Banerjee Arka, Sarkhel Sujit, Dhali Gopal Krishna, Paul Imon, Das Anamika
Department of Gastroenterology, IPGME and R, Kolkata, West Bengal, India.
Institute of Psychiatry, IPGME and R, Kolkata, West Bengal, India.
Indian J Psychiatry. 2024 Feb;66(2):142-147. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_732_23. Epub 2024 Feb 12.
BACKGROUND: Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder and is closely linked to stress. Psychiatric morbidities such as anxiety and depression are common in IBS. Long-term follow-up studies on anxiety and depressive symptoms in IBS and the impact of treatment are lacking in the Indian scenario. AIMS: This study aimed to assess the various subtypes of IBS according to the Rome IV criteria, assess anxiety and depressive symptoms in patients with IBS at baseline and also at various phases of follow-up over one year, and see the impact of the treatment of both IBS and associated anxiety and depressive symptoms if present, in the severity of IBS and other psychiatric symptoms. MATERIALS AND METHODS: Patients with IBS, aged between 18 and 65 years, were enrolled for the study. Subtypes and severity of IBS were assessed. Anxiety and depressive symptoms were assessed by the Hamilton Rating Scale for Anxiety (HAM-A) and the Hamilton Rating Scale for Depression (HAM-D), respectively. The patients were treated with conventional treatment of IBS with concomitant treatment of anxiety and depressive symptoms and were followed up for 1 year. RESULTS: Thirty-seven patients completed a 1-year follow-up. The mean age was 38.4 ± 11.6 years. The majority were males (81%), and IBS-D (84%) was the most common subtype. Stressful life events (67.6%) and chronic stressors (64.9%) were present in the majority of the patients. The patients had moderate-to-severe anxiety at baseline (HAM-A score 27.8 ± 6.4) and moderate-to-severe depression at baseline (HAM-D score 19.7 ± 6.6). The improvement over 1 year was statistically significant ( = 0.000, two-tailed). A positive correlation between the severity score of IBS and HAM-D ( = 0.604) and HAM-A ( = 0.536) scores was present. CONCLUSION: There is a high prevalence of anxiety and depression in patients with IBS. With adequate treatment of both IBS and concomitant anxiety-depressive symptoms, there is a significant decrease in the severity of IBS, anxiety, and depression.
背景：肠易激综合征（IBS）是一种功能性胃肠疾病，与压力密切相关。焦虑和抑郁等精神疾病在IBS患者中很常见。在印度的情况下，缺乏关于IBS患者焦虑和抑郁症状的长期随访研究以及治疗的影响。 目的：本研究旨在根据罗马IV标准评估IBS的各种亚型，在基线以及随访的各个阶段评估IBS患者的焦虑和抑郁症状，并观察IBS及相关焦虑和抑郁症状（如果存在）的治疗对IBS严重程度和其他精神症状的影响。 材料和方法：纳入年龄在18至65岁之间的IBS患者进行研究。评估IBS的亚型和严重程度。分别通过汉密尔顿焦虑量表（HAM-A）和汉密尔顿抑郁量表（HAM-D）评估焦虑和抑郁症状。患者接受IBS的常规治疗并同时治疗焦虑和抑郁症状，随访1年。 结果：37名患者完成了1年的随访。平均年龄为38.4±11.6岁。大多数为男性（81%），最常见的亚型是IBS-D（84%）。大多数患者存在应激性生活事件（67.6%）和慢性应激源（64.9%）。患者在基线时存在中度至重度焦虑（HAM-A评分27.8±6.4）和中度至重度抑郁（HAM-D评分19.7±6.6）。1年期间的改善具有统计学意义（P = 0.000，双侧）。IBS严重程度评分与HAM-D（P = 0.604）和HAM-A（P = 0.536）评分之间存在正相关。 结论：IBS患者中焦虑和抑郁的患病率很高。通过对IBS及伴随的焦虑抑郁症状进行充分治疗，IBS、焦虑和抑郁的严重程度显著降低。
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