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中华消化病与影像杂志(电子版) ›› 2023, Vol. 13 ›› Issue (01) : 33 -38. doi: 10.3877/cma.j.issn.2095-2015.2023.01.007

综述

炎症性肠病相关心理问题及诊治进展
吕苏聪1, 钟国强1, 李瑾1, 李明松1,()   
  1. 1. 510150 广州医科大学附属第三医院消化内科
  • 收稿日期:2022-09-22 出版日期:2023-02-01
  • 通信作者: 李明松
  • 基金资助:
    国家自然科学基金(82070565)

Psychological problems associated with inflammatory bowel disease and its progress in diagnosis and treatment

Sucong Lyv1, Guoqiang Zhong1, Jin Li1, Mingsong Li1,()   

  1. 1. Department of Gastroenterology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
  • Received:2022-09-22 Published:2023-02-01
  • Corresponding author: Mingsong Li
引用本文:

吕苏聪, 钟国强, 李瑾, 李明松. 炎症性肠病相关心理问题及诊治进展[J]. 中华消化病与影像杂志(电子版), 2023, 13(01): 33-38.

Sucong Lyv, Guoqiang Zhong, Jin Li, Mingsong Li. Psychological problems associated with inflammatory bowel disease and its progress in diagnosis and treatment[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(01): 33-38.

炎症性肠病(IBD)患者最常见的心理问题有焦虑和抑郁,其发生率显著高于普通人群,尤其是病情复杂、疾病活动期、女性人群、新确诊及成年患者更容易合并心理问题。同时心理问题和IBD存在相互作用,这些心理问题不仅影响IBD患者的生活质量,同时也影响了生物制剂的疗效,疾病的预后和转归。关于IBD合并心理问题的机制尚不明确,可能与肠黏膜屏障完整性破坏、肠道菌群易位密切相关。目前尚没有专门针对IBD患者焦虑和抑郁的评价指标,早期筛查手段主要通过心理评估量表,但确诊仍要求临床医师的系统访谈。早期治疗主要包括心理治疗和药物治疗,对改善IBD患者的心理和躯体症状,控制疾病进展有一定的效果。本文对IBD患者常见心理问题及其相应的诊断及治疗进行综述。

The most common psychological problems in patients with inflammatory bowel disease(IBD)are anxiety and depression.The incidence of anxiety and depression is significantly higher than that in the general population, especially in patients with complex and active disease, or female, newly diagnosed, adult patients.Moreover, psychological problems interact with IBD, these psychological problems not only affect the quality of life of IBD patients, but also affect effectiveness of biological agents, and the prognosis and outcome of the disease.However, the mechanism of IBD combined with psychological problems is not clear yet and is considered to associate with the damage of intestinal barrier integrity and the intestinal bacterial translocation.At present, there is no specific evaluation indicators for anxiety and depression of IBD patients.The early screening method is mainly through psychological assessment scales, and diagnosis still requires systematic interview by clinicians.The early treatment mainly includes psychological therapies and pharmacotherapies, which can improve the psychological and physical symptoms of IBD patients and control the progression of the disease.This article reviews the common psychological problems of IBD patients and their diagnosis and treatment.

表1 临床常见炎症性肠病心理问题评估量表
表2 炎症性肠病相关心理问题的常见治疗方法
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