PDF(Pubmed)
Abstract：
OBJECTIVE: Irritable bowel syndrome (IBS) is a diagnosis defined by gastrointestinal (GI) symptoms like abdominal pain and changes associated with defecation. The condition is classified as a disorder of the gut-brain interaction (DGBI), and patients with IBS commonly experience psychological distress. The present study focuses on this distress, defined from reports of fatigue, anxiety, depression, sleep disturbances, and performance on cognitive tests. The aim was to investigate the joint contribution of these features of psychological distress in predicting IBS versus healthy controls (HCs) and to disentangle clinically meaningful subgroups of IBS patients.
METHODS: IBS patients ( n = 49 ) and HCs ( n = 28 ) completed the Chalder Fatigue Scale (CFQ), the Hamilton Anxiety and Depression Scale (HADS), and the Bergen Insomnia Scale (BIS), and performed tests of memory function and attention from the Repeatable Battery Assessing Neuropsychological Symptoms (RBANS). An initial exploratory data analysis was followed by supervised (Random Forest) and unsupervised (K-means) classification procedures.
RESULTS: The explorative data analysis showed that the group of IBS patients obtained significantly more severe scores than HCs on all included measures, with the strongest pairwise correlation between fatigue and a quality measure of sleep disturbances. The supervised classification model correctly predicted belongings to the IBS group in 80% of the cases in a test set of unseen data. Two methods for calculating feature importance in the test set gave mental and physical fatigue and anxiety the strongest weights. An unsupervised procedure with K = 3 showed that one cluster contained 24% of the patients and all but two HCs. In the two other clusters, their IBS members were overall more impaired, with the following differences. One of the two clusters showed more severe cognitive problems and anxiety symptoms than the other, which experienced more severe problems related to the quality of sleep and fatigue. The three clusters were not different on a severity measure of IBS and age.
CONCLUSIONS: The results showed that psychological distress is an integral component of IBS symptomatology. The study should inspire future longitudinal studies to further dissect clinical patterns of IBS to improve the assessment and personalized treatment for this and other patient groups defined as disorders of the gut-brain interaction. The project is registered at https://classic.
RESULTS: gov/ct2/show/NCT04296552 20/05/2019.
METHODS: IBS patients ( n = 49 ) and HCs ( n = 28 ) completed the Chalder Fatigue Scale (CFQ), the Hamilton Anxiety and Depression Scale (HADS), and the Bergen Insomnia Scale (BIS), and performed tests of memory function and attention from the Repeatable Battery Assessing Neuropsychological Symptoms (RBANS). An initial exploratory data analysis was followed by supervised (Random Forest) and unsupervised (K-means) classification procedures.
RESULTS: The explorative data analysis showed that the group of IBS patients obtained significantly more severe scores than HCs on all included measures, with the strongest pairwise correlation between fatigue and a quality measure of sleep disturbances. The supervised classification model correctly predicted belongings to the IBS group in 80% of the cases in a test set of unseen data. Two methods for calculating feature importance in the test set gave mental and physical fatigue and anxiety the strongest weights. An unsupervised procedure with K = 3 showed that one cluster contained 24% of the patients and all but two HCs. In the two other clusters, their IBS members were overall more impaired, with the following differences. One of the two clusters showed more severe cognitive problems and anxiety symptoms than the other, which experienced more severe problems related to the quality of sleep and fatigue. The three clusters were not different on a severity measure of IBS and age.
CONCLUSIONS: The results showed that psychological distress is an integral component of IBS symptomatology. The study should inspire future longitudinal studies to further dissect clinical patterns of IBS to improve the assessment and personalized treatment for this and other patient groups defined as disorders of the gut-brain interaction. The project is registered at https://classic.
RESULTS: gov/ct2/show/NCT04296552 20/05/2019.
摘要：
目的：肠易激综合征（IBS）是由胃肠道（GI）症状如腹痛和排便相关变化定义的诊断。这种情况被归类为一种肠-脑相互作用障碍（DGBI），IBS患者通常会经历心理困扰。本研究的重点是这种痛苦，从疲劳报告中定义，焦虑,抑郁症,睡眠障碍,和认知测试的表现。目的是研究心理困扰的这些特征在预测IBS与健康对照（HCs）方面的共同作用，并解开IBS患者的临床意义亚组。
方法：IBS患者（n=49）和HC（n=28）完成了Chalder疲劳量表（CFQ），汉密尔顿焦虑和抑郁量表（HADS），和卑尔根失眠量表(BIS)，并通过可重复电池评估神经心理学症状（RBANS）进行记忆功能和注意力测试。最初的探索性数据分析之后是有监督的(随机森林)和无监督的(K-均值)分类程序。
结果：探索性数据分析显示，在所有纳入指标上，IBS患者组获得的评分明显高于HC，疲劳与睡眠障碍的质量度量之间的成对相关性最强。在一组未知数据的测试集中，监督分类模型正确地预测了80％的IBS组的归属。在测试集中计算特征重要性的两种方法赋予了精神和身体的疲劳和焦虑最大的权重。K=3的无监督程序显示，一个集群包含24％的患者和除两个以外的所有HC。在另外两个集群中，他们的IBS成员总体上更加受损，具有以下差异。两个集群中的一个比另一个表现出更严重的认知问题和焦虑症状，经历了与睡眠质量和疲劳有关的更严重的问题。这三个集群在IBS和年龄的严重程度上没有差异。
结论：结果显示，心理困扰是IBS症状学的一个组成部分。该研究应激发未来的纵向研究，以进一步剖析IBS的临床模式，以改善对该患者和其他被定义为肠-脑相互作用障碍的患者群体的评估和个性化治疗。该项目已在https://classic注册。
结果：gov/ct2/show/NCT0429655220/05/2019。
方法：IBS患者（n=49）和HC（n=28）完成了Chalder疲劳量表（CFQ），汉密尔顿焦虑和抑郁量表（HADS），和卑尔根失眠量表(BIS)，并通过可重复电池评估神经心理学症状（RBANS）进行记忆功能和注意力测试。最初的探索性数据分析之后是有监督的(随机森林)和无监督的(K-均值)分类程序。
结果：探索性数据分析显示，在所有纳入指标上，IBS患者组获得的评分明显高于HC，疲劳与睡眠障碍的质量度量之间的成对相关性最强。在一组未知数据的测试集中，监督分类模型正确地预测了80％的IBS组的归属。在测试集中计算特征重要性的两种方法赋予了精神和身体的疲劳和焦虑最大的权重。K=3的无监督程序显示，一个集群包含24％的患者和除两个以外的所有HC。在另外两个集群中，他们的IBS成员总体上更加受损，具有以下差异。两个集群中的一个比另一个表现出更严重的认知问题和焦虑症状，经历了与睡眠质量和疲劳有关的更严重的问题。这三个集群在IBS和年龄的严重程度上没有差异。
结论：结果显示，心理困扰是IBS症状学的一个组成部分。该研究应激发未来的纵向研究，以进一步剖析IBS的临床模式，以改善对该患者和其他被定义为肠-脑相互作用障碍的患者群体的评估和个性化治疗。该项目已在https://classic注册。
结果：gov/ct2/show/NCT0429655220/05/2019。
