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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >To 'lump' or to 'split' the functional somatic syndromes: can infectious and emotional risk factors differentiate between the onset of chronic fatigue syndrome and irritable bowel syndrome?
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To 'lump' or to 'split' the functional somatic syndromes: can infectious and emotional risk factors differentiate between the onset of chronic fatigue syndrome and irritable bowel syndrome?

机译：使“身体肿块”或“分裂”功能性躯体综合症：传染病和情绪危险因素能否区分慢性疲劳综合症和肠易激综合症？

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OBJECTIVES: Recent academic debate has centered on whether functional somatic syndromes should be defined as separate entities or as one syndrome. The aim of this study was to investigate whether there may be significant differences in the etiology or precipitating factors associated with two common functional syndromes, irritable bowel syndrome (IBS) and chronic fatigue syndrome (CFS). METHODS: We prospectively studied 592 patients with an acute episode of Campylobacter gastroenteritis and 243 with an acute episode of infectious mononucleosis who had no previous history of CFS or IBS. At the time of infection, patients completed a baseline questionnaire that measured their levels of distress using the Hospital Anxiety and Depression scale. At 3- and 6-month follow-up, they completed questionnaires to determine whether they met published diagnostic criteria for chronic fatigue (CF), CFS, and/or IBS. RESULTS: The odds of developing IBS were significantly greater post-Campylobacter than post-infectious mononucleosis at both 3- (odds ratio, 3.45 [95% confidence interval (CI), 1.75-6.67]) and 6- (2.22 [95% CI, 1.11-6.67]) month follow-up. In contrast, the odds for developing CF/CFS were significantly greater after infectious mononucleosis than after Campylobacter at 3 (2.77 [95% CI, 1.08-7.11]) but not 6 (1.48 [95% CI, 0.62-3.55]) months postinfection. Anxiety and depression were the strongest predictors of CF/CFS, whereas the nature of the infection was the strongest predictor of IBS. CONCLUSIONS: These results support the argument to distinguish between postinfectious IBS and CFS. The nature of the precipitating infection appears to be important, and premorbid levels of distress appear to be more strongly associated with CFS than IBS, particularly levels of depression.
机译：目的：最近的学术辩论集中在功能性躯体综合症应定义为单独的实体还是一种综合症。这项研究的目的是调查在与两种常见的功能综合症，肠易激综合症（IBS）和慢性疲劳综合症（CFS）相关的病因或诱发因素上是否可能存在显着差异。方法：我们前瞻性研究了592例急性弯曲杆菌性胃肠炎和243例传染性单核细胞增多症的急性发作，这些患者以前没有CFS或IBS病史。在感染时，患者填写了一份基线调查表，使用医院焦虑和抑郁量表测量了他们的痛苦程度。在3个月和6个月的随访中，他们完成了问卷调查，以确定他们是否满足慢性疲劳（CF），CFS和/或IBS的诊断标准。结果：在3-（优势比，3.45 [95％置信区间（CI），1.75-6.67]）和6--（2.22 [95％CI]时，发生弯曲杆菌后IBS的几率明显大于感染后单核细胞增多症。 ，1.11-6.67]）个月的随访。相比之下，在感染后3个月（2.77 [95％CI，1.08-7.11]）感染单核细胞增多症后发展CF / CFS的几率显着大于弯曲杆菌后，但在感染后6个月（1.48 [95％CI，0.62-3.55]）则没有。 。焦虑和抑郁是CF / CFS的最强预测因子，而感染的性质是IBS的最强预测因子。结论：这些结果支持区分感染后IBS和CFS的观点。诱发感染的性质似乎很重要，而病态发作前的痛苦水平似乎比IBS与CFS的关联性更强，尤其是抑郁症的程度。

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