情绪障碍在功能性胃肠病重叠综合征患者中发生情况的研究

Comorbid Emotional Disorders in Patients With Functional Gastrointestinal Disorder Overlapping Syndrome

背景:功能性胃肠病(FGID)又称肠-脑互动异常,情绪障碍在FGID患者中广泛存在。目的:分析情绪障碍在单纯功能性消化不良(FD)以及FD重叠其他FGID患者中的发生情况。方法:纳入2011年11月—2015年1月在首都医科大学附属北京积水潭医院消化内科门诊就诊、诊断符合罗马Ⅲ标准的FD患者137例,进行消化道症状问卷调查,并以焦虑自评量表(SAS)和抑郁自评量表(SDS)评价患者的情绪状态。结果:合并焦虑/抑郁障碍的FD患者消化道症状评分显著高于无焦虑/抑郁障碍患者(P均<0.05)。单纯FD与重叠1种、2种、3种FGID的患者相比,SAS、SDS评分以及合并焦虑、抑郁障碍的比例均差异显著(P均<0.05);随着重叠FGID种类数目的增加,合并焦虑障碍患者的比例呈增加趋势(P<0.05)。合并焦虑障碍与无焦虑障碍者相比,患FGID的种类数目分布差异有统计学意义(P<0.05)。Spearman相关系数分析显示,FD患者的消化道症状评分与SAS、SDS评分呈显著正相关(r_s=0.223,P=0.009;r_s=0.197,P=0.021)。结论:FGID重叠综合征与情绪障碍关系密切。临床医师应关注以消化道症状为主诉就诊患者的情绪状态,尤其是症状广泛、多样者,及时进行精神心理状态评估。

Background:Functional gastrointestinal disorders(FGID)are referred to as gut⁃brain interaction disorders.Emotional disorders are widely present in patients with FGID.Aims:To analyze the comorbid emotional disorders in patients with functional dyspepsia(FD)or FD overlapped with other FGIDs.Methods:This study included 137 patients who visited the gastroenterology clinic of Beijing Jishuitan Hospital,Capital Medical University from November 2011 to January 2015 and met the RomeⅢcriteria of FD.All patients completed a detailed gastrointestinal symptom survey questionnaire.Their emotional status was assessed by using self⁃rating anxiety scale(SAS)and self⁃rating depression scale(SDS).Results:Among FD patients with anxiety or depression disorder,the gastrointestinal symptom score were significantly higher than those without anxiety or depression(all P<0.05).There were statistically significant differences in SAS score,SDS score,and proportion of patients with anxiety or depression disorder between patients with simple FD and those overlapped with 1,2,and 3 other FGIDs(all P<0.05).With the increase in number of FGIDs overlapped,the proportion of patients with anxiety disorder showed an increasing tendency(P<0.05).Significant difference was existed in distribution of quantities of FGIDs between patients with and without anxiety disorder(P<0.05).Spearman correlation coefficient analysis revealed that the gastrointestinal symptom score of FD patients was positively correlated with the score of SAS and SDS(rs=0.223,P=0.009;rs=0.197,P=0.021).Conclusions:FGIDs overlapping syndrome is closely related to emotional disorders.Clinicians should pay attention to the emotional status of patients complaining of gastrointestinal symptoms,especially those with extensive and diverse symptoms and timely psychological assessment is recommended.