Symptoms of psychologic distress associated with irritable bowel syndrome. Comparison of community and medical clinic samples.
Symptoms of psychologic distress associated with irritable bowel syndrome. Comparison of community and medical clinic samples.
复制标题
DOI：
10.1016/s0016-5085(88)80018-0
复制
发表时间：
1988-09
期刊：
影响因子：
29.4
通讯作者：
W. Whitehead;L. Bosmajian;A. Zonderman;P. Costa;M. Schuster
中科院分区：
文献类型：
--
作者：
W. Whitehead;L. Bosmajian;A. Zonderman;P. Costa;M. Schuster
将有肠易激综合征症状但未咨询医生的女性患者与胃肠病诊所的女性患者进行比较，以调查肠易激综合征临床患者的心理异常是否与自我选择治疗有关。两套诊断标准进行了比较，限制性标准的基础上的工作曼宁和传统的标准（腹痛加改变排便习惯）。乳糖吸收不良者被列为对照组，因为他们有医学解释的肠道症状类似于那些定义肠易激综合征。因此，他们控制了慢性肠道症状对心理困扰的致病作用。符合肠易激综合征限制性标准但没有咨询医生的妇女在霍普金斯症状检查表上没有比无症状对照组更多的心理困扰症状。然而，与无症状的对照组或相同诊断的非咨询者相比，患有肠易激综合征和乳糖吸收不良的门诊患者有更多的心理症状。仅符合肠易激综合征常规标准的个体比对照组报告了更多的心理困扰，无论他们是否咨询过医生。这些结果表明：（a）心理痛苦的症状与肠易激综合征无关，但影响患者咨询医生的方式;（B）传统诊断标准比限制性标准能识别出更多的心理痛苦个体。
Women with symptoms indicative of irritable bowel syndrome who had not consulted a physician were compared with female patients at a gastroenterology clinic to investigate whether self-selection for treatment accounts for psychologic abnormalities in clinic patients with irritable bowel syndrome. Two sets of diagnostic criteria were compared; restrictive criteria based on the work of Manning and conventional criteria (abdominal pain plus altered bowel habits). Lactose malabsorbers were included as a control group because they have medically explained bowel symptoms similar to those that define irritable bowel syndrome. Thus they control for the causative effects of chronic bowel symptoms on psychologic distress. Women who met restrictive criteria for irritable bowel syndrome but had not consulted a physician had no more symptoms of psychologic distress on the Hopkins Symptom Checklist than asymptomatic controls. However, medical clinic patients with both irritable bowel syndrome and lactose malabsorption had significantly more psychologic symptoms than asymptomatic controls or nonconsulters with the same diagnoses. Individuals who met only the conventional criteria for irritable bowel syndrome reported more psychologic distress than controls, whether or not they consulted a physician. These results suggest that (a) symptoms of psychologic distress are unrelated to irritable bowel syndrome but influence which patients consult a doctor and (b) conventional diagnostic criteria identify more psychologically distressed individuals than do restrictive criteria.