Dancey C P, Taghavi M, Fox R J
Psychology Department, University of East London, UK.
J Psychosom Res. 1998 May;44(5):537-45. doi: 10.1016/s0022-3999(97)00255-9.
Irritable bowel syndrome (IBS), a chronic disorder that includes symptoms such as abdominal pain and altered bowel habits, affects up to 22% of people in Western populations. The causes of IBS are not well understood, but are believed to be multifactorial. Although stress is widely believed to be implicated, empirical evidence in support of this is lacking, perhaps because a typical between-participants analysis ignores individual differences and therefore may obscure any link. The present study used a within-person, lagged time-series approach to investigate the links between everyday stress and symptomatology in 31 IBS sufferers. Both everyday stress and symptomatology exhibited serial dependence for a statistically significant proportion of sufferers. Multiple regression analysis carried out on same-day and lagged relationships up to and including 4 days found that, for over half the participants, everyday stress and symptoms were related. The best regression model was one in which symptoms were a function of hassles and symptoms on the previous 2 days, and hassles on the same day, fitting the data for 67% of participants. This prospective study confirms other studies that have suggested stress is a significant factor in IBS, and concludes that stress management programs may be both useful and cost-effective in the treatment of IBS.
肠易激综合征(IBS)是一种慢性疾病,症状包括腹痛和排便习惯改变,在西方人群中,受其影响的人高达22%。IBS的病因尚不完全清楚,但被认为是多因素的。尽管人们普遍认为压力与之有关,但缺乏支持这一观点的实证证据,这可能是因为典型的组间分析忽略了个体差异,因此可能掩盖了任何联系。本研究采用个体内滞后时间序列方法,调查了31名IBS患者日常压力与症状之间的联系。对于相当一部分患者,日常压力和症状都表现出序列依赖性。对当天以及滞后1至4天的关系进行的多元回归分析发现,超过半数的参与者,日常压力和症状之间存在关联。最佳回归模型是,症状是前两天的困扰和症状以及当天困扰的函数,该模型适用于67%参与者的数据。这项前瞻性研究证实了其他研究的观点,即压力是IBS的一个重要因素,并得出结论,压力管理计划在IBS治疗中可能既有用又具有成本效益。