Tiêu chí lo âu ảnh hưởng đến tỷ lệ hiện mắc của rối loạn tiêu hóa chức năng

BMC Gastroenterology - Tập 14 - Trang 1-7 - 2014
Charlotte Markert1, Kerstin Suarez-Hitz2, Ulrike Ehlert2, Urs M Nater1
1Department of Psychology, University of Marburg, Marburg, Germany
2Department of Psychology, University of Zurich, Zurich, Switzerland

Tóm tắt

Các rối loạn tiêu hóa chức năng (FGID) được định nghĩa bởi sự kết hợp của các triệu chứng tiêu hóa mãn tính hoặc tái phát. Tỷ lệ hiện mắc của FGID thường cao. Các triệu chứng này liên quan đến sự khó chịu, và những người mắc bệnh cho thấy mức độ căng thẳng cao. Tuy nhiên, các tiêu chí chẩn đoán hiện tại không tính đến sự khó chịu chủ quan do các triệu chứng gây ra, do đó có thể dẫn đến việc đánh giá cao hơn về tỷ lệ hiện mắc. Mục tiêu của nghiên cứu này là khám phá sự giảm trong tỷ lệ hiện mắc khi tính đến sự khó chịu trong các tiêu chí chẩn đoán. Trong nghiên cứu trên web này, FGID được chẩn đoán theo tiêu chí Rome II. Các tỷ lệ hiện mắc có và không có sự khó chịu chủ quan do triệu chứng gây ra đã được tính toán. Thêm vào đó, mức độ căng thẳng và phản ứng căng thẳng cũng được đánh giá. Tỷ lệ hiện mắc của FGID trong mẫu nghiên cứu của chúng tôi tương tự như trong các nghiên cứu khác. Tuy nhiên, khi xem xét tiêu chí khó chịu, trung bình, đã phát hiện giảm 38,51% trong tỷ lệ hiện mắc của FGID. Những người bị lo âu bởi triệu chứng của họ báo cáo mức độ căng thẳng cao hơn đáng kể so với những người không bị lo âu (tất cả p < 0.001). Việc xem xét một tiêu chí khó chịu chủ quan trong chẩn đoán FGID có những hệ quả đối với tỷ lệ hiện mắc thực tế của FGID. Những người bị lo âu khác biệt rõ rệt với những người không bị lo âu về mức độ căng thẳng của họ. Do đó, việc đưa vào tiêu chí khó chịu trong quá trình phát triển các tiêu chí chẩn đoán cho FGID là hoàn toàn cần thiết.

Từ khóa

#rối loạn tiêu hóa chức năng #tỷ lệ hiện mắc #tiêu chí khó chịu #căng thẳng #nghiên cứu trên web

Tài liệu tham khảo

Drossman DA, Li Z, Andruzzi E, Temple RD, Talley NJ, Thompson WG, Whitehead WE, Janssens J, Funch-Jensen P, Corazziari E, Richter JE, Koch GG: U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci. 1993, 38 (9): 1569-1580. 10.1007/BF01303162. Koloski NA, Talley NJ, Boyce PM: Epidemiology and health care seeking in the functional GI disorders: a population-based study. Am J Gastroenterol. 2002, 97 (9): 2290-2299. 10.1111/j.1572-0241.2002.05783.x. Lee SY, Kim JH, Sung IK, Park HS, Jin CJ, Choe WH, Kwon SY, Lee CH, Choi KW: Irritable bowel syndrome is more common in women regardless of the menstrual phase: a Rome II-based survey. J Korean Med Sci. 2007, 22 (5): 851-854. 10.3346/jkms.2007.22.5.851. Schmulson M, Adeyemo M, Gutierrez-Reyes G, Charua-Guindic L, Farfan-Labonne B, Ostrosky-Solis F, Diaz-Anzaldua A, Medina L, Chang L: Differences in gastrointestinal symptoms according to gender in Rome II positive IBS and dyspepsia in a Latin American population. Am J Gastroenterol. 2010, 105 (4): 925-932. 10.1038/ajg.2010.58. Drossman DA, Richter JE, Talley NJ, Corazziari E, Thompson WG, Whitehead WE: Functional gastrointestinal disorders. 1994, Little, Brown, Boston Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Muller-Lissner SA: Functional bowel disorders and functional abdominal pain. Gut. 1999, 45 (Suppl 2): II43-II47. Drossman DA: The functional gastrointestinal disorders and the Rome III process. Gastroenterology. 2006, 130 (5): 1377-1390. 10.1053/j.gastro.2006.03.008. Park DW, Lee OY, Shim SG, Jun DW, Lee KN, Kim HY, Lee HL, Yoon BC, Choi HS: The Differences in Prevalence and Sociodemographic Characteristics of Irritable Bowel Syndrome According to Rome II and Rome III. J Neurogastroenterol Motil. 2010, 16 (2): 186-193. 10.5056/jnm.2010.16.2.186. Sperber AD, Shvartzman P, Friger M, Fich A: A comparative reappraisal of the Rome II and Rome III diagnostic criteria: are we getting closer to the 'true' prevalence of irritable bowel syndrome?. Eur J Gastroenterol Hepatol. 2007, 19 (6): 441-447. 10.1097/MEG.0b013e32801140e2. Whitehead WE, Drossman DA: Validation of symptom-based diagnostic criteria for irritable bowel syndrome: a critical review. Am J Gastroenterol. 2010, 105 (4): 814-820. 10.1038/ajg.2010.56. Dang J, Ardila-Hani A, Amichai MM, Chua K, Pimentel M: Systematic review of diagnostic criteria for IBS demonstrates poor validity and utilization of Rome III. Neurogastroenterol Motil. 2012, 24 (9): 853-860. 10.1111/j.1365-2982.2012.01943.x. Alander T, Svardsudd K, Johansson SE, Agreus L: Psychological illness is commonly associated with functional gastrointestinal disorders and is important to consider during patient consultation: a population-based study. BMC Med 2005, 3(8). Ringstrom G, Abrahamsson H, Strid H, Simren M: Why do subjects with irritable bowel syndrome seek health care for their symptoms?. Scand J Gastroenterol. 2007, 42 (10): 1194-1203. 10.1080/00365520701320455. Mayer EA, Collins SM: Evolving pathophysiologic models of functional gastrointestinal disorders. Gastroenterology. 2002, 122 (7): 2032-2048. 10.1053/gast.2002.33584. Folkman S, Lazarus RS, Gruen RJ, DeLongis A: Appraisal, coping, health status, and psychological symptoms. J Pers Soc Psychol. 1986, 50 (3): 571-579. 10.1037/0022-3514.50.3.571. McEwen BS: Stress, adaptation, and disease. Allostasis and allostatic load. Ann N Y Acad Sci. 1998, 840: 33-44. 10.1111/j.1749-6632.1998.tb09546.x. Levy RL, Cain KC, Jarrett M, Heitkemper MM: The relationship between daily life stress and gastrointestinal symptoms in women with irritable bowel syndrome. J Behav Med. 1997, 20 (2): 177-193. 10.1023/A:1025582728271. Whitehead WE, Crowell MD, Robinson JC, Heller BR, Schuster MM: Effects of stressful life events on bowel symptoms: subjects with irritable bowel syndrome compared with subjects without bowel dysfunction. Gut. 1992, 33 (6): 825-830. 10.1136/gut.33.6.825. Locke GR, Weaver AL, Melton LJ, Talley NJ: Psychosocial factors are linked to functional gastrointestinal disorders: a population based nested case–control study. Am J Gastroenterol. 2004, 99 (2): 350-357. 10.1111/j.1572-0241.2004.04043.x. Drossman DA, McKee DC, Sandler RS, Mitchell CM, Cramer EM, Lowman BC, Burger AL: Psychosocial factors in the irritable bowel syndrome. A multivariate study of patients and nonpatients with irritable bowel syndrome. Gastroenterology. 1988, 95 (3): 701-708. Bach DR, Erdmann G, Schmidtmann M, Monnikes H: Emotional stress reactivity in irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2006, 18 (6): 629-636. 10.1097/00042737-200606000-00009. Dickhaus B, Mayer EA, Firooz N, Stains J, Conde F, Olivas TI, Fass R, Chang L, Mayer M, Naliboff BD: Irritable bowel syndrome patients show enhanced modulation of visceral perception by auditory stress. Am J Gastroenterol. 2003, 98 (1): 135-143. 10.1111/j.1572-0241.2003.07156.x. Tillisch K, Mayer EA, Labus JS, Stains J, Chang L, Naliboff BD: Sex specific alterations in autonomic function among patients with irritable bowel syndrome. Gut. 2005, 54 (10): 1396-1401. 10.1136/gut.2004.058685. Suarez K, Mayer C, Ehlert U, Nater UM: Psychological stress and self-reported functional gastrointestinal disorders. J Nerv Ment Dis. 2010, 198 (3): 226-229. 10.1097/NMD.0b013e3181d106bc. Leibbrand R, Cuntz U, Hiller W: Assessment of functional gastrointestinal disorders using the Gastro-Questionnaire. Int J Behav Med. 2002, 9 (2): 155-172. 10.1207/S15327558IJBM0902_06. Schulz P, Schlotz W, Becker P: TICS Trierer Inventar zum chronischen Stress [Trier Inventory for the Assessment of Chronic Stress]. Manual. Göttingen: Hogrefe; 2004. Schlotz W, Yim IS, Zoccola PM, Jansen L, Schulz P: The perceived stress reactivity scale: measurement invariance, stability, and validity in three countries. Psychol Assess. 2011, 23 (1): 80-94. 10.1037/a0021148. Schulz P, Jansen LJ, Schlotz W: Stessreaktivität: Theoretisches Konzept und Messung. Diagnostica. 2005, 51: 124-133. 10.1026/0012-1924.51.3.124. West SG, Finch JF, Curran PJ: Structural equation models with non-normal variables: Problems and remedies. Structural Equation Modeling: Concepts, Issues and Applications. Edited by: Hoyle RH. 1995, Sage Publications, Thousand Oaks, 65-75. Halder SL, Locke GR, Schleck CD, Zinsmeister AR, Melton LJ, Talley NJ: Natural history of functional gastrointestinal disorders: a 12-year longitudinal population-based study. Gastroenterology. 2007, 133 (3): 799-807. 10.1053/j.gastro.2007.06.010. Thompson WG, Irvine EJ, Pare P, Ferrazzi S, Rance L: Functional gastrointestinal disorders in Canada: first population-based survey using Rome II criteria with suggestions for improving the questionnaire. Dig Dis Sci. 2002, 47 (1): 225-235. 10.1023/A:1013208713670. Norton GR, Norton PJ, Asmundson GJ, Thompson LA, Larsen DK: Neurotic butterflies in my stomach: the role of anxiety, anxiety sensitivity and depression in functional gastrointestinal disorders. J Psychosom Res. 1999, 47 (3): 233-240. 10.1016/S0022-3999(99)00032-X. Austin P, Henderson S, Power I, Jirwe M, Alander T: An international Delphi study to assess the need for multiaxial criteria in diagnosis and management of functional gastrointestinal disorders. Journal of Psychosomatic Research. 2013, 75 (2): 128-134. 10.1016/j.jpsychores.2013.05.008. Endo Y, Shoji T, Fukudo S, Machida T, Noda S, Hongo M: The features of adolescent irritable bowel syndrome in Japan. J Gastroenterol Hepatol. 2011, 26 (Suppl 3): 106-109. 10.1111/j.1440-1746.2011.06637.x. Blanchard EB, Lackner JM, Jaccard J, Rowell D, Carosella AM, Powell C, Sanders K, Krasner S, Kuhn E: The role of stress in symptom exacerbation among IBS patients. J Psychosom Res. 2008, 64 (2): 119-128. 10.1016/j.jpsychores.2007.10.010. Hillilä MT, Siivola MT, Färkkilä MA: Comorbidity and use of health-care services among irritable bowel syndrome sufferers. Scand J Gastroenterol. 2007, 42 (7): 799-806. 10.1080/00365520601113927. Koloski NA, Boyce PM, Jones MP, Talley NJ: What level of IBS symptoms drives impairment in health-related quality of life in community subjects with irritable bowel syndrome? Are current IBS symptom thresholds clinically meaningful?. Qual Life Res. 2011, 21: 829-836. 10.1007/s11136-011-9985-5. Dong YY, Chen FX, Yu YB, Du C, Qi QQ, Liu H, Li YQ: A school-based study with Rome III criteria on the prevalence of functional gastrointestinal disorders in Chinese college and university students. PLoS One. 2013, 8 (1): e54183-10.1371/journal.pone.0054183. Hazlett-Stevens H, Craske MG, Mayer EA, Chang L, Naliboff BD: Prevalence of irritable bowel syndrome among university students: the roles of worry, neuroticism, anxiety sensitivity and visceral anxiety. J Psychosom Res. 2003, 55 (6): 501-505. 10.1016/S0022-3999(03)00019-9. Hori K, Matsumoto T, Miwa H: Analysis of the gastrointestinal symptoms of uninvestigated dyspepsia and irritable bowel syndrome. Gut Liver. 2009, 3 (3): 192-196. 10.5009/gnl.2009.3.3.192. Drossman DA, Ringel Y, Vogt BA, Leserman J, Lin W, Smith JK, Whitehead W: Alterations of brain activity associated with resolution of emotional distress and pain in a case of severe irritable bowel syndrome. Gastroenterology. 2003, 124 (3): 754-761. 10.1053/gast.2003.50103. Tache Y, Bonaz B: Corticotropin-releasing factor receptors and stress-related alterations of gut motor function. J Clin Invest. 2007, 117 (1): 33-40. 10.1172/JCI30085. Kassinen A, Krogius-Kurikka L, Makivuokko H, Rinttila T, Paulin L, Corander J, Malinen E, Apajalahti J, Palva A: The fecal microbiota of irritable bowel syndrome patients differs significantly from that of healthy subjects. Gastroenterology. 2007, 133 (1): 24-33. 10.1053/j.gastro.2007.04.005. Mättö J, Maunuksela L, Kajander K, Palva A, Korpela R, Kassinen A, Saarela M: Composition and temporal stability of gastrointestinal microbiota in irritable bowel syndrome – a longitudinal study in IBS and control subjects. FEMS Immunol Med Microbiol. 2004, 43: 213-222. 10.1016/j.femsim.2004.08.009. Maukonen J, Satokari R, Matto J, Soderlund H, Mattila-Sandholm T, Saarela M: Prevalence and temporal stability of selected clostridial groups in irritable bowel syndrome in relation to predominant faecal bacteria. J Med Microbiol. 2006, 55 (Pt 5): 625-633. 10.1099/jmm.0.46134-0. Mewes R, Rief W: [Are somatoform complaints and causal attributions in Turkish migrants caused by their cultural background or the migration itself?]. Z Med Psychol. 2009, 18: 135-139. Kirmayer LJ, Sartorius N: Cultural models and somatic syndromes. Psychosom Med. 2007, 69 (9): 832-840. 10.1097/PSY.0b013e31815b002c. Rief W, Martin A: How to use the new DSM-5 somatic symptom disorder diagnosis in research and practice: a critical evaluation and a proposal for modifications. Annu Rev Clin Psychol. 2014, 10: 339-367. 10.1146/annurev-clinpsy-032813-153745. Lackner JM, Quigley BM, Blanchard EB: Depression and abdominal pain in IBS patients: the mediating role of catastrophizing. Psychosom Med. 2004, 66 (3): 435-441. Lackner JM, Quigley BM: Pain catastrophizing mediates the relationship between worry and pain suffering in patients with irritable bowel syndrome. Behav Res Ther. 2005, 43 (7): 943-957. 10.1016/j.brat.2004.06.018. van Tilburg MA, Palsson OS, Whitehead WE: Which psychological factors exacerbate irritable bowel syndrome? Development of a comprehensive model. J Psychosom Res. 2013, 74 (6): 486-492. 10.1016/j.jpsychores.2013.03.004.