Sundas A, Sampath H, Lamtha S C, Soohinda G, Dutta S
Instituto Central de Psiquiatría, Ranchi, India.
Departamento de Psiquiatría, Hospital Central de Referencias, Instituto de Ciencias Médicas de Sikkim Manipal, Universidad de Sikkim Manipal, Gangtok, Sikkim, India.
Rev Gastroenterol Mex (Engl Ed). 2024 Jan-Mar;89(1):11-18. doi: 10.1016/j.rgmxen.2022.04.005. Epub 2022 Jul 7.
Functional gastrointestinal disorders (FGIDs) are complex illnesses characterized by gastrointestinal symptoms, with no underlying organic pathology. They are common, chronic, recurrent, and disabling disorders that significantly impair quality of life (QoL). The aim of the present cross-sectional analytical study was to assess QoL and its correlates in adult patients with FGIDs.
A cross-sectional, observational, hospital-based study was conducted at the gastroenterology outpatient department of a tertiary care teaching hospital. The ROME IV diagnostic criteria were used to identify the FGIDs. Anxiety, depression, coping strategies, social support, and QoL were assessed by the hospital anxiety and depression scale, the coping strategies inventory, the multidimensional scale of perceived social support, and the functional digestive disorders quality-of-life questionnaire, respectively.
Of the 52 consecutive patients diagnosed with FGIDs, functional dyspepsia (51.92%) and irritable bowel syndrome (40.38%) were the most common. There were no significant associations between sociodemographic variables (age, sex, marital status, socioeconomic status, educational level, employment, occupation, dietary pattern) and QoL scores (all p values >0.05). Duration and social support were not significantly associated with QoL (all p values >0.05). In contrast, psychological variables, such as disengagement coping (r=-0.344, p=0.012), depression (r=-0.600, p=0.000), and anxiety (r=-0.590, p=0.000), were significantly correlated with QoL.
Despite advances in neurogastroenterology, patients continue to be disabled by FGIDs. Psychological factors, especially depression, significantly contribute to poor QoL in those patients and should be addressed in a holistic, multidisciplinary way. The biopsychosocial framework, as it applies to FGIDs, should lead to the inclusion of psychosocial assessments in the clinical management and research of those disorders.
功能性胃肠疾病(FGIDs)是一类复杂的疾病,其特征为胃肠道症状,但无潜在的器质性病变。它们常见、慢性、复发性且致残,严重损害生活质量(QoL)。本横断面分析研究的目的是评估FGIDs成年患者的生活质量及其相关因素。
在一家三级护理教学医院的胃肠病门诊进行了一项基于医院的横断面观察性研究。采用罗马IV诊断标准来识别FGIDs。分别通过医院焦虑抑郁量表、应对策略量表、领悟社会支持多维量表和功能性消化疾病生活质量问卷来评估焦虑、抑郁、应对策略、社会支持和生活质量。
在连续诊断的52例FGIDs患者中,功能性消化不良(51.92%)和肠易激综合征(40.38%)最为常见。社会人口学变量(年龄、性别、婚姻状况、社会经济地位、教育水平、就业、职业、饮食模式)与生活质量得分之间无显著关联(所有p值>0.05)。病程和社会支持与生活质量无显著关联(所有p值>0.05)。相反,心理变量,如消极应对(r=-0.344,p=0.012)、抑郁(r=-0.600,p=0.000)和焦虑(r=-0.590,p=0.000)与生活质量显著相关。
尽管神经胃肠病学取得了进展,但FGIDs患者仍然存在功能障碍。心理因素,尤其是抑郁,显著导致这些患者生活质量较差,应采用全面、多学科的方法加以解决。适用于FGIDs的生物心理社会框架应促使在这些疾病的临床管理和研究中纳入心理社会评估。