心理因素对功能性胃肠病患者生活质量的影响

目的 探讨心理因素(焦虑和抑郁)对功能性胃肠病(FGID)患者生活质量的影响.方法 选取符合罗马Ⅲ诊断标准的FGID患者450例(功能性腹泻150例、肠易激综合征150例、功能性便秘150例)为研究组,另选取150例器质性胃肠疾病患者(阳性对照组)和150健康体检者(阴性对照组).3组研究对象均使用综合医院抑郁焦虑量表(HAD)进行自评和国人普适量表(QOL-35)进行生活质量评分.HAD评分≥9分者,再由专业的心理或精神科医生使用Hamilton焦虑量表(HAMA)和Hamilton抑郁量表(HAMD)进行心理评分.结果 研究组、阳性对照组、阴性对照组HAD≥9分者分别占32.7%、17.3%和4.0%,研究组与阳性对照组、阴性对照组比较差异有统计学意义(χ2值分别为27.15和47.16,P＜0.01).3组存在焦虑或抑郁症状者,焦虑或抑郁障碍的患病率分别为70.6%、38.5%和0,研究组与阳性对照组、阴性对照组比较差异有统计学意义(χ2值分别为7.52和9.26,P＜0.01).33.8%的FGID患者生活质量下降,7.8%的患者生活质量明显下降,16.7%的阳性对照和4.7%的阴性对照生活质量下降.在研究组HAD≥9分者(143例)中,不同QOL-35评分者HAD、HAMA、HAMD评分不同,差异有统计学意义(P＜0.05);QOL-35评分越低,HAD、HAMA、HAMD评分越高.结论 近1/3的FGID患者存在抑郁或焦虑症状,且FGID患者抑郁或焦虑症状发生率显著高于器质性胃肠疾病患者和健康者;FGID患者的生活质量下降,且生活质量越低,患者的焦虑或抑郁越严重.

Effects of Psychological Factors on the Quality of Life of Functional Gastrointestinal Disease Patients

Objective To explore the effects of psychological factors (anxiety and depression) on quality of life of patients with functional gastrointestinal diseases(FGID).Methods Forty-five patients consistent with Roma Ш diagnosis standard on FGID as trial group were enrolled,including 150 for each of functional diarrhea,irritable bowel syndrome and functional constipation; 150 patients with organic gastrointestinal diseases as positive controls and 150 healthy physical examinees as negative controls were also enrolled.The Hospital Anxiety and Depression Scale (HAD) was used for self-assessment,and Chinese Quality of Life Score-35 (QOL-35) was taken to score.For those whose HAD≥9 were again scored by professional psychologist or psychiatrist according to Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD).Results The subjects with HAD≥9 in the trial,positive control and negative control groups accounted respectively for 32.7%,17.3% and 4.0%; difference between the trial group and positive and negative control groups was significant(χ2=27.15,47.16,P＜0.01).The morbidities of anxiety/depression in the 3 groups were respectively 68.7%,38.5% and 0,with a significant difference between the trial group and positive and negative control groups (χ2=7.52,9.26,P＜0.01).The QOL of 33.8% FGID patients got lower,and 7.8% obviously lower; and the QOL of 16.7% subjects in the positive group and 4.7% subjects in the negative control group got a little lower.The differences in score of QOL-35 and in HAD,HAMA and HAMD scores for the patients with HAD≥9 showed significantly different (P＜0.05).The lower the QOL-35 score were,the higher the HAD,HAMA and HAMD scores were.Conclusion Some 1/3 FGID patients have anxiety/depression symptoms,and the prevalence of the FGID patients is remarkably higher than those of the patients with organic gastrointestinal diseases and health persons.The quality of life of FGID patients decreases,and the lower the life quality is,the severer the patients′ anxiety/depression is.