State and trait anxiety and depression in patients affected by gastrointestinal diseases: psychometric evaluation of 1641 patients referred to an internal medicine outpatient setting
State and trait anxiety and depression in patients affected by gastrointestinal diseases: psychometric evaluation of 1641 patients referred to an internal medicine outpatient setting
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DOI：
10.1111/j.1742-1241.2008.01763.x
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发表时间：
2008-07-01
影响因子：
2.6
通讯作者：
Gasbarrini, G.
中科院分区：
文献类型：
--
作者：
Addolorato, G.;Mirijello, A.;Gasbarrini, G.
目的：了解胃肠道疾病患者焦虑和抑郁的状态和特点。方法：对1997年至2005年期间1641例胃肠疾病门诊患者进行研究，并与本院内科门诊患者对照。采用状态焦虑和特质焦虑问卷评定状态焦虑和特质焦虑。采用Zung抑郁自评量表评定当前抑郁状态。结果：状态焦虑1379例(84.1%)，特质焦虑1098例(67%)，当前抑郁442例(27%)。胃肠道疾病的数量与状态焦虑(p<；0.001)和特质焦虑(p=0.04)直接相关。女性表现出比男性更高的焦虑和抑郁水平(p<；0.001)。状态焦虑与食物过敏(p<；0.001)、小肠细菌过度生长(p=0.001)、幽门螺杆菌感染(p=0.001)和活动期溃疡性结肠炎(p=0.03)有关。特质焦虑与肠易激综合征(p<；0.001)、幽门螺杆菌(HP)感染(p=0.001)、食物过敏(p=0.001)和肠易激综合征(p=0.001)有关。目前的抑郁与肠易激综合征(P<；0.001)、腹部疾病(P=0.01)、SIBO(P=0.02)有关。在这些患者中，状态焦虑、特质焦虑和抑郁的预测概率分别为0.77+/-0.16、0.66+/-0.12和0.39+/-0.14。结论：大多数因胃肠道问题就诊的患者表现出相关的情感障碍。这些患者应该由胃肠病专家、心理学家和/或精神病学家组成的团队进行管理，或者由具有心理障碍治疗专业知识的胃肠病专家进行管理。
Objectives: To evaluate state and trait form of anxiety and current depression in patients affected by gastrointestinal diseases. Methods: We studied 1641 outpatients with gastrointestinal disorders, consecutively referred to our Internal Medicine outpatients from 1997 to 2005. State and trait anxiety were assessed by the State and Trait Anxiety Inventory. Current depression was assessed by the Zung self-rating depression scale. Results: Among patients, 1379 (84.1%) showed state anxiety, 1098 (67%) showed trait anxiety and 442 (27%) showed current depression. The number of gastrointestinal diseases was directly correlated to state anxiety (p < 0.001) and trait anxiety (p = 0.04). Females showed higher levels of anxiety and depression than males (p < 0.001). State anxiety was related to food allergies (p < 0.001), small intestinal bacterial overgrowth (SIBO) (p = 0.001), Hp infection (p = 0.01) and ulcerative colitis in active phase (p = 0.03). Trait anxiety was related to irritable bowel syndrome (IBS) (p < 0.001), Helicobacter pylori (Hp) infection (p = 0.001), food allergies (p = 0.001) and SIBO (p = 0.001). Current depression was related to IBS (p < 0.001) and coeliac disease (p = 0.01), SIBO (p = 0.02). A predicted probability of 0.77 +/- 0.16 to have state anxiety, of 0.66 +/- 0.12 to have trait anxiety and of 0.39 +/- 0.14 to have depression was found in these patients. Conclusions: Most of the patients who seek medical consultation for gastrointestinal problems show an associated affective disorder. These patients should be managed by a team including gastroenterologists, psychologists and/or psychiatrists, or by a gastroenterologist having expertise in the treatment of psychological disorders.