Food & Mood Centre, IMPACT Institute, Deakin University Geelong, Melbourne, Victoria, Australia.
Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK.
Nat Rev Gastroenterol Hepatol. 2023 Sep;20(9):582-596. doi: 10.1038/s41575-023-00794-z. Epub 2023 Jun 2.
Irritable bowel syndrome (IBS) affects 5-10% of the global population. Up to one-third of people with IBS also experience anxiety or depression. Gastrointestinal and psychological symptoms both drive health-care use in people with IBS, but psychological comorbidity seems to be more important for long-term quality of life. An integrated care approach that addresses gastrointestinal symptoms with nutrition and brain-gut behaviour therapies is considered the gold standard. However, best practice for the treatment of individuals with IBS who have a comorbid psychological condition is unclear. Given the rising prevalence of mental health disorders, discussion of the challenges of implementing therapy for people with IBS and anxiety and depression is critical. In this Review, we draw upon our expertise in gastroenterology, nutrition science and psychology to highlight common challenges that arise when managing patients with IBS and co-occurring anxiety and depression, and provide recommendations for tailoring clinical assessment and treatment. We provide best practice recommendations, including dietary and behavioural interventions that could be applied by non-specialists and clinicians working outside an integrated care model.
肠易激综合征（IBS）影响全球 5-10%的人口。多达三分之一的 IBS 患者也会出现焦虑或抑郁。胃肠道症状和心理症状都会导致 IBS 患者的医疗保健使用，但心理共病似乎对长期生活质量更为重要。一种综合护理方法，通过营养和肠道-大脑行为疗法来解决胃肠道症状，被认为是黄金标准。然而，对于有心理疾病的 IBS 患者的个体治疗的最佳实践尚不清楚。鉴于精神健康障碍的患病率不断上升，讨论为患有 IBS 和焦虑症和抑郁症的患者实施治疗的挑战至关重要。在这篇综述中，我们借鉴了我们在胃肠病学、营养科学和心理学方面的专业知识，强调了在管理同时患有 IBS 和焦虑症和抑郁症的患者时出现的常见挑战，并提供了针对临床评估和治疗的个性化建议。我们提供了最佳实践建议，包括非专业人士和在综合护理模式之外工作的临床医生可以应用的饮食和行为干预措施。
