The impact of abuse and mood on bowel symptoms and health-related quality of life in irritable bowel syndrome (IBS).
The impact of abuse and mood on bowel symptoms and health-related quality of life in irritable bowel syndrome (IBS).
复制标题
DOI：
10.1111/nmo.12848
复制
发表时间：
2016-10
影响因子：
3.5
通讯作者：
Sayuk GS
中科院分区：
文献类型：
--
作者：
Kanuri N;Cassell B;Bruce SE;White KS;Gott BM;Gyawali CP;Sayuk GS
肠易激综合征（IBS）是一种常见的腹痛疾病，没有有机的解释。虐待史（身体，性，情感）在IBS中很普遍。虽然滥用与IBS中也常见的情绪障碍（抑郁和焦虑）有关，但尚未研究滥用对GI症状和健康相关生活质量（HRQOL）的影响及其与心理症状合并症的独立性。连续GI门诊患者完成了罗马III研究诊断问卷和创伤问卷（生活压力问卷），情绪（贝克抑郁/焦虑量表），躯体症状（PHQ-12）和HRQOL（SF-36）。使用10 cm VAS量表评估当前GI症状严重程度和困扰。272例罗马定义的IBS（47.6±0.9岁，81%女性）和246例非FGID（51.6±1.0岁，65%女性）受试者参与了研究。IBS患者报告身体、性和情感虐待的发生率更高（p < 0.006），抑郁、焦虑和躯体症状更高（p < 0.001）。在滥用的IBS患者中，观察到大肠症状困扰（7.4±0.2 vs 6.7±0.2，p=0.040）、严重程度（7.7±0.2 vs 6.5±0.2，p<0.001）、近期症状天数（9.8±0.4 vs 8.5±0.3，p=0.02）和较差的HRQOL（40.9±2.3 vs 55.5±1.7，p<0.001）。滥用效应是累加的，在多种形式滥用的情况下，IBS症状严重程度更高，HRQOL更差。中介分析表明，滥用对胃肠道症状和HRQOL的影响部分介导的情绪。IBS患者中常见的虐待经历与更大的GI症状和更差的HRQOL报告相关，特别是在那些有多种形式虐待的患者中;这种关系可能部分由伴随的情绪障碍介导。我们研究了有和没有滥用史的IBS患者的GI和情绪症状之间的关系。有虐待经历的IBS患者有更严重的腹痛和疾病相关的残疾，这种影响部分由共病情绪介导。多次滥用的经验产生负面影响肠易激综合征的症状和健康相关的生活质量的累加方式。
Irritable bowel syndrome (IBS) is a common abdominal pain disorder without an organic explanation. Abuse histories (physical, sexual, emotional) are prevalent in IBS. While abuse relates to mood disorders (depression and anxiety) also common in IBS, the influence of abuse on GI symptoms and health-related quality of life (HRQOL) and its independence from psychological symptom comorbidity, has not been studied. Consecutive GI outpatients completed the ROME III Research Diagnostic Questionnaire and questionnaires on trauma (Life-Stress Questionnaire), mood (Beck Depression/Anxiety Inventories), somatic symptoms (PHQ-12) and HRQOL (SF-36). Current GI symptom Severity and Bother were assessed using 10-cm VAS scales. 272 ROME-defined IBS (47.6±0.9 yrs, 81% female) and 246 non-FGID (51.6±1.0 yrs, 65% female) subjects participated. IBS patients reported greater rates of physical, sexual, and emotional abuse (p < 0.006 each), and higher depression, anxiety, and somatic symptoms (p < 0.001). Greater bowel symptom bother (7.4±0.2 vs 6.7±0.2, p=0.040), severity (7.7±0.2 vs 6.5±0.2, p<0.001), recent symptomatic days (9.8±0.4 vs. 8.5±0.3, p=0.02), and poorer HRQOL (40.9±2.3 vs 55.5±1.7, p<0.001) were noted in IBS with abuse. Abuse effects were additive, with greater IBS symptom severity and poorer HRQOL noted in cases with multiple forms of abuse. Mediation analyses suggested that abuse effects on GI symptoms and HRQOL were partially mediated by mood. Abuse experiences common among IBS sufferers are associated with reports of greater GI symptoms and poorer HRQOL, particularly in those with multiple forms of abuse; this relationship may be partially mediated by concomitant mood disturbances. We studied the relationship of GI and mood symptoms among IBS patients with- and without abuse histories. IBS patients with abuse experiences had more severe abdominal pain and illness-related disability, an effect partially mediated by comorbid mood. Multiple abuse experiences exerted negative effects on IBS symptoms and health-related quality of life in an additive fashion.
登录
查看更多内容
影响因子：
7.6
作者：
BARON, RM;KENNY, DA
通讯作者：
KENNY, DA
影响因子：
6.9
作者：
Leserman, J;Li, Z;Hu, YJB
通讯作者：
Hu, YJB
影响因子：
3.3
作者：
Briere, John;Kaltman, Stacey;Green, Bonnie L.
通讯作者：
Green, Bonnie L.
按胃肠道诊断和虐待史分列的健康状况
影响因子：
29.4
作者：
Drossman, DA;Li, ZM;Hu, YMJB
通讯作者：
Hu, YMJB
影响因子：
2.4
作者：
Bengtsson, Mariette;Ohlsson, Bodil;Ulander, Kerstin
通讯作者：
Ulander, Kerstin