- 作者：Jeffrey M. Lackner ; Chang-Xing Ma ; Laurie Keefer ; Darren M. Brenner ; Gregory D. Gudleski ; Nikhil Satchidan ; Rebecca Firth ; Michael D. Sitrin ; Leonard Katz ; Susan S. Krasner ; Sarah K. Ballou ; Bruce D. Naliboff ; Emeran A. Mayer
- 关键词：Chronic Disease ; Health-Related Quality of Life ; Comorbidity ; Transdiagnostic ; Stress ; Mental Functioning
- 刊名：Clinical Gastroenterology and Hepatology
- 出版年：2013
- 出版时间：September, 2013
- 年：2013
- 卷：11
- 期：9
- 页码：1147-1157
- 全文大小：374 K
Background & Aims
Irritable bowel syndrome (IBS) has significant mental and physical comorbidities. However, little is known about the day-to-day burden these comorbidities place on quality of life (QOL), physical and mental function, distress, and symptoms of patients.Methods
We collected cross-sectional data from 175 patients with IBS, which was diagnosed on the basis of Rome III criteria (median age, 41 years; 78 % women), who were referred to 2 specialty care clinics. Patients completed psychiatric interviews, a physical comorbidity checklist, the IBS Symptom Severity Scale, the IBS-QOL instrument, the Brief Symptom Inventory, the abdominal pain intensity scale, and the Short Form-12 Health Survey.
Results
Patients with IBS reported an average of 5 comorbidities (1 mental, 4 physical). Subjects with more comorbidities reported worse QOL after adjusting for confounding variables. Multiple linear regression analyses indicated that comorbidity type was more consistently and strongly associated with illness burden indicators than disease counts. Of 10,296 possible physical-mental comorbidity pairs, 6 of the 10 most frequent dyads involved specific conditions (generalized anxiety, depression, back pain, agoraphobia, tension headache, and insomnia). These combinations were consistently associated with greater illness and symptom burdens (QOL, mental and physical function, distress, more severe symptoms of IBS, and pain).
Conclusions
Comorbidities are common among patients with IBS. They are associated with distress and reduced QOL. Specific comorbidities are associated with more severe symptoms of IBS.