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肠易激综合征、心理健康和生活质量:来自德国基于人群的调查(SHIP-Trend-0)的数据。

Irritable bowel syndrome, mental health, and quality of life: Data from a population-based survey in Germany (SHIP-Trend-0).

机构信息

Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.

Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.

出版信息

Neurogastroenterol Motil. 2019 Mar;31(3):e13511. doi: 10.1111/nmo.13511. Epub 2018 Nov 15.

Abstract

BACKGROUND

Irritable bowel syndrome (IBS) is associated with reduced quality of life and high healthcare costs. This study aimed to assess the prevalence and risk factors for IBS in a general adult population.

METHODS

The Study of Health in Pomerania (SHIP) is a population-based cohort study in northeastern Germany. SHIP-Trend-0 participants enrolled from 2008 to 2012 were grouped according to Rome III criteria (main criteria: abdominal discomfort or crampy or bloating pain for at least six months plus 2/3 additional criteria). Factors associated with IBS were assessed using survey-weighted backward stepwise logistic regression.

KEY RESULTS

The final data set included 4194 records. IBS prevalence was 3.5% (3.0%-4.2%). Unemployment (OR: 2.02, 1.26-3.21), headaches (OR: 2.37, 1.59-3.52), mental quality of life (OR: 0.95 per unit increase, 0.93-0.97), and interactions between gender and physical quality of life (P = 0.004) and gender and alexithymia (P = 0.002) predicted IBS probability. The model resulted in a good discrimination (area under the curve = 75.4%) and model fit (F = 0.72, P = 0.69). History of depression (OR: 2.77, 1.94-3.95), back pain (OR: 2.38, 1.69-3.35), early trauma (OR: 1.03, 1.02-1.04), and duration of inpatient treatment within the last twelve months (OR: 1.02, 1.01-1.04) lost their significance in multivariable analysis.

CONCLUSIONS & INFERENCES: IBS prevalence was relatively low compared to other studies. Factors predicting IBS were of biological, psychological, and social nature. The association between IBS and pain in different areas of the body indicates a potential underlying complex somatic symptom disorder.

摘要

背景

肠易激综合征(IBS)与生活质量下降和医疗保健费用高有关。本研究旨在评估一般成年人群中 IBS 的患病率和危险因素。

方法

波罗的海健康研究(SHIP)是德国东北部的一项基于人群的队列研究。SHIP-Trend-0 参与者于 2008 年至 2012 年入组,根据罗马 III 标准(主要标准:腹部不适或痉挛性或腹胀疼痛至少 6 个月,加 2/3 项其他标准)进行分组。使用调查加权逐步逻辑回归评估与 IBS 相关的因素。

主要结果

最终数据集包括 4194 条记录。IBS 的患病率为 3.5%(3.0%-4.2%)。失业(OR:2.02,1.26-3.21)、头痛(OR:2.37,1.59-3.52)、心理生活质量(OR:每单位增加 0.95,0.93-0.97),以及性别与生理生活质量(P=0.004)和性别与述情障碍(P=0.002)之间的相互作用预测 IBS 的可能性。该模型具有良好的区分度(曲线下面积=75.4%)和模型拟合度(F=0.72,P=0.69)。抑郁症病史(OR:2.77,1.94-3.95)、背痛(OR:2.38,1.69-3.35)、早期创伤(OR:1.03,1.02-1.04)和过去 12 个月内住院治疗的持续时间(OR:1.02,1.01-1.04)在多变量分析中失去了意义。

结论

与其他研究相比,IBS 的患病率相对较低。预测 IBS 的因素具有生物、心理和社会性质。IBS 与身体不同部位疼痛之间的关联表明存在潜在的复杂躯体症状障碍。

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