肠脑交互紊乱的诊断分类系统应包括心理症状。

IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Neurogastroenterology and Motility Pub Date : 2024-10-25 DOI:10.1111/nmo.14940
Michael P Jones, Gerald J Holtmann, Jan Tack, Florencia Carbonne, William Chey, Natasha Koloski, Ayesha Shah, Shrikant I Bangdiwala, Ami D Sperber, Olafur S Palsson, Nicholas J Talley
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引用次数: 0

摘要

背景和目的:被称为 "肠脑互动障碍"(DGBI)的一组疾病最初被称为功能性胃肠道疾病,并被认为是胃肠道疾病合并多种心理疾病。尽管有越来越多的证据表明,心理疾病在 DGBI 的病因和维持过程中起着先天性的作用,但罗马 IV 标准中却没有任何一项包含对心理症状的测量。本研究对以下假设进行了测试:如果仅考虑消化道症状,与将消化道症状与心理症状相结合,个体的聚类会有所不同:方法:数据来自罗马基金会全球流行病学研究(Rome Foundation Global Epidemiology Study),该研究测量了罗马IV型消化道症状、心理测量和人口特征。主要结果:根据(i)仅有胃肠道症状(仅有胃肠道症状)和(ii)胃肠道症状和心理测量(胃肠道症状 + 心理),使用潜伏特征分析模型对个体进行聚类:主要结果:无论是仅根据胃肠道症状还是根据胃肠道症状+心理症状,个体聚类为同一群体的比例从两类解决方案(最简单的)的 96%到 6 类解决方案(最合理的系统)的 76%,以及 22 类解决方案(模拟罗马四)的 59%不等。这一发现在六个地理区域之间的普遍性得到了证实,2 个群组的吻合率为 95%-97%,6 个等级的吻合率为 71%-79%,22 个等级的吻合率为 51%-63%。这些结果在 DGBI(2 个班级为 94%,22 个班级为 50%)和非 DGBI(2 个班级为 97%,22 个班级为 65%)组之间也是一致的:我们的数据表明,考虑心理症状和胃肠道症状将导致在更复杂、更准确的分类系统中对个体进行不同的聚类。因此,未来的 DGBI 分类工作应考虑纳入心理特征。
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Diagnostic classification systems for disorders of gut-brain interaction should include psychological symptoms.

Background and aims: The group of disorders known as Disorders of Gut Brain Interaction (DGBI) were originally labeled functional GI disorders and were thought to be disorders of the gastrointestinal tract that had several psychological conditions as comorbidities. Despite mounting evidence that psychological morbidity plays an innate role in the etiology and maintenance of DGBI, none of the Rome IV criteria include any measure of psychological symptoms. This study tested the hypothesis that individuals would cluster differently if GI symptoms alone were considered versus GI symptoms combined with measures of psychological symptoms.

Methods: Data were obtained from the Rome Foundation Global Epidemiology Study measuring Rome IV GI symptoms, psychological measures and demographic characteristics. Latent profile models were used to cluster individuals based on (i) GI symptoms only (GI only) and then (ii) GI and psychological measures (GI + Psych).

Key results: Individuals clustering into the same group of individuals whether formed via GI only or GI + Psych, ranged from 96% for a 2-class solution (the most simplistic) to 76% with 6 classes (the parsimonious system) and 59% with twenty-two classes (mimicking Rome IV). The generalisability of this finding between six geographic regions was confirmed with agreement varying between 95%-97% for 2 clusters and 71-79% for 6 classes and 51%-63% for 22 classes. These findings were also consistent between DGBI (range 94% with 2 classes to 50% with 22 classes) and non-DGBI (range 97% with 2 clusters to 65% with 22 classes) groups.

Conclusions & inferences: Our data suggest that considering psychological as well as gastrointestinal symptoms would lead to a different clustering of individuals in more complex, and accurate, classification systems. For this reason, future work on DGBI classification should consider inclusion of psychological traits.

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来源期刊
Neurogastroenterology and Motility
Neurogastroenterology and Motility 医学-临床神经学
CiteScore
7.80
自引率
8.60%
发文量
178
审稿时长
3-6 weeks
期刊介绍: Neurogastroenterology & Motility (NMO) is the official Journal of the European Society of Neurogastroenterology & Motility (ESNM) and the American Neurogastroenterology and Motility Society (ANMS). It is edited by James Galligan, Albert Bredenoord, and Stephen Vanner. The editorial and peer review process is independent of the societies affiliated to the journal and publisher: Neither the ANMS, the ESNM or the Publisher have editorial decision-making power. Whenever these are relevant to the content being considered or published, the editors, journal management committee and editorial board declare their interests and affiliations.
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