我是一个彻底的失败者：在精神生活质量较差的炎症性肠病患者中，信念与焦虑和抑郁之间存在关联。

I am a total failure: associations between beliefs and anxiety and depression in patients with inflammatory bowel disease with poor mental quality of life.

机构信息

Department of Medical Psychology, Amsterdam University of Medical Centres, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands.

Department of Medical Psychology, Amsterdam University of Medical Centres, Vrije University of Amsterdam, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands.

出版信息

Behav Cogn Psychother. 2020 Jan;48(1):91-102. doi: 10.1017/S1352465819000444. Epub 2019 Aug 19.

DOI:10.1017/S1352465819000444

PMID:31423955

Abstract

BACKGROUND

According to cognitive behavioural theory, cognitive factors (i.e. underlying general dysfunctional beliefs and (situation) specific illness beliefs) are theorized to lead to outcomes like anxiety and depression. In clinical practice, general dysfunctional beliefs are generally not tackled directly in short-term-therapy.

AIMS

The goal of the present study was to investigate the associations of general versus specific illness beliefs on anxiety and depressive symptoms and psychiatric disorders among a subgroup of patients with inflammatory bowel disease (IBD) with poor mental quality of life (QoL).

METHOD

This study concerns cross-sectional data, collected at baseline from a randomized clinical trial. One hundred and eighteen patients, recruited at four Dutch hospitals, with poor QoL (score ≤23 on the mental health subscale of the Short-Form 36-item Health-Survey; SF-36) were included. General dysfunctional beliefs were measured by the Dysfunctional Attitude Scale (DAS), specific illness beliefs by the Illness Perceptions Questionnaire-Revised (IPQ-R), anxiety and depressive symptoms by the Hospital Anxiety and Depression Scale (HADS), and psychiatric disorders by the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I).

RESULTS

Univariate analyses showed associations between the level of anxiety and/or depression and general dysfunctional beliefs and four specific illness beliefs (consequences, personal control, emotional representations and treatment control). Among patients with IBD with psychiatric disorders, only the DAS was significantly associated with anxiety and depression (DAS added to IPQ-R and IPQ-R added to DAS).

CONCLUSIONS

Psychological interventions may have to target general dysfunctional beliefs of patients with IBD with co-morbid psychiatric disorders to be effective. These patients with IBD are especially in need of psychological treatment.

摘要

背景

根据认知行为理论，认知因素（即潜在的一般功能失调信念和（特定情况）特定疾病信念）被认为会导致焦虑和抑郁等结果。在临床实践中，一般功能失调信念在短期治疗中通常不会直接解决。

目的

本研究旨在调查一般和特定疾病信念与炎症性肠病（IBD）患者亚组焦虑和抑郁症状以及精神障碍的相关性，这些患者的精神健康生活质量（QoL）较差。

方法

本研究涉及横断面数据，在一项随机临床试验的基线时收集。在荷兰的四家医院招募了 118 名 QoL 较差（心理健康子量表得分≤23 的患者；SF-36）的患者。一般功能失调信念通过 Dysfunctional Attitude Scale（DAS）进行测量，特定疾病信念通过 Illness Perceptions Questionnaire-Revised（IPQ-R）进行测量，焦虑和抑郁症状通过 Hospital Anxiety and Depression Scale（HADS）进行测量，精神障碍通过 DSM-IV 轴 I 障碍的结构临床访谈（SCID-I）进行测量。