肠易激综合征患者的睡眠特征

Objective To investigate the sleep features in the patients with irritable bowel syndrome (IBS) and compare the sleep quality between those IBS patients who were with and without anxiety and depression.Methods Pittsburgh sleep quality index questionnaire (PSQI), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were measured in the 145 IBS patients and 59 regular physical examination volunteers.IBS patients were also divided into two subgroups-patients with or without anxiety and depression based on cutoff scores of SAS and SDS.Comparisons of sleep quality were made between subgroups, and between IBS patients and volunteer controls.Results Compared with the controls,the SAS raw score, SDS raw score and SAS positive incidence in IBS patients were shown statistically significant differences (P ＜ 0.05 ), while the SDS positive incidence had no statistically significant difference(P ＞ 0.05 ).PSQI total scores were significantly higher in the IBS patients without anxiety and depression (P ＜ 0.05), 3 domains (sleep quality, sleep disturbances and daytime function disorder) were also found statistically significant differences ( P ＜ 0.05 ), compared with the controls.The IBS patients with anxiety and depression were statistically significantly different from the controls ( P ＜ 0.05 ) in 6 domains (sleep quality, sleep latency, sleep efficiency, sleep disturbances, sleep time and daytime function disorder) and significantly higher PSQI total scores( P ＜ 0.05 ).Statistically significant differences (P ＜0.05) were also found in all 7 domains and with higher PSQI total scores in IBS patients with anxiety and depression, compared with IBS patients without anxiety and depression.Conclusions IBS patients were more likely to have sleep abnormality, mainly in sleep quality, sleep disturbances and daytime function disorder and PSQI total scores.The abnormalities of these factors were independent of emotional disorder.However, emotional disorder worsened the sleep disorder in IBS patients.     

Health-related quality of life,anxiety, depression and impulsivity in patients with advanced gastroenteropancreatic neuroendocrine tumours

AIM To compare health-related quality of life(HRQoL),anxiety, depression, and impulsivity scores in patients with and without carcinoid syndrome(CS), and correlated them with serum 5-hydroxyindoleacetic acid(5-HIAA) levels.METHODS Patients with advanced gastroenteropancreatic neuroendocrine tumours(GEPNET), with and without CS completed HRQoL QLQ-C30 and QLQ-GI.NET21, Hospital Anxiety and Depression Scale(HADS) and Barratt Impulsivity Scale(BIS) questionnaires. Twosample Wilcoxon test was applied to assess differences in serum 5-HIAA levels, two-sample Mann-Whitney U test for HRQoL and BIS, and proportion test for HADS, between those with and without CS.RESULTS Fifty patients were included; 25 each with and without CS. Median 5-HIAA in patients with and without CS was 367 nmol/L and 86 nmol/L, respectively(P = 0.003). Scores related to endocrine symptoms were significantly higher amongst patients with CS(P = 0.04) and scores for disease-related worries approached significance in the group without CS, but no other statistically-significant differences were reported between patients with and without CS in responses on QLQ-C30 or QLQ-GI.NET21. Fifteen patients(26%) scored ≥ 8/21 on anxiety scale, and 6(12%) scored ≥ 8/21 on depression scale. There was no difference in median 5-HIAA between those scoring or ≥ 8/21 on anxiety scale(P = 0.53). There were no statistically significant differences between groups in first or second-order factors(BIS) or total sum(P = 0.23).CONCLUSION Excepting endocrine symptoms, there were no significant differences in HRQoL, anxiety, depression or impulsivity between patients with advanced GEPNET, with or without CS. Over one quarter of patients had high anxiety scores, unrelated to peripheral serotonin metabolism.     

Anxiety and depression in patients with gastroesophageal reflux disease and their effect on quality of life

AIM: To explore the role of psychological factors in gastroesophageal reflux disease(GERD) and their effect on quality of life(Qo L) of GERD patients.METHODS: A total of 279 consecutive patients with typical symptoms and 100 healthy controls were enrolled in the study.All of the participants wereevaluated with the Zung Self-Rating Anxiety Scale(ZSAS), the Zung Self-Rating Depression Scale(ZSDS) and the SF-36 questionnaire.The scores for anxiety, depression and Qo L of the two groups were analyzed.The correlation between psychological factors and Qo L was also analyzed.RESULTS: Compared with healthy controls(34.70 ± 8.00), the scores of ZSAS in the non-erosive reflux disease( N E R D) group(48.27±10.34) and the reflux esophagitis(RE) group(45.38 ± 10.27) were significantly higher(P 0.001).The mean ZSAS score of the NERD group was significantly higher than that of the RE group(P = 0.01).Compared with healthy controls(37.61 ± 8.44), the mean ZSDS scores were significantly higher in the NERD group(49.65 ± 11.09, P 0.001) and the RE group(46.76 ± 11.83, P 0.001).All dimensions of the SF-36 form were negatively correlated with the SAS and SDS scores in patients with NERD and RE(P 0.05).According to the S F- 3 6 form, vitality, mentalhealth and social functioning were significantly correlated with symptoms of depression in patients with NERD and RE.General health was obviously affected by symptoms of depression in patients with NERD(P 0.05).CONCLUSION: Anxiety and depression may play an important role in the occurrence of GERD and especially that of NERD.The Qo L of patients with GERD is reduced by anxiety and depression.     

Influence of excessive daytime sleepiness and sleep quality on anxiety and depression in patients with obstructive sleep apnea hypopnea syndrome.

<正>Objective To explore the factors that contribute to the anxiety and depression in obstructive sleep apnea hypopnea syndrome (OSAHS) patients in terms of excessive daytime sleepiness (EDS) and sleep quality. Methods A total of 196 OSAHS patients,including 103 severe     

Cerebral magnetic resonance imaging in quiescent Crohn's disease patients with fatigue

AIM To evaluate brain involvement in quiescent Crohn's disease (CD) patients with fatigue using quantitative magnetic resonance imaging(MRI).METHODS Multiple MRI techniques were used to assess cerebral changes in 20 quiescent CD patients with fatigue(defined with at least 6 points out of an 11-point numeric rating scale compared with 17 healthy age and gender matched controls without fatigue. Furthermore, mental status was assessed by cognitive functioning, based on the neuropsychological inventory including the different domains global cognitive functioning, memory and executive functioning and in addition mood and quality of life scores. Cognitive functioning and mood status were correlated with MRI findings in the both study groups.RESULTS Reduced glutamate + glutamine (Glx = Glu + Gln) concentrations (P = 0.02) and ratios to total creatine(P = 0.02) were found in CD patients compared with controls. Significant increased Cerebral Blood Flow(P = 0.05) was found in CD patients (53.08 ± 6.14 mL/100 g/min) compared with controls (47.60 ± 8.62 mL/100 g/min). CD patients encountered significantly more depressive symptoms (P 0.001). Cognitive functioning scores related to memory (P = 0.007) and executive functioning (P = 0.02) were lower in CD patients and both scores showed correlation with depression and anxiety. No correlation was found subcortical volumes between CD patients and controls in the T1-weighted analysis. In addition, no correlation was found between mental status and MRI findings.CONCLUSION This work shows evidence for perfusion, neurochemical and mental differences in the brain of CD patients with fatigue compared with healthy controls.     

Risk factors for proton pump inhibitor refractoriness in Chinese patients with non-erosive reflux disease

AIM:To analyze risk factors for refractoriness to proton pump inhibitors(PPIs) in patients with non-erosive reflux disease(NERD).METHODS:A total of 256 NERD patients treated with the PPI esomeprazole were enrolled.They were classified into symptom-free and residual symptoms groups according to Quality of Life in Reflux and Dyspepsia(QolRad) scale.All subjects completed questionnaires on psychological status(self-rating anxiety scale;selfrating depression scale) and quality of life scale(Short Form 36).Multivariate analysis was used to determine the predictive factors for PPI responses.RESULTS:According to QolRad,97 patients were confirmed to have residual reflux symptoms,and the remaining 159 patients were considered symptom free.There were no significant differences between the two groups in lifestyle factors(smoking and alcohol consumption),age,Helicobacter pylori infection,and hiatal hernia.There were significant differences between the two groups in relation to sex,psychological distress including anxiety and depression,body mass index(BMI),and irritable bowel syndrome(IBS)(P < 0.05).Logistic regression analysis found that BMI < 23,comorbid IBS,anxiety,and depression were major risk factors for PPI resistance.Symptomatic patients had a lower quality of life compared with symptom-free patients.CONCLUSION:Some NERD patients are refractory to PPIs and have lower quality of life.Residual symptoms are associated with psychological distress,intestinal disorders,and low BMI.     

Anxiety and depression in adult patients with celiac disease on a gluten-free diet

AIM: To compare anxiety and depression levels in adult patients with celiac disease (CD) on a gluten-free diet (GFD) with controls.METHODS: The levels of anxiety, depression and of a probable anxiety or depressive disorder were assessed by the Hospital Anxiety and Depression Scale in 441 adult patients with CD recruited by the German Celiac Society, in 235 age-and sex-matched patients with inflammatory bowel disease (IBD) in remission or with slight disease activity, and in 441 adult persons of a representa...     

Depression and anxiety before and after percutaneous coronary intervention and their relationship to age

Background and Objective Percutaneous coronary intervention (PCI) is becoming a common practice in the treatment of patients with coronary heart disease (CHD) of all age. Depression is considered to be a risk factor for the development of CHD and deteriorates the outcome after cardiac rehabilitation efforts. The aim of our study was to evaluate the presence of clinically relevant anxiety and depression in patients before and after PCI. Additionally we evaluated their relationship to age because of the increasing number of elderly patients undergoing PCI. Methods One hundred and twelve consecutive patients in three Sanatoria for Retired Cadres in Beijing who underwent PCI were asked to fill in the Hospital Anxiety and Depression Scale (HADS) to measure depression and anxiety scores two days before and ten days after PCI. Differences between these pre- and post-surgical scores were then calculated as means for changes, and the amount of elevated scores was appraised. In order to investigate the relationship between age and anxiety and depression, respectively, Spearman correlations between age and the difference scores were calculated. In addition, ANOVA procedures with the factor “age group” and McNemar tests were calculated. Results 25.8% of the patients were clinically depressed before and 17.5% after PCI; 34.0% of the patients were clinically anxious before and 24.7% after PCI. This overall change is not significant. We found a significant negative correlation between age and the difference between the two time points for anxiety (Spearman rho = -.218, P = 0.03), but not for depression (Spearman rho = -.128, P = 0.21). ANOVA and McNemar tests revealed that anxiety scores and the number of patients high in anxiety declined statistically meaningful only in the youngest patient group. Such a relationship could not be found for depression. Conclusions Our data show a relationship between age and anxiety. Younger patients are more anxious before PCI than older ones and show a decline in symptoms while elderly patients show hardly any change.     

Prevalence of depression and anxiety in patients with chronic digestive system diseases: A multicenter epidemiological study

AIM To investigate the prevalence of depression and anxiety in patients with chronic digestive system diseases.METHODS A total of 1736 patients with chronic digestive systemdiseases were included in this cross-sectional study, including 871 outpatients and 865 in-patients. A selfdesigned General Information for Patients of the Department of Gastroenterology of General Hospitals questionnaire was used to collect each patient's general information, which included demographic data(including age, sex, marital status, and education) and disease characteristics(including major diseases, disease duration, principal symptoms, chronic pain, sleep disorder, and limited daily activities).RESULTS The overall detection rate was 31.11%(540/1736) for depression symptoms alone, 27.02%(469/1736) for anxiety symptoms alone, 20.68%(359/1736) for both depression and anxiety symptoms, and 37.44%(650/1736) for either depression or anxiety symptoms. Subjects aged 70 years or above had the highest detection rate of depression(44.06%) and anxiety symptoms(33.33%). χ2 trend test showed: the higher the body mass index(BMI), the lower the detection rate of depression and anxiety symptoms(χ2trend = 13.697, P 0.001; χ2trend = 9.082, P = 0.003); the more severe the limited daily activities, the higher the detection rate of depression and anxiety symptoms(χ2trend = 130.455, P 0.001, χ2trend = 108.528, P 0.001); and the poorer the sleep quality, the higher the detection rate of depression and anxiety symptoms(χ2trend = 85.759, P 0.001; χ2trend = 51.969, P 0.001). Patients with digestive system tumors had the highest detection rate of depression(57.55%) and anxiety(55.19%), followed by patients with liver cirrhosis(41.35% and 48.08%). Depression and anxiety symptoms were also high in subjects with comorbid hypertension and coronary heart disease. CONCLUSION Depression and anxiety occur in patients with tumors, liver cirrhosis, functional dyspepsia, and chronic viral hepatitis. Elderly, divorced/widowed, poor sleep quality, and lower BMI are associated with higher risk of depression and anxiety.     

Therapeutic effect of Tandospirone citrate in Alzheimer's disease with depression and anxiety disorder

正Objective To evaluate the effect of Tandospirone citrate in the treatment of Alzheimer's disease with depression and anxiety disorder.Methods A total of 122patients with Alzheimer's disease with depression and anxiety were enrolled at the Second Hospital of Jinhua City from January 2015 to December 2016.They were