Dynamic Relationship between Severity of Gastrointestinal Symptoms and Psychological Stress among Teachers after the Lushan Earthquake_West China Medical Journal

Authors：

 ZhangYe ¹ ,  ZhangJun ¹ , ZhuShenyue ² , TianYulian ³ , YangHengwei ⁴ , ChenDechao ¹ , GongYao ¹ , ChenRan ¹

1. Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Education Supervision Department, Baoxing County Education Bureau, Ya'an, Sichuan 625700, P. R. China;
3. Department of Nursing, People'Hospital of Baoxing County, Ya, an, Sichuan 625700, P. R. China;
4. Department of Psychiatry, Chinese Traditional Medicine Hospital of Anyue County, Ziyang, Sichuan 642350, P. R. China;

Corresponding?author：

ZhangJun, Email: zh2000jun2000@163.com

Keywords：

Psychological; Stress; Digestive system; Earthquake

DOI：

10.7507/1002-0179.20160079

Video：

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Objective To explore the relationship between severity of gastrointestinal symptoms and psychological stress after the earthquake. Methods The sample was teachers from Baoxing county which was most affected by the earthquake. Post-traumatic stress disorder checklist civilian version (PCL-C) scale was used to assess the symptoms of psychological stress at 2-3 weeks, 2-3 months, and 6 months after the earthquake, and gastrointestinal symptoms were evaluated using three questions of patient health questionare (PHQ)-15 at 2-3 months and 6 months after the earthquake. Spearman rank correlation was used to explore the dynamic relationship between the symptoms of psychological stress evaluated at the three waves and gastrointestinal symptoms evaluated at 2-3 months and 6 months after the earthquake. Results Prevalence rates of gastrointestinal symptoms in teachers were 6.7% and 4.7% for stomach and abdominal pain, 6.7% and 5.6% for constipation and diarrhea, and 9.1% and 8.1% for nausea and gastrointestinal flatulence or dyspepsia at 2-3 months and 6 months after the earthquake. The relationships between three gastrointestinal symptoms evaluated at 2-3 months and 6 months after the earthquake and psychological stress symptoms evaluated at the three waves were all significant (all P<0.05). Conclusion Gastrointestinal symptoms are common among the teachers. The association between psychological stress symptoms and severity of gastrointestinal symptoms at the same point after the earthquake is most strong, and psychological stress symptoms in the early period can predict the severity of subsequent gastrointestinal symptoms, and gastrointestinal symptoms in the early period can predict symptoms of subsequent psychological stress.

Citation： ZhangYe, ZhangJun, ZhuShenyue, TianYulian, YangHengwei, ChenDechao, GongYao, ChenRan. Dynamic Relationship between Severity of Gastrointestinal Symptoms and Psychological Stress among Teachers after the Lushan Earthquake. West China Medical Journal, 2016, 31(2): 297-300. doi: 10.7507/1002-0179.20160079 Copy

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2.	Sastre J. Special issue on "oxidative stress and redox signaling in the gastrointestinal tract and related organs"[J]. Free Radic Res, 2013, 47(11):851-853.
3.	Neria Y, Nandi A, Galea S. Post-traumatic stress disorder following disasters:a systematic review[J]. Psychol Med, 2008, 38(4):467-480.
4.	Xu J, Song X. Posttraumatic stress disorder among survivors of the Wenchuan earthquake 1 year after:prevalence and risk factors[J]. Compr Psychiatry, 2011, 52(4):431-437.
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7.	王友平. 應激與上消化道潰瘍[J]. 臨床薈萃, 1988, 4(7):294-295.
8.	Gulewitsch MD, Enck P, Schwille-Kiuntke J, et al. Mental strain and chronic stress among university students with symptoms of irritable bowel syndrome[J]. Gastroenterol Res Pract, 2013:206574.
9.	于顯釗. 應激與功能性腸病[J]. 武警醫學, 2010, 21(9):807-809.
10.	李明陽, 王志強, 孫剛, 等. 軍人在汶川地震中功能性胃腸病發病的調查及相關因素[J]. 世界華人消化雜志, 2010, 18(15):1594-1597.
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13.	Kim YJ, Kim EH, Hahm KB. Oxidative stress in inflammation-based gastrointestinal tract diseases:challenges and opportunities[J]. J Gastroenterol Hepatol, 2012, 27(6):1004-1010.
14.	Lambert GP. Stress-induced gastrointestinal barrier dysfunction and its inflammatory effects[J]. J Anim Sci, 2009, 87(Suppl 14):E101-E108.
15.	Papatheodoridis GV, Karamanolis DG. Prevalence and impact of upper and lower gastrointestinal symptoms in the Greek urban general population[J]. Scand J Gastroenterol, 2005, 40(4):412-421.
16.	Stanghellini V. Three-month prevalence rates of gastrointestinal symptoms and the influence of demographic factors:results from the domestic/international gastroenterology surveillance Study (DIGEST)[J]. Scand J Gastroenterol Suppl, 1999, 231:20-28.
17.	Yang SY, Lee OY, Bak YT, et al. Prevalence of gastroesophageal reflux disease symptoms and uninvestigated dyspepsia in Korea:a population-based study[J]. Dig Dis Sci, 2008, 53(1):188-193.
18.	Ruggiero KJ, Del Ben K, Scotti JR, et al. Psychometric properties of the PTSD Checklist-Civilian Version[J]. J Trauma Stress, 2003, 16(5):495-502.
19.	Conybeare D, Behar E, Solomon A, et al. The PTSD Checklist-Civilian version:reliability, validity, and factor structure in a nonclinical sample[J]. J Clin Psychol, 2012, 68(6):699-713.
20.	楊曉云, 楊宏愛, 劉啟貴, 等. 創傷后應激檢查量表平民版的效度、信度及影響因素的研究[J]. 中國健康心理學雜志, 2007, 15(1):6-9.
21.	Kroenke K, Spitzer RL, Williams JB. The PHQ-15:validity of a new measure for evaluating the severity of somatic symptoms[J]. Psychosom Med, 2002, 64(2):258-266.
22.	李曉靖, 張嵐, 李斌. 成都市綜合醫院門診患者抑郁、焦慮障礙診治狀況研究[J]. 華西醫學, 2011, 26(2):192-194.
23.	李明陽, 朱敏, 王志強, 等. 地震災區居民消化道癥狀與睡眠障礙的關系[J]. 中華內科雜志, 2010, 49(12):1032-1034.
24.	韓聚強, 李恕軍, 馮軍, 等. 震后災區居民胃腸道應激癥狀現況調查[J]. 中國健康教育, 2009, 25(4):278-279, 282.
25.	Suarez K, Mayer C, Ehlert U, et al. Psychological stress and self-reported functional gastrointestinal disorders[J]. J Nerv Ment Dis, 2010, 198(3):226-229.
26.	Shen L, Kong H, Hou X. Prevalence of irritable bowel syndrome and its relationship with psychological stress status in Chinese university students[J]. J Gastroenterol Hepatol, 2009, 24 (12):1885-1890.
27.	Knowles SR, Nelson EA, Palombo EA. Investigating the role of perceived stress on bacterial flora activity and salivary cortisol secretion:a possible mechanism underlying susceptibility to illness[J]. Biol Psychol, 2008, 77(2):132-137.
28.	趙洪巖, 喬菲. 上消化道出血合并創傷后應激障礙的相關因素分析[J]. 慢性病學雜志, 2010, 12(12):1657-1659.

1. Hartono JL, Mahadeva S, Goh KL. Anxiety and depression in various functional gastrointestinal disorders:do differences exist?[J]. J Dig Dis, 2012, 13(5):252-257.
2. Sastre J. Special issue on "oxidative stress and redox signaling in the gastrointestinal tract and related organs"[J]. Free Radic Res, 2013, 47(11):851-853.
3. Neria Y, Nandi A, Galea S. Post-traumatic stress disorder following disasters:a systematic review[J]. Psychol Med, 2008, 38(4):467-480.
4. Xu J, Song X. Posttraumatic stress disorder among survivors of the Wenchuan earthquake 1 year after:prevalence and risk factors[J]. Compr Psychiatry, 2011, 52(4):431-437.
5. Cheng Z, Ma N, Yang L, et al. Depression and posttraumatic stress disorder in temporary settlement residents 1 year after the Sichuan earthquake[J]. Asia Pac J Public Health, 2015, 27(2):NP1962-NP1972.
6. Pan X, Liu W, Deng G, et al. Symptoms of posttraumatic stress disorder, depression, and anxiety among junior high school students in worst-hit areas 3 years after the Wenchuan earthquake in China[J]. Asia Pac J Public Health, 2015, 27(2):NP1985-NP1994.
7. 王友平. 應激與上消化道潰瘍[J]. 臨床薈萃, 1988, 4(7):294-295.
8. Gulewitsch MD, Enck P, Schwille-Kiuntke J, et al. Mental strain and chronic stress among university students with symptoms of irritable bowel syndrome[J]. Gastroenterol Res Pract, 2013:206574.
9. 于顯釗. 應激與功能性腸病[J]. 武警醫學, 2010, 21(9):807-809.
10. 李明陽, 王志強, 孫剛, 等. 軍人在汶川地震中功能性胃腸病發病的調查及相關因素[J]. 世界華人消化雜志, 2010, 18(15):1594-1597.
11. Veenstra RP, Geelkerken RH, Verhorst PM, et al. Acute stress-related gastrointestinal ischemia[J]. Digestion, 2007, 75(4):205-207.
12. Huerta-Franco MR, Vargas-Luna M, Tienda P, et al. Effects of occupational stress on the gastrointestinal tract[J]. World J Gastrointest Pathophysiol, 2013, 4(4):108-118.
13. Kim YJ, Kim EH, Hahm KB. Oxidative stress in inflammation-based gastrointestinal tract diseases:challenges and opportunities[J]. J Gastroenterol Hepatol, 2012, 27(6):1004-1010.
14. Lambert GP. Stress-induced gastrointestinal barrier dysfunction and its inflammatory effects[J]. J Anim Sci, 2009, 87(Suppl 14):E101-E108.
15. Papatheodoridis GV, Karamanolis DG. Prevalence and impact of upper and lower gastrointestinal symptoms in the Greek urban general population[J]. Scand J Gastroenterol, 2005, 40(4):412-421.
16. Stanghellini V. Three-month prevalence rates of gastrointestinal symptoms and the influence of demographic factors:results from the domestic/international gastroenterology surveillance Study (DIGEST)[J]. Scand J Gastroenterol Suppl, 1999, 231:20-28.
17. Yang SY, Lee OY, Bak YT, et al. Prevalence of gastroesophageal reflux disease symptoms and uninvestigated dyspepsia in Korea:a population-based study[J]. Dig Dis Sci, 2008, 53(1):188-193.
18. Ruggiero KJ, Del Ben K, Scotti JR, et al. Psychometric properties of the PTSD Checklist-Civilian Version[J]. J Trauma Stress, 2003, 16(5):495-502.
19. Conybeare D, Behar E, Solomon A, et al. The PTSD Checklist-Civilian version:reliability, validity, and factor structure in a nonclinical sample[J]. J Clin Psychol, 2012, 68(6):699-713.
20. 楊曉云, 楊宏愛, 劉啟貴, 等. 創傷后應激檢查量表平民版的效度、信度及影響因素的研究[J]. 中國健康心理學雜志, 2007, 15(1):6-9.
21. Kroenke K, Spitzer RL, Williams JB. The PHQ-15:validity of a new measure for evaluating the severity of somatic symptoms[J]. Psychosom Med, 2002, 64(2):258-266.
22. 李曉靖, 張嵐, 李斌. 成都市綜合醫院門診患者抑郁、焦慮障礙診治狀況研究[J]. 華西醫學, 2011, 26(2):192-194.
23. 李明陽, 朱敏, 王志強, 等. 地震災區居民消化道癥狀與睡眠障礙的關系[J]. 中華內科雜志, 2010, 49(12):1032-1034.
24. 韓聚強, 李恕軍, 馮軍, 等. 震后災區居民胃腸道應激癥狀現況調查[J]. 中國健康教育, 2009, 25(4):278-279, 282.
25. Suarez K, Mayer C, Ehlert U, et al. Psychological stress and self-reported functional gastrointestinal disorders[J]. J Nerv Ment Dis, 2010, 198(3):226-229.
26. Shen L, Kong H, Hou X. Prevalence of irritable bowel syndrome and its relationship with psychological stress status in Chinese university students[J]. J Gastroenterol Hepatol, 2009, 24 (12):1885-1890.
27. Knowles SR, Nelson EA, Palombo EA. Investigating the role of perceived stress on bacterial flora activity and salivary cortisol secretion:a possible mechanism underlying susceptibility to illness[J]. Biol Psychol, 2008, 77(2):132-137.
28. 趙洪巖, 喬菲. 上消化道出血合并創傷后應激障礙的相關因素分析[J]. 慢性病學雜志, 2010, 12(12):1657-1659.

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Dynamic Relationship between Severity of Gastrointestinal Symptoms and Psychological Stress among Teachers after the Lushan Earthquake

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