| Objective:This study aimed to investigate the overlaps of functional gastrointestinal disorders in digestive clinics and explore the correlation between overlaps and psychological disorders.Methods: Consecutive FGIDs patients at the general and specialist gastroenterology outpatient clinics,who were defined by Rome III criteria,and asymptomatic healthy checkup controls(with age,gender,and other demographic characteristics matched)from Renji Hospital,Shanghai Jiaotong University School of Medicine,were enrolled in the study from April 2014 to December 2015.Participants were requested to complete the gastrointestinal symptoms screening questionnaire along with the 9-tiem Patient Health Questionnaire(PHQ-9)and 7-tiem Generalized Anxiety Disorder scale(GAD-7).Patients who met more than one diagnosis were identified as overlaps.The mean scores for anxiety and depression and were analyzed.All P-values were two-tailed,and the level of significance was defined at 0.05.Results:1.A total of 667 subjects were included in this study,consisting of 328 general outpatients,278 specialist outpatients and 61 controls.100 patients had overlapping disorders among general outpatients,accounting for 30.5%.While there were 208 patients with overlapping FGIDs in specialist outpatient,accounting for 73.0%.The most prevalent overlap was the combination of GERD and FD in the two groups.2.Compared with healthy controls,the PHQ-9 and GAD-7 scores were significantly higher in GERD,EPS,PDS,IBS-D and IBS-C group.3.Compared with the EPS group,the scores of GAD-7 in the PDS group were similar(5.2±3.5 vs 6.3±3.2,P=0.095),while the scores of PHQ-9 were significantly higher(8.4±3.3 vs 3.6±2.1,P=0.000).Compared with the IBS-D group,the scores of GAD-7 in the IBS-C group were significantly lower(5.4±2.5 vs 7.4±3.5,P=0.002),while the scores of PHQ-9 were significantly higher(9.8±2.8 vs 4.2±2.8,P=0.000).4.In general outpatient,compared with the GERD group,the scores of PHQ-9 in the GERD+EPS group were similar(4.4±2.4 vs 3.8±2.5,P=0.404),while the scores of GAD-7 were significantly higher(8.5±2.4 vs 6.6±3.6,P=0.017).In contrast,no significance was observed with regard to the scores of GAD-7 in the GERD and GERD+PDS group(6.6±3.6 vs 6.7±2.5,P=0.920),while the scores of PHQ-9 in GERD+PDS group were significantly higher(8.4±3.0 vs 3.8±2.5,P=0.000).In expert outpatient,compared with the GERD+EPS group,the scores of GAD-7 in the GERD+EPS+PDS group were significantly higher(10.9±2.1 vs 9.1±3.5,P=0.007),as the same as the scores of PHQ-9(11.6±3.0 vs 6.8±3.6,P=0.000).compared with the GERD+PDS group,the scores of GAD-7 in the GERD+EPS+PDS group were significantly higher(10.9±2.1 vs 8.0±3.1,P=0.000),along with the scores of PHQ-9(11.6±3.0 vs 10.0±3.2,P=0.019).5.Older age(OR=1.05,95%CI 1.02-1.08,P=0.001),higher level of education(moderate OR=5.29,95%CI 2.09-13.39,P=0.000;high OR=5.77,95%CI 2.26-14.1,P=0.000),sleep disturbance(OR=2.99,95%CI 1.01-8.87,P=0.048),anxiety(OR=1.17,95%CI 1.03-1.33,P=0.008),depression(OR=1.33,95%CI 1.19-1.49,P=0.000),seemed to be potential risk factors for FGIDs overlaps.Conclusions: Clinical overlap of FGIDs is very common at the gastroenterology clinics,especially in senior outpatient.And it is apparently associated with psychological disorders. |
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