PSYCHOSOCIAL FACTORS IN THE IRRITABLE BOWEL SYNDROME - A MULTIVARIATE STUDY OF PATIENTS AND NONPATIENTS WITH IRRITABLE BOWEL SYNDROME
PSYCHOSOCIAL FACTORS IN THE IRRITABLE BOWEL SYNDROME - A MULTIVARIATE STUDY OF PATIENTS AND NONPATIENTS WITH IRRITABLE BOWEL SYNDROME
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DOI：
10.1016/s0016-5085(88)80017-9
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发表时间：
1988-09-01
期刊：
影响因子：
29.4
通讯作者：
BURGER, AL
中科院分区：
文献类型：
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作者：
DROSSMAN, DA;MCKEE, DC;BURGER, AL
在这个肠易激综合征（IBS）的多变量分析中，我们描述了这种情况的症状和心理特征及其对寻求医疗保健的可能贡献。我们研究了72例IBS患者，82人IBS谁没有寻求医疗，和84名正常人。所有受试者均接受完整的医疗评估，腹痛和排便习惯的日记卡评估，以及疼痛，个性，情绪，应激性生活事件，疾病行为和社会支持的标准心理测试。疼痛和腹泻是与患者状态相关的最重要症状。当控制这些症状时，我们发现（a）IBS患者比非IBS患者有更高比例的异常人格模式，更大的疾病行为和更低的积极压力生活事件评分（p < 0.001）和正常（p < 0.001）;（B）非IBS患者，尽管在心理上介于患者和正常人之间，但与正常人没有差异（p < 0.21）;（c）非IBS患者比患者有更高的应对能力，经历疾病对生活的破坏性较小，并且倾向于表现出较少的心理否认。这些因素可能有助于慢性肠道症状患者的“健康行为”。我们的结论是，以前归因于IBS的心理因素与患者状态相关，而不是与疾病本身相关。这些因素可能与肠道的生理紊乱相互作用，以确定疾病是如何经历和作用的。
In this multivariate analysis of the irritable bowel syndrome (IBS) we describe the symptomatic and psychologic features of the condition and their possible contributions to health care seeking. We studied 72 IBS patients, 82 persons with IBS who had not sought medical treatment, and 84 normal subjects. All subjects received complete medical evaluation, diary card assessment of abdominal pain and stool habit, and standard psychologic tests of pain, personality, mood, stressful life events, illness behavior, and social support. Pain and diarrhea were the most important symptoms associated with patient status. When controlling for these symptoms we found that (a) IBS patients have a higher proportion of abnormal personality patterns, greater illness behaviors, and lower positive stressful life event scores than IBS nonpatients (p < 0.001) and normals (p < 0.001); (b) IBS nonpatients, although psychologically intermediate between patients and normals, are not different from normals (p < 0.21); and (c) IBS nonpatients have higher coping capabilities, experience illness as less disruptive to life, and tend to exhibit less psychologic denial than patients. These factors may contribute to “wellness behaviors” among people with chronic bowel symptoms. We conclude that the psychologic factors previously attributed to the IBS are associated with patient status rather than to the disorder per se. These factors may interact with physiologic disturbances in the bowel to determine how the illness is experienced and acted upon.