Prevalência do uso de psicofármacos em um ambulatório universitário de gastroenterologia no sul do Brasil e a associação com doenças funcionais entre 2020 e 2022.
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Data
2024-06
Tipo de documento
Artigo Científico
Título da Revista
ISSN da Revista
Título de Volume
Área do conhecimento
Modalidade de acesso
Acesso fechado
Editora
Autores
REIS, Ana Beatriz dos
PIRES, Jenypher de Oliveira
Orientador
JUNIOR, Pedro Docusse
Coorientador
JUNIOR, Nelson Silveira Cathcart
Resumo
Contexto: O trato gastrointestinal e o cérebro estão intimamente conectados por meio de vias neurais, endócrinas e imunológicas bidirecionais, constituindo o eixo cérebro-intestino. A obtenção de um tratamento eficaz para as enfermidades também denominadas como funcionais ainda é um desafio atualmente. Os psicofármacos têm se tornado opções terapêuticas viáveis para o tratamento das doenças do eixo cérebro-intestino (DECI), especialmente quando os tratamentos convencionais não são eficazes, sugerindo mecanismos de doença compartilhados ou interativos, possivelmente relacionados à comunicação proposta deste eixo. Objetivos: Identificar a prevalência do uso de psicofármacos em um ambulatório universitário de gastroenterologia do sul do país e associar com a presença de doenças funcionais. Métodos: Estudo transversal analítico com 514 prontuários de pacientes do Ambulatório Universitário de Gastroenterologia da Universidade do Sul de Santa Catarina (UNISUL), entre julho de 2020 e julho de 2022. As variáveis dependentes foram o uso de psicotrópicos e o diagnóstico de doença funcional. As variáveis independentes incluíram idade, sexo, exames complementares e sintomas gastrointestinais. Realizou-se análise estatística descritiva com frequências para dados qualitativos e medidas de tendência central e dispersão para dados quantitativos. A análise bivariada foi realizada por meio do teste qui-quadrado (IC95%). Resultados: A maioria dos pacientes era do sexo feminino (64,8%), com idade média de 51,8 anos. Utilizando critérios do ROMA IV, 54,9% dos pacientes atendiam aos critérios para doenças funcionais. Observou-se que 31,3% dos participantes faziam uso de psicofármacos, principalmente ISRS (57,2%). Foi constatada uma associação estatística entre o diagnóstico de doença funcional registrado em prontuário e o uso de psicotrópicos (p = 0,034). Discussão: Os psicofármacos podem agir de forma periférica, reduzindo a hipersensibilidade visceral e a resposta à dor no nível intestinal, ao passo que agem no SNC modulando neurotransmissores e auxiliando na melhora do quadro psíquico e na percepção dolorosa. Transtornos psiquiátricos comuns, como ansiedade e depressão, foram identificados, destacando a importância do tratamento multidisciplinar. Uma associação bidirecional entre transtornos psiquiátricos e doenças funcionais gastrointestinais foi sugerida. O estudo contribui para uma compreensão mais ampla dessas interações complexas, enfatizando a necessidade de abordagens terapêuticas integrais. Conclusão: Este estudo destacou uma alta prevalência de pacientes em uso de psicotrópicos, com uma associação estatisticamente significativa entre o uso desses medicamentos e o diagnóstico de doença funcional registrado em prontuário, sugerindo que a abordagem terapêutica para essas condições frequentemente envolve o tratamento de sintomas psicológicos e gastrointestinais de forma concomitante. Estudos adicionais são necessários para estabelecer associações causais e melhorar a abordagem clínica desses pacientes.
Context: The gastrointestinal tract and the brain are intimately connected through bidirectional neural, endocrine and immunological pathways, constituting the brain-gut axis. Obtaining an effective treatment for diseases also known as functional is still a challenge today. Psychotropic drugs have become viable therapeutic options for the treatment of diseases of the brain-gut axis (GIFD), especially when conventional treatments are not effective, suggesting shared or interactive disease mechanisms, possibly related to the proposed communication of this axis. Objectives: To identify the prevalence of psychotropic drug use in a university gastroenterology outpatient clinic in the south of the country and associate it with the presence of functional diseases. Methods: Analytical cross-sectional study with 514 patient records from the University Ambulatory of Gastroenterology at the University of Southern Santa Catarina (UNISUL), between July 2020 and July 2022. The dependent variables were the use of psychotropic drugs and the diagnosis of functional disease. Independent variables included age, sex, complementary exams and gastrointestinal symptoms. Descriptive statistical analysis was performed with frequencies for qualitative data and measures of central tendency and dispersion for quantitative data. Bivariate analysis was performed using the chi-square test (95% CI). Results: The majority of patients were female (64.8%), with a mean age of 51.8 years. Using ROME IV criteria, 54.9% of patients met criteria for functional diseases. It was observed that 31.3% of participants used psychotropic drugs, mainly SSRIs (57.2%). A statistical association was found between the diagnosis of functional disease recorded in the medical record and the use of psychotropic drugs (p = 0.034). Discussion: Psychotropic drugs can act peripherally, reducing visceral hypersensitivity and the response to pain at the intestinal level, while they act in the CNS, modulating neurotransmitters and helping to improve the psychological condition and pain perception. Common psychiatric disorders such as anxiety and depression have been identified, highlighting the importance of multidisciplinary treatment. A bidirectional association between psychiatric disorders and functional gastrointestinal diseases has been suggested. The study contributes to a broader understanding of these complex interactions, emphasizing the need for comprehensive therapeutic approaches. Conclusion: This study highlighted a high prevalence of patients using psychotropic drugs, with a statistically significant association between the use of these medications and the previous diagnosis of functional illness, suggesting that the therapeutic approach for these conditions often involves the treatment of psychological and gastrointestinal symptoms concomitantly. Additional studies are needed to establish causal associations and improve the clinical management of these patients.
Context: The gastrointestinal tract and the brain are intimately connected through bidirectional neural, endocrine and immunological pathways, constituting the brain-gut axis. Obtaining an effective treatment for diseases also known as functional is still a challenge today. Psychotropic drugs have become viable therapeutic options for the treatment of diseases of the brain-gut axis (GIFD), especially when conventional treatments are not effective, suggesting shared or interactive disease mechanisms, possibly related to the proposed communication of this axis. Objectives: To identify the prevalence of psychotropic drug use in a university gastroenterology outpatient clinic in the south of the country and associate it with the presence of functional diseases. Methods: Analytical cross-sectional study with 514 patient records from the University Ambulatory of Gastroenterology at the University of Southern Santa Catarina (UNISUL), between July 2020 and July 2022. The dependent variables were the use of psychotropic drugs and the diagnosis of functional disease. Independent variables included age, sex, complementary exams and gastrointestinal symptoms. Descriptive statistical analysis was performed with frequencies for qualitative data and measures of central tendency and dispersion for quantitative data. Bivariate analysis was performed using the chi-square test (95% CI). Results: The majority of patients were female (64.8%), with a mean age of 51.8 years. Using ROME IV criteria, 54.9% of patients met criteria for functional diseases. It was observed that 31.3% of participants used psychotropic drugs, mainly SSRIs (57.2%). A statistical association was found between the diagnosis of functional disease recorded in the medical record and the use of psychotropic drugs (p = 0.034). Discussion: Psychotropic drugs can act peripherally, reducing visceral hypersensitivity and the response to pain at the intestinal level, while they act in the CNS, modulating neurotransmitters and helping to improve the psychological condition and pain perception. Common psychiatric disorders such as anxiety and depression have been identified, highlighting the importance of multidisciplinary treatment. A bidirectional association between psychiatric disorders and functional gastrointestinal diseases has been suggested. The study contributes to a broader understanding of these complex interactions, emphasizing the need for comprehensive therapeutic approaches. Conclusion: This study highlighted a high prevalence of patients using psychotropic drugs, with a statistically significant association between the use of these medications and the previous diagnosis of functional illness, suggesting that the therapeutic approach for these conditions often involves the treatment of psychological and gastrointestinal symptoms concomitantly. Additional studies are needed to establish causal associations and improve the clinical management of these patients.
Palavras-chave
Psicotrópicos, Psicofármacos, Gastroenteropatias, Doenças funcionais, Doenças gastrointestinais, Eixo cérebro-intestino