Sugawara Norio, Sato Ken, Takahashi Ippei, Satake Ryu, Fukuda Shinsaku, Nakaji Shigeyuki, Yasui-Furukori Norio
Department of Neuropsychiatry, Hirosaki University School of Medicine, Japan.
Intern Med. 2017;56(5):493-498. doi: 10.2169/internalmedicine.56.7695. Epub 2017 Mar 1.
Objective Irritable bowel syndrome (IBS) is associated with a high prevalence of psychological disorders. Coping, which is used to manage stressful events, can have adaptive or maladaptive effects on a patient's health status. However, these coping behaviors have not been well studied in individuals with IBS. The association between the use of coping behaviors and the reported levels of depressive symptoms was examined in individuals with IBS. Methods Among 993 volunteers (382 men and 611 women) who participated in the Iwaki Health Promotion Project in 2013, we included 58 subjects who fulfilled the Rome III criteria for IBS in our analysis. Coping behaviors were assessed using the Brief Scale for Coping Profile (BSCP). The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess the four dimensions of depressive symptoms (depressed affect, somatic symptoms, interpersonal problems, and lack of positive affect) and the prevalence of probable depression using a cut-off score of 16. Results Among the 58 subjects with IBS, 22 (36.1%) exhibited probable depression. After adjustment for confounders, "active solution" was found to be significantly associated with somatic symptoms. Under the same conditions, "avoidance and suppression" was significantly associated with the CES-D total score, depressed affect, somatic symptoms, and (lack of) positive affect. There were no other significant relationships between depressive symptoms and the BSCP sub-scale scores. Conclusion These findings indicate that coping behaviors may influence the experience of depressive symptoms among individuals with IBS. Psychological therapy may reduce depressive symptoms as well as the severity of IBS symptoms. Additional studies are needed to examine the relationships between coping behaviors and depressive symptoms using a longitudinal study design.
目的 肠易激综合征（IBS）与心理障碍的高患病率相关。应对方式用于处理应激事件，可能对患者的健康状况产生适应性或适应不良的影响。然而，这些应对行为在IBS患者中尚未得到充分研究。本研究探讨了IBS患者应对行为的使用与报告的抑郁症状水平之间的关联。方法 在参与2013年磐城健康促进项目的993名志愿者（382名男性和611名女性）中，我们纳入了58名符合罗马III标准的IBS患者进行分析。使用应对方式简要量表（BSCP）评估应对行为。采用流行病学研究中心抑郁量表（CES-D）评估抑郁症状的四个维度（抑郁情绪、躯体症状、人际关系问题和缺乏积极情绪），并使用16分的临界值评估可能的抑郁症患病率。结果 在58名IBS患者中，22名（36.1%）表现出可能的抑郁症。在对混杂因素进行调整后，发现“积极解决”与躯体症状显著相关。在相同条件下，“回避和抑制”与CES-D总分、抑郁情绪、躯体症状和（缺乏）积极情绪显著相关。抑郁症状与BSCP子量表得分之间没有其他显著关系。结论 这些发现表明，应对行为可能会影响IBS患者的抑郁症状体验。心理治疗可能会减轻抑郁症状以及IBS症状的严重程度。需要进一步的研究采用纵向研究设计来探讨应对行为与抑郁症状之间的关系。
