Faculty of Psychology, University of Warsaw, Poland.
Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Poland.
J Psychosom Res. 2024 Dec;187:111904. doi: 10.1016/j.jpsychores.2024.111904. Epub 2024 Aug 23.
OBJECTIVE: Despite high prevalence of irritable bowel syndrome (IBS) and its significant negative impact on individuals' quality of life, its etiology remains poorly understood. This prospective study explored whether early life factors (adverse childhood experiences; ACEs) and alexithymia intensity, could explain IBS symptom severity and its effects on psychological functioning over time. We also compared the studied variables between an IBS sample and a healthy control group. METHOD: Based on the Rome III Diagnostic Criteria for IBS, 245 individuals with a diagnosis of IBS were recruited from a national sample of Poles. The IBS sample completed the following psychometric questionaries in three waves, one month apart: Adverse Childhood Experiences Questionnaire, Toronto Alexithymia Scale, IBS Symptom Severity Score, Short Form Perceived Stress Scale, and Ultra-Brief Patient Health Questionnaire for Anxiety and Depression. Latent transition analysis was used to identify distinct profiles of IBS symptom dynamics. RESULTS: The IBS group reported a significantly higher number of ACEs, greater alexithymia severity, and more intense levels of stress, anxiety, and depressive symptoms compared to the healthy controls. Four profiles of IBS individuals with distinct dynamics of IBS symptoms, stress, anxiety, and depressive symptoms were extracted, which correlated with the baseline number of ACEs and alexithymia intensity among participants. CONCLUSION: Childhood adversity and associated problems in emotional processing affect IBS symptom severity. ACEs should be included in IBS screening and considered in the design of individualized multidisciplinary treatment approaches for IBS patients.
目的:尽管肠易激综合征(IBS)的患病率很高,对个体的生活质量有重大负面影响,但它的病因仍知之甚少。本前瞻性研究旨在探讨早期生活因素(不良童年经历;ACEs)和述情障碍的严重程度是否可以解释 IBS 症状的严重程度及其对心理功能的长期影响。我们还比较了 IBS 样本和健康对照组之间的研究变量。
方法:根据罗马 III 诊断标准,从波兰全国样本中招募了 245 名 IBS 患者。IBS 样本在相隔一个月的三个时间点上完成了以下心理计量问卷:不良童年经历问卷、多伦多述情障碍量表、IBS 症状严重程度评分、短式感知压力量表和超简短患者健康问卷焦虑和抑郁量表。潜在转移分析用于确定 IBS 症状动态的不同特征。
结果:IBS 组报告的 ACEs 数量明显更多,述情障碍严重程度更高,压力、焦虑和抑郁症状更强烈,与健康对照组相比。从参与者中提取了 4 种具有不同 IBS 症状、压力、焦虑和抑郁症状动态的 IBS 个体特征,与基线 ACEs 数量和参与者的述情障碍强度相关。
结论:童年逆境和相关的情绪处理问题会影响 IBS 症状的严重程度。应将 ACEs 纳入 IBS 筛查,并在为 IBS 患者设计个体化多学科治疗方法时加以考虑。
Neurogastroenterol Motil. 2024-3
Compr Psychiatry. 2014-10
J Clin Gastroenterol. 2020-1
Clin Gastroenterol Hepatol. 2013-3-21
Neurogastroenterol Motil. 2016-10