Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands.
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, the Netherlands.
J Psychosom Res. 2021 Feb;141:110351. doi: 10.1016/j.jpsychores.2020.110351. Epub 2020 Dec 24.
Momentary ecological assessment indicated alleviated abdominal pain in escitalopram treatment of irritable bowel syndrome (IBS) with comorbid panic disorder. Hitherto, little is known about symptom formation, i.e., how psychological impact physical symptoms, and vice versa, and about the effect of SSRI-treatment on symptom formation.
To investigate how psychological and somatic symptoms co-vary over time in IBS patients with comorbid panic disorder and how they are affected by escitalopram treatment.
Experience sampling data from 14 IBS patients with panic disorder were obtained from a single-centre, double-blind, parallel-group, randomized controlled trial on escitalopram versus placebo. At baseline, after three and six months, multilevel time-lagged linear regression analysis was used to construct symptom networks. Network connections represented coefficients between various affect and gastrointestinal items.
Connectivity increased up to 3 months in both groups. Between 3 and 6 months, connectivity decreased for placebo and further increased in the escitalopram group. Additionally, a steep increase in node strength for negative affect nodes was observed in the escitalopram network and the opposite for positive affect nodes. Over time, group symptom networks became increasingly different from each other. Anxious-anxious and enthusiastic-relaxed became significantly different between groups at 6 months. The connection that changed significantly in all analyses was anxious-anxious.
Escitalopram treatment was associated with changes in the symptom networks in IBS patients with panic disorder. While mood and physical symptoms improve over time, mainly connectivity between mood nodes changed, possibly pointing towards a healthier emotion regulation resulting in alleviation of physical symptoms.
瞬间生态学评估表明，在伴有惊恐障碍的肠易激综合征（IBS）中，艾司西酞普兰治疗可缓解腹痛。迄今为止，人们对症状的形成知之甚少，即心理影响身体症状的方式，反之亦然，以及 SSRI 治疗对症状形成的影响。
研究伴有惊恐障碍的 IBS 患者的心理和躯体症状如何随时间变化，以及艾司西酞普兰治疗如何影响这些症状。
从一项关于艾司西酞普兰与安慰剂治疗的单中心、双盲、平行组、随机对照试验中获得了 14 例伴有惊恐障碍的 IBS 患者的经验抽样数据。在基线、治疗 3 个月和 6 个月时，采用多层次时间滞后线性回归分析构建症状网络。网络连接代表了各种情感和胃肠道项目之间的系数。
两组的连接性在 3 个月内增加。在 3 至 6 个月期间，安慰剂组的连接性下降，而艾司西酞普兰组的连接性进一步增加。此外，在艾司西酞普兰网络中观察到负性情绪节点的节点强度急剧增加，而正性情绪节点的节点强度则相反。随着时间的推移，两组的症状网络变得越来越不同。在 6 个月时，焦虑-焦虑和热情-放松两组之间变得明显不同。在所有分析中变化显著的连接是焦虑-焦虑。
艾司西酞普兰治疗与惊恐障碍伴发 IBS 患者的症状网络变化有关。随着时间的推移，情绪和身体症状有所改善，主要是情绪节点之间的连接性发生了变化，这可能表明情绪调节更为健康，从而减轻了身体症状。
