Anxiety And Depression In Patients With Functional Gastrointestinal Disorders: Prevalence And Correlation With Severity Of Gastrointestinal Symptoms

Background:Functional gastrointestinal disorders(FGIDs)are a highly common group of disorders that can affect any part of the gastrointestinal tract and affect health related quality of life.Irritable bowel syndrome(IBS),functional dyspepsia(FD)and functional constipation(FC)are the most prevalent,with major clinical manifestations of abdominal pain,bloating,constipation,diarrhoea and non-cardiac chest pain.The pathogenesis of functional gastrointestinal disorders is complex and diverse.Currently,the high morbidity,repeated symptoms and prolonged course of FGIDs lead to serious physical and psychological burden of patients.In addition,due to the low cure rate of FGIDs,the relevant cost of medical treatment brings a huge economic burden to community and individual.Therefore,FGIDs has become one of the most intractable diseases in gastroenterology department.The pathogenesis of FGIDs has not yet been clarified.Existing studies have shown that they are associated with psychiatric disorders,such as personality disorders,psychological disorders and so on,which affect the quality of healthy life.Cognitive and affective factors,the nervous system disorders caused by visceral hypersensitivity and gastrointestinal motility dysfunction are key pathophysiological mechanisms.There is evidence that patients with recurrent or severe gastrointestinal symptoms,there poor quality of life,somatization scores are higer,and are more likely to accompany anxiety,depression,and sleep disorders.Objective:To investigate the prevalence of anxiety or depression in patients with functional gastrointestinal disorders(FGIDs),and identify the correlation between scores of anxiety or depression and the severity of FGIDs,so as to improve the diagnosis and treatment of FGIDs.Methods:Two hundred and ten patients who were diagnosed with FGIDs according to Rome Ⅲ criteria were randomly selected in First Affiliated Hospital of Zhengzhou University.At the same time,two hundred healthy persons were also selected randomly in the hospital as control group.All the people were screening using the Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS).Gastrointestinal symptom rating scale(GSRS)was used to evaluate the patients whose SAS≥50 or SDS≥53 in study group.Finally we analyzed all the relevant data.Results:Of the 210 FGIDs patients included,78 suffered from functional dyspepsia(male 35,female 43,mean age 36.1±8.9);79 from irritable bowel syndrome(male 38,female 41,mean age 35.7±7.7)and 53 from functional constipation(male 26,female 27,mean age 39.9±10.1).There are two hundred healthy persons in control group(male 98,female 102,mean age 37.9±9.9);There was no significant difference in age and gender between the study group and the control group(P > 0.05).The morbidity of anxiety or depression FGIDs was significantly higher in patients with FGIDs than in the control group(P < 0.05),but it showed no significant among different diseases group(P > 0.05).There was a positive correlation between the severity of FGIDS and scores of anxiety or depression in study group(r=0.63,r=0.45,p<0.01).Conclusion:1.FGIDs patients are more likely to be associated with anxiety or depression than healthy people.2.The severity of gastrointestinal symptoms can be predicted by assessing the psychological factors of patients with FGIDs.