Functional gastrointestinal disorders: An update for the psychiatrist

被引:40
作者
Jones, Michael P.
Crowell, Michael D.
Olden, Kevin W.
Creed, Francis
机构
[1] Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA
[2] Mayo Clin, Coll Med, Scottsdale, AZ USA
[3] Univ S Alabama, Mobile, AL 36688 USA
[4] Manchester Royal Infirm, Manchester M13 9WL, Lancs, England
关键词
D O I
10.1176/appi.psy.48.2.93
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Functional gastrointestinal disorders (FGID) are common conditions, with well-established diagnostic criteria. They are associated with impaired health-related quality of life and increased societal and healthcare costs. Their symptoms are probably related to altered 5-HT transmission and central processing of noxious visceral stimuli. Evaluation and treatment are best formulated using a biopsychosocial model that integrates gut function with psychosocial assessment. Psychological therapies may improve overall well-being and appear to help patients without significant psychiatric comorbidity. Antidepressants help comorbid anxiety and depressive disorders and have primary efficacy in improving the symptoms of FGID. Finally, there is a need for greater involvement of psychiatrists in both the evaluation and treatment of patients with FGID as well as the education and training of practitioners caring for these patients.
引用
收藏
页码:93 / 102
页数:10
相关论文
共 69 条
[1]   Functional somatic syndromes [J].
Barsky, AJ ;
Borus, JF .
ANNALS OF INTERNAL MEDICINE, 1999, 130 (11) :910-921
[2]   Level of chronic life stress predicts clinical outcome in irritable bowel syndrome [J].
Bennett, EJ ;
Tennant, CC ;
Piesse, C ;
Badcock, CA ;
Kellow, JE .
GUT, 1998, 43 (02) :256-261
[3]   Seeking medical consultation: Perceptual and behavioral characteristics distinguishing consulters and nonconsulters with functional dyspepsia [J].
Cheng, C .
PSYCHOSOMATIC MEDICINE, 2000, 62 (06) :844-852
[4]   Outcome in severe irritable bowel syndrome with and without accompanying depressive, panic and neurasthenic disorders [J].
Creed, F ;
Ratcliffe, J ;
Fernandes, L ;
Palmer, S ;
Rigby, C ;
Tomenson, B ;
Guthrie, E ;
Read, N ;
Thompson, DG .
BRITISH JOURNAL OF PSYCHIATRY, 2005, 186 :507-515
[5]   The cost-effectiveness of psychotherapy and paroxetine for severe irritable bowel syndrome [J].
Creed, F ;
Fernandes, L ;
Guthrie, E ;
Palmer, S ;
Ratcliffe, J ;
Read, N ;
Rigby, C ;
Thompson, D ;
Tomenson, B .
GASTROENTEROLOGY, 2003, 124 (02) :303-317
[6]   FUNCTIONAL ABDOMINAL-PAIN, PSYCHIATRIC-ILLNESS, AND LIFE EVENTS [J].
CREED, F ;
CRAIG, T ;
FARMER, R .
GUT, 1988, 29 (02) :235-242
[7]  
Creed Francis, 1999, American Journal of Medicine, V107, p74S
[8]  
Cremonini F, 2004, Minerva Med, V95, P427
[9]   Sexual abuse is more frequently reported by IBS patients than by patients with organic digestive diseases or controls. Results of a multicentre inquiry [J].
Delvaux, M ;
Denis, P ;
Allemand, H ;
Lamoulliatte, H ;
Dapoigny, M ;
Hostein, J ;
Grimaud, PC ;
Charles, F ;
Dorval, ED ;
Brandy, J ;
Lepinay, P ;
Olivier, C ;
Giordanella, J .
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 1997, 9 (04) :345-352
[10]   A systematic review of neuroimaging data during visceral stimulation [J].
Derbyshire, SWG .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2003, 98 (01) :12-20