Weinryb R M, Österberg E, Blomquist L, Hultcrantz R, Krakau I, Åsberg M
a Dept. of Clinical Neuroscience, Psychotherapy Section Karolinska Institutet Stockholm Sweden.
b Dept. of Medicine, Family Practice Karolinska Institutet Stockholm Sweden.
Scand J Gastroenterol. 2003;38(5):503-510. doi: 10.1080/00365520310002166.
It has been suggested that psychopathology in irritable bowel syndrome (IBS) patients is a function of patient status rather than of the disease. Although there are many studies comparing IBS patients, IBS non-patients, and controls with each other, no previous study has recruited all three groups from a representative community sample and had all subjects diagnosed by a physician. In the present study we aimed to compare psychological factors in IBS patients, IBS non-patients, and normal controls in a sample recruited from the population.
Subjects aged 18-45 years were recruited from a random sample of the normal population. Seventeen (2 M and 15 F) IBS patients were matched by sex and age with IBS non-patients and normals. Measures of personality traits, interpersonal distress, and temporary psychological distress were used. A physician diagnosed all 51 subjects in order to exclude possible gastrointestinal diagnoses other than IBS.
Controls often differed from IBS non-patients and patients on the personality, interpersonal, and psychological distress measures, while IBS non-patients and patients very rarely differed from each other. All three groups were non-alexithymic.
The results indicate that there are psychopathological differences between normals and IBS persons (patients and non-patients), but they could not confirm that psychopathology was a function of patient status. Whether this psychopathology is a vulnerability factor for IBS, or a consequence of it, remains to be studied.
有观点认为,肠易激综合征(IBS)患者的精神病理学表现是患者自身状况的函数,而非疾病本身的函数。尽管有许多研究对IBS患者、非IBS患者和对照组进行了相互比较,但此前尚无研究从具有代表性的社区样本中招募这三组人群,并由医生对所有受试者进行诊断。在本研究中,我们旨在比较从人群中招募的样本中IBS患者、非IBS患者和正常对照组的心理因素。
从正常人群的随机样本中招募年龄在18至45岁之间的受试者。17名(2名男性和15名女性)IBS患者在性别和年龄上与非IBS患者及正常人相匹配。使用了人格特质、人际困扰和临时心理困扰的测量方法。为排除IBS以外可能的胃肠道诊断,由一名医生对所有51名受试者进行了诊断。
在人格、人际和心理困扰测量方面,对照组与非IBS患者及患者常常存在差异,而非IBS患者和患者之间很少有差异。所有三组均无述情障碍。
结果表明,正常人与IBS患者(包括患者和非患者)之间存在精神病理学差异,但无法证实精神病理学是患者自身状况的函数。这种精神病理学是IBS的易患因素还是其结果,仍有待研究。