Department of Medicine, University of Otago, Christchurch, New Zealand.
Department of Gastroenterology and Hepatology, AGEM research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Neurogastroenterol Motil. 2023 Jan;35(1):e14465. doi: 10.1111/nmo.14465. Epub 2022 Sep 25.
Functional gastrointestinal disorders (FGIDs) are common and cause significant morbidity. Psychiatric comorbidities associated with FGIDs include anxiety and depression. However, little is understood about the factors that modulate this association. The aim of this study was to examine the association between FGIDs and depression and anxiety, and to determine the covariates influencing this association in a New Zealand cohort.
The Christchurch IBS cOhort to investigate Mechanisms FOr gut Relief and improved Transit (COMFORT) study is an observational case-control study that recruited FGID cases and healthy controls between 2016 and 2018. In addition to the collection of a wide range of biological samples, participants completed questionnaires concerning socioeconomic status, physical activity, smoking, alcohol intake, anxiety, and depression (the latter two measured using the Hospital Anxiety and Depression Score [HADS]). A multivariate analysis was performed using the significant covariates from the univariate analyses to test whether their effect was independently significant on anxiety and depression.
A total of 315 participants (57 with diarrhea-predominant IBS (IBS-D), 30 with constipation-predominant IBS (IBS-C), 41 with mixed-IBS (IBS-M), 16 with functional diarrhea (FD), 42 with functional constipation (FC), and 129 controls); mean age 53 years (range 18-70 years), 221 (70%) female) completed the questionnaires. Anxiety (odds ratio [OR] 2.85 [95% confidence interval [CI] 1.64-4.94, p < 0.01) and depression (OR 3.40 [95% CI 1.35-8.55, p = 0.01]) were strongly associated with FGID cases versus controls. Lower economic living status (p < 0.01) was an independent covariate associated with depression, while lower economic living status (p < 0.005) and abdominal pain (p = 0.005) were both independently associated with anxiety.
CONCLUSIONS & INFERENCES: In addition to the established associations between FGIDs and anxiety and depression, we have shown that the economic standard of living, pain, and IBS phenotype are significant independent covariates. This study demonstrates the range of lifestyle and demographic factors that modulate morbidity associated with FGIDs and may provide targets for intervention.
功能性胃肠疾病（FGIDs）很常见，会导致显著的发病率。与 FGIDs 相关的精神共病包括焦虑和抑郁。然而，对于调节这种关联的因素知之甚少。本研究的目的是检查 FGIDs 与抑郁和焦虑之间的关联，并确定影响这种关联的协变量在新西兰队列中的情况。
基督城 IBS 队列研究以调查肠道缓解和改善转运的机制（COMFORT）是一项观察性病例对照研究，该研究于 2016 年至 2018 年期间招募了 FGID 病例和健康对照者。除了收集广泛的生物样本外，参与者还完成了关于社会经济地位、身体活动、吸烟、饮酒、焦虑和抑郁（后两者使用医院焦虑和抑郁评分 [HADS] 测量）的问卷。使用单变量分析中的显著协变量进行多变量分析，以测试其对焦虑和抑郁的影响是否具有独立意义。
共有 315 名参与者（57 名腹泻为主的 IBS（IBS-D）、30 名便秘为主的 IBS（IBS-C）、41 名混合 IBS（IBS-M）、16 名功能性腹泻（FD）、42 名功能性便秘（FC）和 129 名对照者；平均年龄 53 岁（18-70 岁），221 名（70%）为女性）完成了问卷。与对照组相比，焦虑症（比值比 [OR] 2.85 [95%置信区间 [CI] 1.64-4.94，p < 0.01）和抑郁症（OR 3.40 [95% CI 1.35-8.55，p = 0.01））与 FGID 病例强烈相关。较低的经济生活水平（p < 0.01）是与抑郁相关的独立协变量，而较低的经济生活水平（p < 0.005）和腹痛（p = 0.005）均与焦虑相关。
除了 FGIDs 与焦虑和抑郁之间已建立的关联外，我们还表明，经济生活水平、疼痛和 IBS 表型是重要的独立协变量。这项研究表明了调节 FGIDs 相关发病率的一系列生活方式和人口统计学因素，并可能为干预提供目标。
