Systematic review: psychosocial factors associated with pain in inflammatory bowel disease

作者：Louise Sweeney, Rona E Moss-Morris, Wladyslawa Czuber‐Dochan, Laura B. Meade, Gill Chumbley, Christine S Norton · 发表于：Alimentary Pharmacology & Therapeutics · 年份：2018 · DOI：10.1111/apt.14493 · 被引用次数：115 · 研究领域：Inflammatory Bowel Disease、Gastrointestinal motility and disorders、Microscopic Colitis

BACKGROUND: Pain is a frequently reported symptom of inflammatory bowel disease (IBD) experienced by patients in active disease and remission. Psychological factors play a significant role in pain, but have not been systematically reviewed in IBD. AIM: To review psychosocial factors associated with pain in adults diagnosed with IBD. METHODS: Electronic (PsycInfo, MEDLINE, EMBASE, Cochrane Library, CINAHL, Web of Science), and hand-searching were conducted February-May 2017. Two authors carried out screening and data extraction. RESULTS: Fifteen studies including 5539 IBD patients were identified. Emotional, cognitive-behavioural and personality factors were associated with IBD-pain. Depression and anxiety were the most commonly explored constructs, followed by perceived stress and pain catastrophising, all of which were positively associated with greater pain. Greater abdominal pain was associated with a concurrent mood disorder over fivefold (OR 5.76, 95% CI 1.39, 23.89). Coping strategies and pain fear avoidance correlated with pain levels. Perceived social support (r = .26) and internal locus of control (r = .33) correlated with less pain. Patients reporting pain in IBD remission more frequently had an existing diagnosis of a mood disorder, a chronic pain disorder and irritable bowel syndrome. Six studies controlled for disease activity, of which 4 found that psychosocial factors significantly predicted pain. The majority of studies (n = 10) were of high quality. CONCLUSIO...