| 1 | Personality traits and emotional patterns in irritable bowel syndrome显示文摘The review focuses on those personality traits(neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness), constructs(alexithymia and distressed- Type D personality) and emotional patterns(negative and positive) that are of particular concern in health psychology, with the aim to highlight their potential role on the pathogenesis, onset, symptom clusters, clinical course, and outcome of irritable bowel syndrome(IBS). Personality traits and emotional patterns play key roles in affecting autonomic, immune, inflammatory, and endocrine functions, thus contributing not only to IBS clinical expression and symptomatic burden, but also to disease physiopathology. In this sense, psychological treatments should address those personality traits and emotional features that are constitutive of, and integral to IBS. The biopsychosocial model of illness applied to IBS acknowledges the interaction between biological, psychological, environmental, and social factors in relation to pain and functional disability. A holistic approach to IBS should take into account the heterogeneous nature of the disorder, and differentiate treatments for different types of IBS, also considering the marked individual differences in prevalent personality traits and emotional patterns. Beyond medications, and lifestyle/dietary interventions, psychological and educational treatments may provide the optimal chance of addressing clinical symptoms, comorbid conditions, and quality of life in IBS patients. | Maria Rosaria A Muscatello Antonio Bruno Carmela Mento Gianluca Pandolfo Rocco A Zoccali | 2016 | World Journal of Gastroenterology2016，22，28： | 7 |
| 2 | Perceived risk as a barrier to appropriate diagnosis of irritable bowel syndrome显示文摘AIM:To evaluate perceived risk,diagnostic testing,and acceptance of a diagnosis of irritable bowel syndrome(IBS)among the Korean laypersons.METHODS:We designed a conceptual framework to evaluate the health-seeking behavior of subjects based on a knowledge,attitude,and practice model.We developed a vignette-based questionnaire about IBS based on a literature review and focused group interviews.The vignette described a 40-year-old woman who meets the RomeⅢcriteria for IBS without red-flag signs.It was followed by questions about demographic characteristics,health behaviors,IBS symptoms,risk perception,perceived need for diagnostic tests,and acceptance of a positive diagnosis of IBS.Weplanned a nationwide survey targeting laypersons without IBS and between the ages of 20 and 69 years.Survey participants were selected by quota sampling stratified by gender,age,and nationwide location.A multivariate logistic model was constructed based on literature reviews,univariate analysis,and a stepwise selection method to investigate correlations between the perceived risk,need for diagnostic tests,and acceptance of a positive diagnosis.RESULTS:Of 2354 eligible households,1000 subjects completed the survey and 983 subjects were analyzed,excluding those who met symptom criteria for IBS.After reading the IBS vignette,the majority of subjects(86.8%)responded that the patient was at increased risk of severe disease.The most frequent concern was colon cancer(59.8%),followed by surgical condition(51.5%).Most subjects responded the patient needs diagnostic tests(97.2%).Colonoscopy was the most commonly required test(79.5%).Less than half of the respondents requested a stool examination(45.0%),blood test(40.7%),abdominal ultrasound(36.0%),or computed tomography(20.2%).The subjects who felt increased risk were more likely to see a need for colonoscopy[adjusted odds ratio(a OR)=2.10,95%CI:1.38-3.18].When asked about the positive diagnosis,the most frequent response was that'the patient would not be reassured'(65.7%).The increased risk perception group was less likely to be reassured by a positive diagnosis of IBS,compared to the other respondents(a OR=0.52,95%CI:0.34-0.78).CONCLUSION:For IBS diagnosis,increased risk perception is a possible barrier to the appropriate use of diagnostic tests and to the patient’s acceptance of a positive diagnosis. | Eunmi Ahn Ki Young Son Dong Wook Shin Min Kyu Han Hyejin Lee Ah Reum An Eun Ho Kim Be Long Cho | 2014 | World Journal of Gastroenterology2014，20，48： | 2 |
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