Department of Neuroscience, Psychiatry Uppsala University, Uppsala, Sweden.
Department of Medical Sciences, Gastroenterology/Hepatology, Uppsala University, Uppsala, Sweden.
BMC Psychiatry. 2020 Nov 11;20(1):535. doi: 10.1186/s12888-020-02940-2.
Patients with functional gastrointestinal disorders have a high psychiatric co-morbidity. This study aimed to investigate and characterise gastrointestinal symptoms in relation to depressive symptoms and trait anxiety in a well-defined population of young adult psychiatric outpatients and healthy controls.
Gastrointestinal symptoms were assessed with the Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS). Depressive symptoms were assessed with the Montgomery-Åsberg Depression Rating Scale- Self assessment (MADRS-S). Trait anxiety was estimated with three of the Swedish universities of Personality (SSP) scales: Somatic trait anxiety, Psychic trait anxiety and Stress susceptibility. Self-ratings were collected from 491 young adult psychiatric outpatients and 85 healthy controls. Gastrointestinal symptom severity was compared between patients with and without current psychotropic medication and controls. Associations between gastrointestinal symptoms, depressive symptoms and trait anxiety were assessed using Spearman's coefficients and generalized linear models adjusting for possible confounders (sex, body mass index, bulimia nervosa).
Patients, with and without current psychotropic medication, reported significantly more gastrointestinal symptoms than controls. In the generalized linear models, total MADRS-S score (p < 0.001), Somatic trait anxiety (p < 0.001), Psychic trait anxiety (p = 0.002) and Stress susceptibility (p = 0.002) were independent predictors of the total GSRS-IBS score. Further exploratory analysis using unsupervised learning revealed a diverse spectrum of symptoms that clustered into six groups.
Gastrointestinal symptoms are both highly prevalent and diverse in young adult psychiatric outpatients, regardless of current psychotropic medication. Depressive symptom severity and degree of trait anxiety are independently related to the total gastrointestinal symptom burden.
功能性胃肠疾病患者存在较高的精神共病。本研究旨在调查和描述年轻成年精神科门诊患者和健康对照者中与抑郁症状和特质焦虑相关的胃肠道症状。
采用肠易激综合征胃肠道症状评分量表（GSRS-IBS）评估胃肠道症状。采用蒙哥马利-阿斯伯格抑郁评定量表自我评估（MADRS-S）评估抑郁症状。采用瑞典人格大学三项量表（SSP）中的躯体特质焦虑、精神特质焦虑和应激易感性评估特质焦虑。从 491 名年轻成年精神科门诊患者和 85 名健康对照者中收集自我报告数据。比较有和无当前精神药物治疗的患者与对照组之间的胃肠道症状严重程度。使用 Spearman 系数和广义线性模型评估胃肠道症状与抑郁症状和特质焦虑之间的关联，并调整可能的混杂因素（性别、体重指数、神经性贪食症）。
服用和未服用当前精神药物的患者报告的胃肠道症状明显多于对照组。在广义线性模型中，总 MADRS-S 评分（p<0.001）、躯体特质焦虑（p<0.001）、精神特质焦虑（p=0.002）和应激易感性（p=0.002）是 GSRS-IBS 总分的独立预测因素。使用无监督学习的进一步探索性分析显示，存在多种症状，可聚类为六个组。
无论是否服用当前精神药物，年轻成年精神科门诊患者的胃肠道症状均高度普遍且多样化。抑郁症状严重程度和特质焦虑程度与总胃肠道症状负担独立相关。
