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首页> 外文期刊>World Journal of Gastroenterology >Functional dyspepsia: are psychosocial factors of relevance?
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Functional dyspepsia: are psychosocial factors of relevance?

机译：功能性消化不良：与心理社会因素有关吗？

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摘要

The pathogenesis of Functional Dyspepsia (FD) remains unclear, appears diverse and is thus inadequately understood. Akin to other functional gastrointestinal disorders, research has demonstrated an association between this common diagnosis and psychosocial factors and psychiatric morbidity. Conceptualising the relevance of these factors within the syndrome of FD requires application of the biopsychosocial model of disease. Using this paradigm, dysregulation of the reciprocal communication between the brain and the gut is central to symptom generation, interpretation and exacerbation. Appreciation and understanding of the neurobiological correlates of various psychological states is also relevant. The view that psychosocial factors exert their influence in FD predominantly through motivation of health care seeking also persists. This appears too one-dimensional an assertion in light of the evidence available supporting a more intrinsic aetiological link. Evolving understanding of pathogenic mechanisms and the heterogeneous nature of the syndrome will facilitate effective management. Co-morbid psychiatric illness warrants treatment with conventional therapies. Acknowledging the relevance of psychosocial variables in FD, the degree of which is subject to variation, has implications for assessment and management. Available evidence suggests psychological therapies may benefit FD patients particularly those with chronic symptoms. The rationale for use of psychotropic medications in FD is apparent but the evidence base to support the use of antidepressant pharmacotherapy is to date limited.
机译：功能性消化不良（FD）的发病机制仍不清楚，似乎是多种多样的，因此未被充分了解。类似于其他功能性胃肠道疾病，研究表明这种常见的诊断与心理社会因素和精神病发病率之间存在关联。在FD综合征中将这些因素的相关性概念化需要应用疾病的生物心理社会模型。使用这种范例，大脑与肠道之间的相互交流失调是症状产生，解释和加剧的关键。对各种心理状态的神经生物学相关性的欣赏和理解也很重要。心理社会因素主要通过寻求医疗的动机在FD中发挥影响的观点也仍然存在。根据现有证据支持更内在的病因学联系，这似乎是一维的断言。对致病机制和综合征的异质性的不断发展的理解将有助于有效的治疗。合并症的精神疾病需要常规治疗。承认心理社会变量在FD中的相关性，其程度可能会发生变化，这对评估和管理具有影响。现有证据表明，心理疗法可能会使FD患者受益，尤其是那些患有慢性症状的患者。 FD中使用精神药物的基本原理是显而易见的，但迄今为止，支持抗抑郁药物治疗的证据基础有限。

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