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[心理治疗在肠易激综合征治疗中的作用]

[The Role of Psychotherapy in the Treatment of Irritable Bowel Syndrome].

作者信息

Weibert Elena, Stengel Andreas

机构信息

Medizinische Klinik mit Schwerpunkt Psychosomatik, Charité-Universitätsmedizin Berlin.

Innere Medizin VI, Psychosomatische Medizin und Psychotherapie, Medizinische Universitätsklinik, Tübingen.

出版信息

Psychother Psychosom Med Psychol. 2019 Oct;69(9-10):360-371. doi: 10.1055/a-0829-6990. Epub 2019 Feb 7.

DOI:10.1055/a-0829-6990
PMID:30731513
Abstract

Irritable bowel syndrome is a common functional gastrointestinal disorder that greatly impacts on quality of life due to gastrointestinal complaints such as pain or altered stool habits. Based on the biopsychosocial model the severity of the disease is affected by the combination of physiological processes, social aspects and psychological factors. While treatment approaches mainly focused on the reduction of gut complaints by dietary means or medication, psychotherapy is becoming an alternative or additional approach with very good evidence, especially in light of associated psychiatric comorbidities (e. g. depression, anxiety disorder). Often psychiatric symptoms/comorbidities increase the probability of a complicated course of the disease with a reciprocal interaction of gut complaints and psychiatric symptoms. Behavioral therapy, psychodynamic psychotherapy, hypnotherapy, mindfulness interventions and other psychotherapeutic methods are used to increase coping as well as disease control and to restructure dysregulated cognitive processes. The current review focuses on psychosocial aspects of the irritable bowel syndrome and discusses the benefit of psychotherapeutic interventions.

摘要

肠易激综合征是一种常见的功能性胃肠疾病,因疼痛或大便习惯改变等胃肠道症状而对生活质量产生重大影响。基于生物心理社会模型,该疾病的严重程度受生理过程、社会因素和心理因素共同作用的影响。虽然治疗方法主要集中在通过饮食手段或药物减轻肠道症状,但心理治疗正成为一种有充分证据的替代或辅助方法,尤其是考虑到相关的精神共病(如抑郁症、焦虑症)。精神症状/共病常常会增加疾病复杂病程的可能性,肠道症状和精神症状之间存在相互作用。行为疗法、精神动力心理治疗、催眠疗法、正念干预和其他心理治疗方法被用于增强应对能力以及疾病控制,并重构失调的认知过程。本综述聚焦于肠易激综合征的社会心理方面,并探讨心理治疗干预的益处。

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Intensive short-term dynamic psychotherapy for irritable bowel syndrome: a randomized controlled trial examining improvements in emotion regulation, defense mechanisms, quality of life, and IBS symptoms.肠易激综合征的强化短期动态心理治疗:一项随机对照试验,考察情绪调节、防御机制、生活质量和肠易激综合征症状的改善情况。
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