Comorbidity Patterns Of Functional Gastrointestinal Disorders And Depressive Disorders

Background and objectives:Functional gastrointestinal disorders (FGID) and depressive disorders are two common groups of disorders that cause severe public health burden. Associated psychiatric disorders such as depression and anxiety are often noted among FGID patients. Gastrointestinal (GI) symptoms are often present among depressive patients as well. However, few convincing and well-designed studies have focused on distinguishing comorbid psychiatric disorders using Diagnostic and Statistical Manual of Mental Disorders,4th edition (DSM-Ⅳ) criteria, with FGID in Rome Ⅲ criteria, instead of describing of symptoms correlation. The aim of our study is to assess the comorbid rate of psychiatric disorders among FGID patients, and the comorbid rate of FGID among depressive patients; to study the subgroup characteristics of depressive patients who first visit medical department instead of psychiatry department; to explore possible physiological mechanism of the comorbidity of these two groups of disorders.Method:The research was conducted in general hospital. Patients met DSM-Ⅳ criteria for major depressive disorder (MDD) and Rome Ⅲ criteria for functional dyspepsia (FD) were continuously enrolled from psychological medicine department and FGID clinic in gastroenterology department. All patients were offered with clinical referral to the other department for professional clinical diagnosis.Results:17MDD patients from psychological medicine department and53FD patients from FGID clinic in gastroenterology department were recruited.14and48patients underwent structured psychiatric interviews using Composite International Diagnostic Interview3.0version(CIDI3.0) in Chinese.20.8%(11/49) FGID patients were found to have a lifetime comorbid rate of MDD, and52.1%(26/49) have a lifetime comorbid rate of any psychiatric disorder. The predominant diagnoses were mood disorders, anxiety disorders and intermittent explosive disorder. GI symptoms were noted in all MDD patients. Many of them have met Rome Ⅲ criteria for FGID. MDD patients who first visit medical department present with less severe depressive symptoms, low rate of past depression treatment, more severe GI and pain symptoms, however with a better quality of life. Conclusions:The comorbidity of FGID and psychiatric disorders including MDD is common. A better understanding and recognition of these two groups of disorders, with rational and standardized treatment for these patients should be further discussed and developed. Exploration on possible mechanisms of comorbidity is the direction for future research.