Tarricone Ilaria, Regazzi Maria Giulia, Bonucci Giulia, Rizzello Fernando, Carini Giovanni, Muratori Roberto, Poggioli Gilberto, Campieri Massimo
Department of Medical and Surgical Sciences, University of Bologna, Italy; Department of Psychiatry and Psychological Addictions, Local Health Authority, Bologna, Italy.
Department of Medical and Surgical Sciences, University of Bologna, Italy.
J Psychosom Res. 2017 Oct;101:68-95. doi: 10.1016/j.jpsychores.2017.07.001. Epub 2017 Jul 26.
Higher prevalence of psychiatric disorders, such as anxiety and depression, has been found in people with Crohn's disease and Ulcerative Colitis compared to the general population. Nowadays, international guidelines advocate psychotherapy and psycho-pharmacological treatments as playing an important role in IBD care. The main goal of this systematic literature review was summarize the evidence on the utilization and effectiveness of treatments for depression and anxiety in persons with IBD.
A systematic literature review was conducted using three different electronic databases: MEDLINE, PsychINFO, and EMBASE to identify studies reporting the prevalence and efficacy of psycho-pharmacological and psychotherapeutic treatments for IBD. A quality appraisal was conducted using several scales as appropriate for each study design. A narrative synthesis was also performed.
Forty-three studies were included. Although a high rate of psychoactive drug use was found in people with IBD, a low proportion of IBD patients have access to psychiatric referral. 1/3 of the studies found that psychotherapy was effective for improving the quality of life, perception of stress, anxiety and depression as well as disease. Antidepressants proved effective in reducing disease activity, gastrointestinal symptoms, anxiety and depression.
Our results suggest that psychiatric treatment should be implemented in IBD care. However, further studies are needed to confirm the findings of our systematic review.
与普通人群相比，克罗恩病和溃疡性结肠炎患者中焦虑和抑郁等精神疾病的患病率更高。如今，国际指南提倡心理治疗和心理药物治疗在炎症性肠病护理中发挥重要作用。本系统文献综述的主要目的是总结炎症性肠病患者抑郁和焦虑治疗的应用及有效性证据。
使用三个不同的电子数据库进行系统文献综述：医学文献数据库（MEDLINE）、心理学文摘数据库（PsychINFO）和荷兰医学文摘数据库（EMBASE），以识别报告炎症性肠病心理药物治疗和心理治疗患病率及疗效的研究。根据每个研究设计的适当情况，使用多种量表进行质量评估。还进行了叙述性综合分析。
纳入43项研究。虽然炎症性肠病患者中精神活性药物使用率较高，但只有一小部分炎症性肠病患者能获得精神科转诊。三分之一的研究发现心理治疗对改善生活质量、压力感知、焦虑和抑郁以及疾病有效。抗抑郁药被证明对降低疾病活动度、胃肠道症状、焦虑和抑郁有效。
我们的结果表明，应在炎症性肠病护理中实施精神科治疗。然而，需要进一步研究来证实我们系统综述的结果。
