对肠-大脑相互作用障碍的诊断分类系统应包括心理症状
Michael P Jones1, Gerald J Holtmann2, Jan Tack3
1School of Psychological Sciences, Macquarie University, North Ryde, New South Wales, Australia.
Neurogastroenterology and motility
|October 25, 2024
概括
将心理症状与胃肠道 (GI) 症状相结合,可以更准确地对肠脑相互作用障碍 (DGBI) 进行分类. 这种方法改进了患者分组,以更好地理解和治疗DGBI.
科学领域:
- 胃肠病学 胃肠病学
- 精神病学是一个精神病学.
- 医学诊断 医学诊断 医学诊断
背景情况:
- 肠脑相互作用障碍 (DGBI) 以前被称为功能性肠胃障碍,而心理状况被认为是并发症.
- 目前对DGBI的罗马IV标准缺乏对心理症状的措施,尽管有证据表明它们在DGBI病因和维护中的作用.
研究的目的:
- 为了测试这个假设,当考虑胃肠道 (GI) 症状单独与GI症状与心理措施相结合时,对个体的聚类不同.
- 评估包括心理症状在DGBI分类准确性的影响.
主要方法:
- 利用罗马基金会全球流行病学研究的数据.
- 采用潜伏的个人资料模型,以 (i) 仅基于GI症状,以及 (ii) 基于GI和心理测量 (GI+Psych) 的个人进行集群.
主要成果:
- 当将GI-only集群与GI+Psych集群在不同的类解决方案 (2至22类) 中进行比较时,观察到高一致性 (59-96%).
- 在六个地理区域和DGBI和非DGBI组之间确认了通用性,随着类数量的增加,一致性下降.
- 最复杂的分类 (22类) 显示了最低的同意率 (51-63%),这表明心理因素对详细分类的影响很大.
结论:
- 将心理症状整合到分类系统中,可以对患有DGBI的个体进行不同的,可能更准确的分组.
- 未来对DGBI分类的研究应该纳入心理特征,以改善诊断和治疗策略.
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