| [ Summary ] |
"Psychiatric therapy is composed of psychotherapy and psychotropic therapy. These therapies are typically performed by psychiatric specialists and clinical psychotherapists. However, it might be necessary for gastroenterologists to care for patients with functional gastrointestinal disorders (FGID) from a psychological viewpoint as well as a biological viewpoint, due to the high prevalence of psychological problems amongst these patients and the proven efficacy of a bio‒psychological approach to treatment. However, the "psychosocial alarm questionnaire for FGID" may indicate that a patient has a more serious psychological problem, suggesting that the physician should consider referring the patient to a mental health professional. Statements in the "Clinical Guideline of FGID 2014" edited by the Japanese Society of Gastroenterology, demonstrate that psychotherapy and some psychotropic medicines are effective, and propose their use for patients with functional dyspepsia (FD) and irritable bowel syndrome (IBS). Of note, hypnotherapy has been proven to be effective and to have a long‒lasting effect. Cognitive behavioral therapy should be performed for intractable FGID, in which anxiety and depression are frequent comorbidities. Based on the understanding of the effect, adverse effect, dependency, and risk of anxiolytic and antidepressant drugs, psychotropic medicines should be prescribed for FGID. |