Analysis Of Two Subtypes Of Gastroesophageal Reflux Disease Combined With Anxiety, Depression And Their Relationgship With Quality Of Life

ObjectiveTo compare the difference in the anxiety,depression score among differentsubgroups non-erosive reflux disease(NERD) and reflux esophagitis(RE),to evaluatethe influence of psychological factors on symptoms,to analyze the relationshipbetween the status of anxiety,depression and quality of life,to analyze two subtypes ofGERD combined with functional dyspepsia(FD) and irritable bowel syndrome(IBS),to explore the influence of mental factors on the pathogenesis of GERD and thequality of life.Methods58patients with NERD and62patients with RE fulfilling the2013AmericanCollege of Gastroenterology（ACG） criteria Guidelines for the Diagnosis andManagement of Gastroesophageal Refux Disease were selected. GerdQ, HospitalAnxiety and Depre ssion Scale(HAD) and Short Form-36Health Survey(SF-36) wereused to evaluate the psychological status of two subtypes and their relationship withquality of life. Two Subtypes of GERD combined with FD,IBS was evaluated byRome III criteria.Results①The patients with GERD,58had NERD,62had RE.The ratio of sex(male:female) were1:1.9,1.8:1and the mean age were45.1±13.7,50.6±10.7respectively in NERD and RE groups. There were more females than males in NERDgroup(P=0.001). The mean age of NERD was younger than RE groups(P=0.016).Thedifference of two subtypes course was not statistical significance(P=0.837).②Anxiety,depression scores of NERD were5.19±3.53(anxiety12,20.7%),5.29±3.01(depression15,25.9%),RE were4.00±3.75(anxiety10,16.1%),4.47± 3.07(depression10,16.1%).There were not significance comparing their difference.③The GerdQ scores on NERD were little higher than that of RE group(P=0.034).④The scores of anxiety were positively correlated with the scores of GerdQ inGERD(r=0.266,P=0.003), especially in RE group (r=0.495,P<0.001).⑤The scoresof emotional role(P=0.001)and the total scores of quality of life(QoL)(P=0.013) inNERD were significantly lower than those in RE. Within the NERD group,depressedNERD patients had lower total QoL scores compared to non-depressed NERDsubjects(P<0.001).However, the overall QoL scores of anxious NERD patientscompared to non-anxious NERD subjects were not statistically significant(P=0.060).Within the RE group,anxious RE subjects had lower total QoL scores ascompared to non-anxious RE subjects(P=0.015).Depressed RE subjects also hadlower total QoL scores as compared to non-depressed RE patients(P=0.010).⑥Eachdimension of the qualiy of life was significantly negatively correlated with anxietyand depression scores except the physical functioning and anxiety score.⑦The totalQoL scores and the social functioning score in RE were negatively correlated with thescores of GerdQ,but it had no pertinence between the scores of other dimensions andthe scores of GerdQ.⑧There was no significant difference in the status of FD(36.2%vs33.9%),IBS(25.9%vs17.7%)in NERD and RE.Conclusion(1) There were no significant difference in concomitant anxiety or depression betweenNERD and RE subjects.(2)Reflux-related symptoms of NERD were more serious than that of RE.(3) The symptom levels were correlated with the status of anxiety in GERD,especiallyin RE group.(4) The quality of life and especially emotional role in NERD were significantly low-er than those in RE.Depressed NERD(RE) patients had lower quality of life comparedto non-depressed NERD(RE) subjects.Anxious RE subjects had lower quality of lifeas compared to non-anxious RE subjects.(5) The qualiy of life of each dimension was significantly negatively correlated withanxiety or depression scole except the physical functioning and anxiety scole.The higher scores of anxiety,depression,the lower quality of life.However,symptoms hadno significant effect on quality of life.(6) Concomitant status of FD or IBS in NERD and RE is common，but there was nosignificant difference in the status between NERD and RE.