Gajdos Panna, Rigó Adrien
Pszichológiai Intézet, Eötvös Loránd Tudományegyetem Budapest, Izabella u. 46., 1064.
Pszichológiai Doktori Iskola, Eötvös Loránd Tudományegyetem Budapest.
Orv Hetil. 2018 Dec;159(50):2115-2121. doi: 10.1556/650.2018.31247.
Irritable bowel syndrome is a chronic functional gastrointestinal disorder with a prevalence of 7-21%. It has a negative impact on health-related quality of life and work productivity and it is associated with increased psychological distress and mental comorbidity, like major depression disorder and generalised anxiety disorder. Due to biopsychosocial factors and the brain-gut axis playing a key role in the aetiology of the disease, the use of psychological treatments has great importance in the therapy of irritable bowel syndrome. These interventions focus on central mechanisms, like visceral sensitivity, pain amplification, hypervigilance and gastrointestinal symptom-specific anxiety. They significantly reduce damaging illness-related cognitions, the use of maladaptive coping strategies, catastrophic appraisals of bodily sensations and chronic muscle tension. The utilization of these treatments is associated with clinically significant symptom improvement and positive mental health outcomes. This review study focuses on the psychiatric comorbidity of irritable bowel syndrome and the use of evidence-based psychological therapies in the treatment of the disease. Using ScienceDirect and PubMed databases, almost 60 studies have been selected. A high number of studies investigate the efficacy of cognitive behaviour therapy and hypnotherapy with meta-analyses included. There is also growing evidence on the beneficial impacts of mindfulness-based stress reduction. Future research will need to concentrate on studying the utility of mind-body therapies such as relaxation techniques in the treatment of irritable bowel syndrome with meta-analyses on the effects of mindfulness-based interventions. Orv Hetil. 2018; 159(50): 2115-21121.
肠易激综合征是一种慢性功能性胃肠疾病,患病率为7%-21%。它对健康相关生活质量和工作效率有负面影响,且与心理困扰增加及精神共病相关,如重度抑郁症和广泛性焦虑症。由于生物心理社会因素以及脑-肠轴在该疾病病因中起关键作用,心理治疗在肠易激综合征的治疗中具有重要意义。这些干预措施聚焦于中枢机制,如内脏敏感性、疼痛放大、过度警觉和胃肠道症状特异性焦虑。它们能显著减少与疾病相关的有害认知、不良应对策略的使用、对身体感觉的灾难性评估以及慢性肌肉紧张。使用这些治疗方法与临床上显著的症状改善和积极的心理健康结果相关。本综述研究聚焦于肠易激综合征的精神共病以及循证心理治疗在该疾病治疗中的应用。通过科学Direct和PubMed数据库,选取了近60项研究。大量研究通过荟萃分析探讨了认知行为疗法和催眠疗法的疗效。基于正念减压的有益影响也有越来越多的证据。未来研究需要集中于研究身心疗法如放松技巧在肠易激综合征治疗中的效用,并对基于正念干预的效果进行荟萃分析。《匈牙利医学周报》。2018年;159(50):2115 - 21121。