Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease
Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease
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DOI：
10.3748/wjg.v20.i13.3552
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发表时间：
2014-04-07
影响因子：
4.3
通讯作者：
Filipovic, Branka F.
中科院分区：
文献类型：
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作者：
Filipovic, Branislav R.;Filipovic, Branka F.
溃疡性结肠炎和克罗恩病，通常称为炎症性肠病（IBD），引起了各种疾病专家的注意，包括胃肠病学，精神病学和放射学。脑-肠轴中皮质影响的参与以及下丘脑-垂体-肾上腺轴和外周神经系统的相互作用提供了与IBD相关的心理症状的初步解释。边缘系统结构的参与，如前扣带皮层、前额叶皮层和杏仁核，为发现IBD发病后抑郁、焦虑、述情障碍、人格特质和其他心理障碍的潜在机制铺平了道路。IBD患者的精神病学治疗几乎与胃肠病学方法一样重要，包括药物治疗和心理治疗。现有的精神病治疗方法都不被认为是金标准，因为这两种方法都有副作用，精神药物可以引起IBD症状的恶化。因此，这两种方法都必须在意识到副作用的可能性的情况下应用。我们建议精神科医生和胃肠病学家共同努力，就IBD治疗达成共识，以确保成功，并将副作用和复发率降至最低。（C）2014年百世登出版集团有限公司有限公司All rights reserved.
Ulcerative colitis and Crohn's disease, commonly known as inflammatory bowel disease (IBD), draw attention from specialists of various disorders, including gastroenterology, psychiatry, and radiology. The involvement of a cortical influence in the brain-gut axis as well as the interaction of the hypothalamic-pituitary-adrenal axis and the peripheral nervous system provide an initial explanation of the psychological symptoms associated with IBD. The involvement of structures the limbic system, such as the anterior cingulate cortex, the prefrontal cortex, and the amygdala, paves the way for the discovery of the mechanisms underlying depression depression, anxiety, alexithymia, personality traits, and other psychological impairments following the onset of IBD. Psychiatric therapy in IBD patients is almost as important as the gastroenterological approach and consists of pharmacological treatment and psychotherapy. Neither of the available psychiatric treatment methods is considered the golden standard because both methods have side effects, and psychotropic medication can provoke the worsening of IBD symptoms. Thus, both approaches must be applied with awareness of the possibility of side effects. We suggest that psychiatrists and gastroenterologists work together to reach a consensus on IBD therapy to ensure success and to reduce side effects and relapse to the lowest possible rates. (C)2014 Baishideng Publishing Group Co., Limited. All rights reserved.