Gorard D A, Gomborone J E, Libby G W, Farthing M J
Digestive Diseases Research Centre, St Bartholomew's, London.
Gut. 1996 Oct;39(4):551-5. doi: 10.1136/gut.39.4.551.
Patients with anxiety and depression often have bowel symptoms. Until now, studies investigating a link between altered bowel habit and psychological illness have focused on patients with disturbed defecation presenting to gastroenterologists.
To determine whether patients with anxiety and depression have objective evidence of abnormal intestinal transit irrespective of any bowel symptoms.
21 psychiatric outpatients fulfilling research criteria for generalised anxiety disorder and/or major depression, and 21 healthy volunteers were studied. Orocaecal transit time (OCTT) was measured by lactulose hydrogen breath test. Whole gut transit time (WGTT) was measured by abdominal radiography after ingestion of radio-opaque markers.
Median (range) WGTT was shorter in patients with anxiety (14 (6-29) hours) than in patients with depression (49 (35-71) hours) (p < 0.001), and controls (42 (10-68) hours) (p < 0.001). In patients with anxiety, orocaecal transit time was shorter (60 (10-70) minutes) than in patients with depression (110 (60-180) minutes) (p < 0.01), and shorter than in controls (75 (50-140)) minutes (p < 0.05). The prolongation of transit times in depression compared with controls was not significant. However, WGTT correlated with both the Beck Depression Inventory score (r = 0.59, p < 0.01) and the depression score of the Hospital Anxiety and Depression scale (r = 0.66, p < 0.001).
These objective measurements of intestinal transit in affective disorders are consistent with clinical impressions that anxiety is associated with increased bowel frequency, and depressed patients tend to be constipated; mood has an effect on intestinal motor function.
焦虑和抑郁患者常伴有肠道症状。迄今为止，研究排便习惯改变与心理疾病之间联系的研究主要集中于就诊于胃肠病科的排便紊乱患者。
确定焦虑和抑郁患者是否存在肠道转运异常的客观证据，而不考虑有无肠道症状。
对21名符合广泛性焦虑障碍和/或重度抑郁研究标准的精神科门诊患者及21名健康志愿者进行研究。采用乳果糖氢呼气试验测量口盲肠转运时间（OCTT）。摄入不透X线标志物后，通过腹部X线摄影测量全肠道转运时间（WGTT）。
焦虑患者的中位（范围）WGTT（14（6 - 29）小时）短于抑郁患者（49（35 - 71）小时）（p < 0.001）和对照组（42（10 - 68）小时）（p < 0.001）。焦虑患者的口盲肠转运时间（60（10 - 70）分钟）短于抑郁患者（110（60 - 180）分钟）（p < 0.01），且短于对照组（75（50 - 140）分钟）（p < 0.05）。与对照组相比，抑郁患者转运时间的延长不显著。然而，WGTT与贝克抑郁量表评分（r = 0.59，p < 0.01）及医院焦虑抑郁量表的抑郁评分（r = 0.66，p < 0.001）均相关。
这些情感障碍患者肠道转运的客观测量结果与临床印象一致，即焦虑与排便频率增加有关，而抑郁患者往往便秘；情绪对肠道运动功能有影响。
