Depression and abdominal pain in IBS patients: The mediating role of catastrophizing
Depression and abdominal pain in IBS patients: The mediating role of catastrophizing
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DOI：
10.1097/01.psy.0000126195.82317.46
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发表时间：
2004-05-01
影响因子：
3.3
通讯作者：
Blanchard, EB
中科院分区：
文献类型：
--
作者：
Lackner, JM;Quigley, BM;Blanchard, EB
目的：抑郁症与肠易激综合征(IBS)有关，但这种关系的机制尚不清楚。这项横断面研究探索了患者对腹痛(即，灾难)持有的负面偏向信念在抑郁和疼痛严重程度之间调解关系的可能性。方法：样本包括244名连续接受评估的患者，他们符合罗马II标准的IBS诊断，没有合并胃肠道疾病，并完成了疼痛严重性、特质焦虑、灾难、适应不良信念和抑郁的测量，作为美国国立卫生研究院资助的两种非药物治疗的随机对照试验的基线评估的一部分。结果：使用包含一系列线性回归的中介模型，结果表明疼痛灾变部分中介了抑郁和腹痛严重程度之间的联系。抑郁、灾难和控制变量解释了疼痛严重程度差异的21%。发现患有更严重抑郁的IBS患者报告的疼痛严重程度可以部分解释为他们倾向于参与更多针对疼痛的灾难性思维。结论：抑郁症和疼痛之间的关系并不像心理模型预测的那样，严格地说是直接和线性的，而是在一定程度上通过患者对总体疼痛和特定疼痛灾难的信念发挥作用。研究结果对从生物心理社会角度理解和研究抑郁症与IBS之间的联系的意义进行了讨论。
Objective: Depression has been linked to irritable bowel syndrome (IBS), but the mechanism underlying this relationship is unknown. This cross-sectional study explores the possibility that negatively skewed beliefs patients hold regarding abdominal pain (ie, catastrophizing) mediate the relationship between depression and pain severity. Methods: The sample included 244 consecutively evaluated individuals who met Rome II diagnosis for IBS without comorbid gastrointestinal disease and completed measures of pain severity, trait anxiety, catastrophizing, maladaptive beliefs, and depression as part of baseline assessment of an National Institutes of Health-funded randomized controlled trial of 2 nondrug treatments. Results: Using a mediational model involving a series of linear regressions, results indicated that pain catastrophizing partially mediated the link between depression and abdominal pain severity. Depression, catastrophizing, and control variables accounted for 21% of the variance in pain severity. The finding that patients with IBS with greater depression reported greater pain severity can be partially explained by their tendency to engage in more catastrophic thinking specific to pain. Conclusions: The relation between depression and pain is not, as psychogenic models predict, strictly a direct and linear one but works partly through patients' beliefs regarding their pain in general and pain catastrophizing in specific. Implications of the findings for understanding and investigating the depression-IBS link from a biopsychosocial perspective are discussed.