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炎症性肠病患者的抑郁和焦虑障碍:是否存在性别差异?

Depressive and Anxiety Disorders in Patients with Inflammatory Bowel Diseases: Are There Any Gender Differences?

机构信息

Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.

Division of Gastroenterology and Endoscopy, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.

出版信息

Int J Environ Res Public Health. 2023 Jun 29;20(13):6255. doi: 10.3390/ijerph20136255.

Abstract

Gender differences were identified in the frequency and clinical presentations of inflammatory bowel disease (IBD) and depressive and anxiety disorders, which are more common in IBD patients than in the general population. The present manuscript provides a critical overview of gender differences in the frequency and clinical course of mood and anxiety disorders in IBD patients, with the aim of helping clinicians provide individualized management for patients. All of the included studies found that IBD patients reported a higher frequency of depressive and anxiety disorders than the general population. These findings should encourage healthcare providers to employ validated tools to monitor the mental health of their IBD patients, such as the Patient Health Questionnaire (PHQ-9). In addition, most studies confirm that women with IBD are more likely than men to develop affective disorders and show that up to 65% of women with IBD have depressive and anxiety disorders. Women with IBD require close mental health monitoring and ultimately a multidisciplinary approach involving mental health professionals. Drug treatment in women should be individualized and medications that may affect mental health (e.g., corticosteroids) should be thoroughly reconsidered. Further data are needed to ensure individualized treatment for IBD patients in a framework of precision medicine.

摘要

性别差异在炎症性肠病(IBD)和抑郁及焦虑障碍的频率和临床表现中得以识别,IBD 患者比普通人群更常见这些疾病。本文批判性地概述了 IBD 患者情绪和焦虑障碍的频率和临床病程中的性别差异,旨在帮助临床医生为患者提供个体化管理。所有纳入的研究均发现,IBD 患者报告的抑郁和焦虑障碍频率高于普通人群。这些发现应鼓励医疗保健提供者使用经过验证的工具来监测他们的 IBD 患者的心理健康,例如患者健康问卷(PHQ-9)。此外,大多数研究证实,IBD 女性比男性更容易发生情感障碍,并且表明多达 65%的 IBD 女性患有抑郁和焦虑障碍。IBD 女性需要密切的心理健康监测,最终需要涉及心理健康专业人员的多学科方法。女性的药物治疗应个体化,并且应彻底重新考虑可能影响心理健康的药物(例如,皮质类固醇)。需要进一步的数据来确保在精准医学框架内为 IBD 患者提供个体化治疗。

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