肠易激综合征与精神心理因素的相关性

Correlation between psychological factors and irritable bowel syndrome

目的:比较肠易激综合征(irritable bowel syndrome,IBS)的焦虑、抑郁发生率;探讨此类患者出现焦虑、抑郁的相关影响因素,为伴有精神心理异常的IBS患者进行抗焦虑抑郁及心理治疗提供理论依据.方法:收集2010-12/2011-12昆明医科大学第一附属医院消化内科门诊及住院已确诊IBS的患者60例,正常对照60例.采用一般情况调查表、ZUNG焦虑自评量表(self-rating anxiety scale,SAS)、ZUNG抑郁自评量表(self-rating depression scale,SDS)、生活事件量表(life event scale,LES)及社会支持评定量表(social support rating scale,SSRS)分别对IBS患者及正常对照进行评定.运用SPSS统计软件分析,P<0.05为有统计学意义,P<0.01为有显著统计学意义.结果:(1)焦虑、抑郁发生率比较:焦虑发生率IBS组>正常对照组,两两比较P均<0.05;IBS组抑郁发生率与正常对照比较P均<0.01;(2)SAS、SDS评分结果显示:IBS患者与正常对照比较P<0.01;(3)LES、SSRS评分结果显示:组间两两比较正性事件分及社会支持总分无统计学差异P>0.05,IBS组与正常对照比较负性事件分有显著统计学差异P<0.01;(4)焦虑、抑郁相关影响因素比较:年龄、负性事件分有显著统计学意义P<0.01,IBS组发生焦虑的危险因素为负性事件,抑郁相关影响因素比较,负性事件是IBS组的危险因素,年龄、负性事件是抑郁分的危险因素(P<0.01).结论:(1)IBS患者焦虑、抑郁发生率高于正常人;(2)负性生活事件对IBS患者精神心理有重要影响;(3)生活事件、社会支持度与IBS患者精神心理变化密切相关;(4)临床实践中应关注IBS患者的心理状态,对有明显焦虑和抑郁的患者应给予相应的干预措施.

AIM： To investigate the incidence of anxiety and depression and factors associated with the occurrence of anxiety and depression in patients with irritable bowel syndrome （IBS） to provide a theoretical basis for the use of anti-anxiety/ depression and psychological treatments in IBS patients with psychological abnormalities. METHODS： Sixty patients with IBS treated from December 2010 to December 2011 in Department of Gastroenterology of the First Affiliated Hospital of Kunming Medical University and 60 healthy controls were included in this study. The patients were assessed using the ZUNG self-rating anxiety scale, ZUNG self-rating depression scale, life event scale and social support rating scale. All scores were compared using statistical methods.RESULTS： The incidences of anxiety and depression were significantly higher in IBS patients than in healthy controls （P ＆lt; 0.05, P ＆lt; 0.01）. The self-rating anxiety scale and self-rating depression scale scores differed significantly between IBS patients and healthy controls （both P ＆lt; 0.01）. Although there was no significant difference in positive event scores and social support total scores between IBS patients and healthy controls （both P ＆gt; 0.05）, a statistical significance was noted in negative event score between the two groups （P ＆lt; 0.01）. CONCLUSION： The incidences of anxiety and depression are significantly higher in IBS patients than in normal controls. Negative life events have an important mental impact on IBS patients. Life events and social support are closely related to psychological changes in IBS patients. IBS patients’ psychological state should be monitored in clinical practice, and appropriate interventions should be given if anxiety and depression develop in these patients.