Predictors of irritable bowel-type symptoms and healthcare-seeking behavior among adults with celiac disease
Predictors of irritable bowel-type symptoms and healthcare-seeking behavior among adults with celiac disease
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DOI：
10.1097/psy.0b013e318050d6bb
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发表时间：
2007-05-01
影响因子：
3.3
通讯作者：
Stallmach, Andreas
中科院分区：
文献类型：
--
作者：
Haeuser, Winfried;Musial, Frauke;Stallmach, Andreas
目的：评估成人乳糜泻（CD）患者肠易激综合征（IBS）型症状和连续就医行为的频率、其对健康相关生活质量（HRQOL）的影响及其可能的生物心理社会决定因素。研究方法：来自德国乳糜泻协会的1000例成人CD患者通过邮寄调查完成了医学（包括肠道）和社会人口学问卷、简明健康调查表（SF-36）和医院焦虑和抑郁量表。结果如下：在412名报告活检证实诊断的应答者中，主要坚持无麸质饮食（GFD）≥ 1年，96名（23.3%）患者符合改良罗马I IBS标准。在这96例患者中，76例（79.2%）因肠道症状（称为IBS患者）寻求帮助（医疗和/或非医疗）。IBS型症状对SF-36的身体总分有显著的负面影响（p = 0.05）。精神障碍（OR = 2.29; beta = 0.83; p = 0.006）、女性（OR = 2.34; beta = 0.85; p = 0.03）和偶尔不遵守GFD（OR = 1.74; beta = 0.56; p = 0.05）是IBS型症状的危险因素。活动性内科合并症预测IBS患者状态（OR = 0.40; β = -0.92; p = .001）。结论：这些数据支持IBS的生物心理社会模型：成人CD患者的IBS型症状可以通过临床和社会心理机制的相互作用来解释。
Objectives: To assess the frequency of irritable bowel syndrome (IBS)-type symptoms and consecutive healthcare-seeking behavior, their impact on health-related quality of life (HRQOL), and their possible biopsychosocial determinants in adult patients with celiac disease (CD). Methods: A total of 1000 adult patients with CD from the German Celiac Society completed a medical (including bowel) and a sociodemographic questionnaire, the Short Form Health Survey (SF-36), and the Hospital Anxiety and Depression Scale through a postal survey. Results: Of 412 respondents with reported biopsy-proven diagnosis with major adherence to a gluten-free diet (GFD) for >= 1 year, 96 (23.3%) patients fulfilled the modified Rome I criteria for IBS. Of these 96 patients, 76 (79.2%) sought help (medical and/or nonmedical) due to bowel symptoms (referred to as patients with IBS). IBS-type symptoms had a significant negative impact on the physical summary score of the SF-36 (p = .05). Mental disorder (OR = 2.29; beta = 0.83; p = .006); female sex (OR = 2.34; beta = 0.85; p = .03), and occasional nonadherence to GFD (OR = 1.74; beta = 0.56; p = .05) were risk factors for IBS-type symptoms. Active medical comorbidities predicted IBS-patient status (OR = 0.40; beta = -0.92; p = .001). Conclusions: The data support the biopsychosocial model of IBS: IBS-type symptoms in adult patients with CD can be explained through an interaction of clinical and sociopsychological mechanisms.