Razi Journal of Medical Sciences

fa بررسی رویکرد ذهن آگاهی بر درمان سندرم روده تحریک پذیر (IBS) Investigating the Approach of Mindfulness on the Treatment of Irritable Bowel Syndrome (IBS) روانشناسی بالینی Clinical Psychiatry مروري review article <div style="text-align: justify;">زمینه و هدف: سندرم روده تحریک پذیر (Irritable Bowel Syndrome-IBS) یکی از بیماری های شایع گوارشی  است. به نظر می‌رسد عوامل روانشناختی در بروز و تشدید علائم این بیماری نقش قابل توجهی دارند. لذا، پژوهش مروری حاضر با هدف بررسی رویکرد ذهن آگاهی بر درمان (IBS)  انجام شده است. روش کار: برای انجام مرور ابتدا یک پنل مرور متشکل از تیم پژوهش تشکیل شد. پنل مرور در ابتدا پروتکل مرور را توسعه داد. این پروتکل شامل بیانیه هدف، پایگاه های داده مورد نظر، حدود جستجو، اصطلاحات جستجو، معیارهای ورود و خروج، راهبرد جستجو، شیوه استخراج، آنالیز و سنتز داده و نهایتاً شیوه گزارش مروری در بازه زمانی از سال 2002 تا 2020 بود. از کلیدواژه‌های ذهن آگاهی، سندرم روده تحریک پذیر (IBS)، سلامت روان، کیفیت زندگی جهت جستجو استفاده شد. با بررسی منابع تحقیقاتی معتبر در پایگاه‌های اطلاعاتی مذکور، تعداد 20 منبع به عنوان مرجع مرور سیستماتیک انتخاب شد. یافته‌ها: یافته‌ها حاکی از آن است که شناخت درمانی بر مبنای ذهن آگاهی ممکن است از طریق کاهش شناخت ناسازگار بیماری و فعال کردن تغییرات در خودپردازی (کاهش سوگیری در پردازش خودمراجعه کننده بیماری و سلامت و افزایش آگاهی بدون قضاوت) تأثیر خود را بر علائم IBS اعمال کند. نتیجه‌گیری: با توجه به اثر بخشی درمان مبتنی برذهن آگاهی در بهبود کیفیت زندگی بیماران مبتلا به سندرم روده تحریک پذیر در پژوهش های اخیر می توان گفت که درمانگری مبتنی بر ذهن آگاهی موثرترین درمان روانشناختی در درمان سندرم روده تحریک پذیر می‌باشد. بنابرآنچه گفته شد و با توجه به نقش عوامل روانشناختی در سندرم روده تحریک پذیر لزوم به کارگیری روش های موثر و نوین روان درمانی در کاهش نشانه های بیماری غیر قبل نقض می باشد که البته به همراه درمان های دارویی می تواند به بهزیستی جسمانی و روانشناختی افراد مبتلا کمک کند که این نیازمند همکاری بین فوق تخصصین گوارش و روانشناسان وروانپزشکان عزیز می باشد.</div> <div style="text-align: justify;"> Bakcground & Aims: Irritable bowel syndrome is a common disorder that affects a significant portion of the general population and leads to frequent consultations with general practitioners and specialists. Its prevalence is about 10-20% of the general population and it is one of the most common and unknown psychosomatic disorders in the field of digestive diseases. But only half of these people apply for medical treatment. Early symptoms of irritable bowel syndrome include: crampy pain or discomfort in the abdomen, chronic or recurrent constipation, chronic or recurrent diarrhea, with changes in bowel habits. There may also be a feeling of urgency to defecate, a feeling of incomplete emptying, bloating and abdominal distention. It has been found that people with the diagnostic feature of irritable bowel syndrome reveal certain signs of mental health disorders such as anxiety, depression and abnormal personality traits. In this regard, Barish et al. (2019) believe that those chronic patients who have anxiety and mood symptoms are more likely to suffer from subsequent problems, and the probability of recurrence of disease symptoms and their death in the coming months is higher. Experiencing high, continuous and long-term stress in patients with irritable bowel syndrome can lead to inconsistency in the individual, and if the stress and negative emotions experienced by the patient are accompanied by social withdrawal, it will have a great impact on the patient's illness and sleep quality. It also leads to an increase in the severity of symptoms in these patients, which requires appropriate psychological interventions for these patients. In the field of treating psychological problems in chronic diseases such as irritable bowel syndrome, many researches and therapeutic measures have been carried out until now, and in this research, the therapeutic approach of mindfulness is examined. Therefore, the present review research was conducted with the aim of investigating the mindfulness approach on the treatment of irritable bowel syndrome (IBS) (1, 2). Methods: This research is a review study. To conduct the review, a review panel consisting of the research team was formed. The review panel originally developed the review protocol. This protocol included the purpose statement, target databases, search limits, search terms, entry and exit criteria, search strategy, method of data extraction, analysis and synthesis, and finally the review report method. The aim of the search was to investigate the mindfulness approach to the treatment of irritable bowel syndrome (IBS). By examining valid research sources in the mentioned databases, 20 sources were selected as systematic review references. Results: According to the studies conducted, 50-90% of patients with irritable bowel syndrome will experience a psychological disorder such as anxiety disorders, especially generalized anxiety disorder. On the other hand, preliminary evidence has shown that compared to people without this disorder, people with generalized anxiety disorder have a high intensity of emotion, a weaker understanding of emotions, and also a lower ability to relax or soothe themselves after negative emotions. Therefore, it can be concluded that there is a relationship between psychological problems and irritable bowel syndrome, which requires psychological interventions to treat this disease. Considering the role of psychological factors in IBS, the need to pay attention to the use of psychological treatments in reducing the symptoms of the disease is not hidden from anyone, many evidences confirm the use of psychotherapies to improve the symptoms of stomach and intestinal diseases. Psychotherapy has been effective in both of them because usually psychotherapy leads to a reduction of stress and neurological symptoms related to the disease and affects the brain-intestinal axis. Meanwhile, for many years, cognitive behavioral therapy has been considered as the most effective psychological treatment for irritable bowel syndrome. The cognitive-behavioral hypothesis is based on the principle that lifestyle, behavioral patterns, the patient's attitude towards himself and the world are influential in the level of anxiety experienced, and during the evaluation sessions, it will be determined which cognitive and behavioral patterns cause the exacerbation or continuation of IBS symptoms. become It can be said that by changing people's thinking, attitude and behavior in the context of cognitive-behavioral therapy, a person suffering from IBS can deal with the disabilities resulting from his chronic disease in an adaptive way by simultaneously correcting his dysfunctional thoughts and behavior and avoid negative consequences. caused by the disease to overcome to a great extent. The use of mindfulness-based approaches, meditation and acceptance and responsibility-based therapy (ACT) can lead to the reduction of physical symptoms, emotions and finally thoughts, as well as experiential avoidance. In mindfulness-based therapy, first the increase in metacognitive awareness (i.e., the ability to re-understand one's thoughts and emotions and view them as passing events rather than those thoughts as reality), then this An increase in metacognitive awareness is assumed to lead to a reduction in rumination, which is the process of repeating negative thoughts, thereby reducing catastrophizing, rumination, and other symptoms including stress and ineffective and passive coping skills, and ultimately leading to a reduction in symptoms. Irritable bowel syndrome and increase the quality of life of patients (3, 4). Conclusion: Considering the effectiveness of mindfulness-based therapy in improving the quality of life of patients with irritable bowel syndrome in recent researches, it can be said that mindfulness-based therapy is the most effective psychological therapy in the treatment of irritable bowel syndrome. According to what has been said and considering the role of psychological factors in irritable bowel syndrome, it is necessary to use effective and modern psychotherapy methods to reduce the symptoms of the disease, which, of course, together with drug treatments, can improve physical and psychological well-being. To help affected people, this requires cooperation between gastroenterologists, psychologists, and dear psychiatrists.    </div> ذهن آگاهی, سندرم روده تحریک پذیر (IBS), سلامت روان, کیفیت زندگی Mindfulness, Irritable Bowel Syndrome (IBS), Mental Health, Quality of Life 1 23 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7798-2&slc_lang=fa&sid=1 Seyed Alireza Seyed Ebrahimi سیدعلیرضا سید ابراهیمی alireza.healthpsychology@gmail.com 3900319475328460090001 0009-0009-3017-7505 Yes Department of Health Psychology, Faculty of Psychology and Educational Science, University of Tehran, Iran گروه روانشناسی سلامت، دانشکده روانشناسی و علوم تربیتی، دانشگاه تهران، ایران