Muscatello Maria Rosaria A, Bruno Antonio, Mento Carmela, Pandolfo Gianluca, Zoccali Rocco A
Maria Rosaria A Muscatello, Antonio Bruno, Carmela Mento, Gianluca Pandolfo, Rocco A Zoccali, Psychiatry Unit, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy.
World J Gastroenterol. 2016 Jul 28;22(28):6402-15. doi: 10.3748/wjg.v22.i28.6402.
The review focuses on those personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness), constructs (alexithymia and distressed - Type D personality) and emotional patterns (negative and positive) that are of particular concern in health psychology, with the aim to highlight their potential role on the pathogenesis, onset, symptom clusters, clinical course, and outcome of irritable bowel syndrome (IBS). Personality traits and emotional patterns play key roles in affecting autonomic, immune, inflammatory, and endocrine functions, thus contributing not only to IBS clinical expression and symptomatic burden, but also to disease physiopathology. In this sense, psychological treatments should address those personality traits and emotional features that are constitutive of, and integral to IBS. The biopsychosocial model of illness applied to IBS acknowledges the interaction between biological, psychological, environmental, and social factors in relation to pain and functional disability. A holistic approach to IBS should take into account the heterogeneous nature of the disorder, and differentiate treatments for different types of IBS, also considering the marked individual differences in prevalent personality traits and emotional patterns. Beyond medications, and lifestyle/dietary interventions, psychological and educational treatments may provide the optimal chance of addressing clinical symptoms, comorbid conditions, and quality of life in IBS patients.
本综述聚焦于健康心理学中特别关注的那些人格特质(神经质、外向性、经验开放性、宜人性和尽责性)、构念(述情障碍和D型苦恼人格)以及情绪模式(消极和积极),旨在突出它们在肠易激综合征(IBS)的发病机制、起病、症状群、临床病程及结局方面的潜在作用。人格特质和情绪模式在影响自主神经、免疫、炎症及内分泌功能方面发挥着关键作用,不仅导致IBS的临床表现和症状负担,还影响疾病的生理病理学。从这个意义上讲,心理治疗应针对那些构成IBS并与之不可分割的人格特质和情绪特征。应用于IBS的疾病生物心理社会模型承认生物、心理、环境和社会因素在疼痛和功能残疾方面的相互作用。对IBS的整体治疗方法应考虑到该疾病的异质性,区分不同类型IBS的治疗方法,同时也要考虑到普遍人格特质和情绪模式中显著的个体差异。除药物治疗以及生活方式/饮食干预外,心理和教育治疗可能为解决IBS患者的临床症状、共病情况及生活质量提供最佳机会。