sinai Medical Center, Los Angeles, CA (Eric Shah, Ali Rezaie, Mark Pimentel), USA.
Enteric Diseases Department, Naval Medical Research Center, Silver Spring, Maryland (Mark Riddle), USA.
Ann Gastroenterol. 2014;27(3):224-230.
Psychological disorders have been associated with irritable bowel syndrome (IBS) for decades in the absence of other objective etiology. However, such associations are also evident in other chronic diseases with more clearly defined pathogenesis such as ulcerative colitis. In this study, we examined the prevalence and severity of psychological disorders among IBS and ulcerative colitis (UC) patients relative to healthy controls.
A review was conducted of English-language literature to identify case-control studies reporting the prevalence of depression or anxiety in IBS and UC populations relative to healthy controls. Our primary endpoint was the pooled prevalence or average score of depression or anxiety in an IBS or UC population relative to healthy control.
Seven case-control studies evaluating IBS and three evaluating UC were included. All IBS and UC studies reported excess prevalence and severity of depression as well as anxiety, relative to healthy controls. The prevalence of depression in excess of healthy controls was 39% in UC case-control trials and 33% in IBS studies, and excess anxiety was present in UC (42%) and IBS (19%) case-control trials as well. Anxiety and depression scores were higher (representing more severe symptoms) in both UC and IBS patients compared to healthy controls.
Anxiety and depressive disorders are associated with both IBS and UC. The non-specific association between these psychological and gastrointestinal disorders could suggest that chronic gastrointestinal illness might affect psychosocial behavior.
数十年来，在没有其他客观病因的情况下，心理障碍一直与肠易激综合征（IBS）相关。然而，在其他发病机制更明确的慢性疾病如溃疡性结肠炎中，这种关联也很明显。在本研究中，我们比较了肠易激综合征（IBS）和溃疡性结肠炎（UC）患者与健康对照者心理障碍的患病率和严重程度。
对英文文献进行综述，以确定报告IBS和UC人群相对于健康对照者抑郁症或焦虑症患病率的病例对照研究。我们的主要终点是IBS或UC人群相对于健康对照者抑郁症或焦虑症的合并患病率或平均得分。
纳入了7项评估IBS的病例对照研究和3项评估UC的病例对照研究。所有IBS和UC研究均报告，相对于健康对照者，抑郁症和焦虑症的患病率及严重程度均更高。在UC病例对照试验中，抑郁症患病率超过健康对照者的比例为39%，在IBS研究中为33%；UC（42%）和IBS（19%）病例对照试验中也存在焦虑症患病率过高的情况。与健康对照者相比，UC和IBS患者的焦虑和抑郁评分更高（代表症状更严重）。
焦虑症和抑郁症与IBS和UC均相关。这些心理障碍与胃肠道疾病之间的非特异性关联可能表明，慢性胃肠道疾病可能会影响心理社会行为。
