A prospective study evaluating emotional disturbance in subjects undergoing defecating proctography

查看全文 作　　者：Amit S [1]Kashyap;Divyanshoo R [1]Kohli;Arnold [2]Raizon;Kevin W [3,4]Olden 机构地区：[1]Department of Medicine, Washington Hospital Center;[2]Department of Radiology, Washington Hospital Center;[3]Division of Gastroenterology, Washington Hospital Center;[4]Department of Internal Medicine, St. Josephs Medical Center Phoenix 出　　处：《World Journal of Gastroenterology》索引2013年第19卷第25期,共6页 摘　　要：AIM: To investigate the prevalence of psychiatric illness in association with functional gastrointestinal disorders using defecating proctography (DP) and validated questionnaires. METHODS: We prospectively evaluated 45 subjects referred for DP using hospital anxiety and depression scale (HADS), state trait anxiety inventory (STAI), patient health questionnaire 15-item somatic symptom severity scale (PHQ-15), validated questionnaires for sexual or physical abuse; post-traumatic stress disorder questionnaire (PTSD) and ROME-Ⅲ questionnaires for gastrointestinal complaints. DP results were considered negative if levator ani function was normal, rectoceles (if any) were < 4 cm and there was no evidence ofintussusception, rectal prolapse, or other anatomic abnormality demonstrated. Subjects were subsequently divided into those with structural defects seen on DP (DP positive group) and those with a normal defecography study (DP negative group). RESULTS: Forty five subjects were included in the study of which 20 subjects were classified as DP negative (44.4%). There was a striking prevalence of a history of sexual abuse in DP negative group compared to the DP positive group (n = 9, 5 respectively; P = 0.036). Further, subjects in the DP negative group scored significantly higher on the HADS anxiety (6.60 ± 1.00 vs 4.72 ± 0.40, P = 0.04) and depression scales (5.72 ± 1.00 vs 3.25 ± 0.46, P = 0.01). This correlated well with significantly higher scores on the STAI state anxiety scale (42.75 ± 3.16vs 35.6 ± 2.00,P = 0.027), PHQ-15 questionnaire (13.15 ± 0.82 vs 10.76 ± 0.97, P = 0.038) and prevalence of PTSD (20%vs 4%,P = 0.045) among DP negative subjects. There was no difference between the groups in terms of STAI trait anxiety. CONCLUSION: The findings of this prospective study demonstrate a significantly high degree of psychiatric ailments in patients with negative findings on DP who should be appropriately screened for a history of sexual abuse and symptoms of psychosocial distress. 关 键 词：Functional GASTROINTESTINAL DISORDERS Sexual ABUSE Defecating proctography POST-TRAUMATIC stress disorder QUESTIONNAIRE