Anxiety and depression in patients with gastroesophageal reflux disorder
Keywords:
Depression; Anxiety; Gastro esophageal Reflux DisorderAbstract
Background: Evidence shows an influence relationship between described symptoms of gastroesophageal reflux disorder (GERD) and emotional state.
Objective: To determine the relationship between anxiety and depression with GERD in patients referred to the endoscopy unit of Bouali-Sina Hospital in Qazvin.
Methods: This case-control study was conducted in the endoscopy unit of Bouali-Sina Hospital in Qazvin, Iran, from April 2014 through May 2015. Two hundred individuals (100 patients with GERD and 100 healthy individuals as a control group) were enrolled into the current study. All subjects completed the hospital anxiety and depression questionnaire. GERD was diagnosed based on the Los Angeles classification system. Demographic and socioeconomic characteristics in addition to clinical history of subjects were collected and analyzed using proper statistical methods (independent-samples t-test and AVOVA) and using SPSS version 22.
Results: Among the recruited patients, 50 subjects had erosive esophagitis (ERD) and 50 had non-erosive esophagitis (NERD). The anxiety score was significantly higher in the NERD group than the ERD and control groups (p=0.017; p<0.001). In addition, the anxiety score was significantly higher in the ERD group than the control group (p=0.014). The score of depression was higher in the NERD group than the ERD and the control groups. However, this difference was not statistically significant for the ERD group (p=0.63), but the difference was significant in comparison to the control group (p<0.001). There was no significant difference among the groups regarding age, gender or body mass index (BMI). The number of smokers was significantly higher in the ERD group than the NERD and control groups (p<0.001).
Conclusion: The current study showed that mental factors (anxiety and depression) play important roles in the development of GERD, especially NERD; therefore, it is recommended to consider these factors to select a suitable treatment plan.
References
Roman S, Pandolfino JE, Kahrilas PJ. Gastroesophageal Reflux Disease. Yamada's Textbook of
Gastroenterology. 2016:906-28.
Grossi L, Ciccaglione AF, Marzio L. Typical and atypical symptoms of gastro esophageal reflux disease:
Does Helicobacter pylori infection matter? World journal of gastrointestinal pharmacology and
therapeutics. 2015;6(4):238. doi: 10.4292/wjgpt.v6.i4.238, PMid: 26558157, PMCid: PMC4635163
Sharifi A, Dolatshahi S, Rezaeifar A, Ramim T. Sensitivity and specificity of endoscopy in diagnosis for
Barrett's esophagus. Tehran University Medical Journal. 2014;72(6):396-403. 4) Kamolz T, Velanovich V. Psychological and emotional aspects of gastroesophageal reflux disease.
Diseases of the Esophagus. 2002;15(3):199-203. doi: 10.1046/j.1442-2050.2002.00261.x, PMid: 12444990
Sanna L, Stuart AL, Berk M, Pasco JA, Girardi P, Williams LJ. Gastro oesophageal reflux disease
(GORD)-related symptoms and its association with mood and anxiety disorders and psychological
symptomology: a population-based study in women. BMC psychiatry. 2013;13(1):1. doi: 10.1186/1471- 244X-13-194, PMid: 23883104, PMCid: PMC3751862
Lee S, Jon D, Kyung-Joon M. Psychological factors influence the symptoms of Gastroesophageal Reflux
Disease (GERD) and their effect on quality of life in Korean fire fighter. European Psychiatry. 2016
(33):S166. doi: 10.1016/j.eurpsy.2016.01.266
Chou P-H, Lin C-C, Lin C-H, Tsai C-J, Cheng C, Chuo Y-P, et al. Prevalence of gastroesophageal reflux
disease in major depressive disorder: a population-based study. Psychosomatics. 2014;55(2):155-62. doi:
1016/j.psym.2013.06.003, PMid: 23953172
Weijenborg PW, de Schepper HS, Smout AJ, Bredenoord AJ. Effects of antidepressants in patients with
functional esophageal disorders or gastroesophageal reflux disease: a systematic review. Clinical
Gastroenterology and Hepatology. 2015;13(2):251-9. e1. 9) Pourshams A, Rahmani A, Hatami K. Gastroesophageal reflux disease in Iran. Govaresh. 2005;10(1):48- 53.
Mahmudi S, Pourshams A, Akbari M, Malekzadeh R. The prevalence of irritable bowel syndrome and
gastroesophageal reflux disease among Tehran University students. Govaresh. 2012;8(4):159-62.
Alipour A, Oraki M, Pourshams A. Comparison of General Psychological Wellbeing Schedule between
Patients with Gastroesophageal Reflux Disease and Healthy Controls. Govaresh. 2014;19(1):26-30.
Choi JY, Jung H-K, Song EM, Shim K-N, Jung S-A. Determinants of symptoms in gastroesophageal reflux
disease: nonerosive reflux disease, symptomatic, and silent erosive reflux disease. European journal of
gastroenterology & hepatology. 2013;25(7):764-71. doi: 10.1097/MEG.0b013e32835f594c, PMid:
Hajseyed Javadi A, Ziaee A, Yazdi Z, Ebrahimabadi N, Shafikhani AA. Prevalence of Anxiety and
Depression in Diabetic Patients: A Comparative Study. Biotech Health Sci. 2017;S(1):e41629. Epub 2017- 03-09.10.5812/bhs.41629
Hartono JL, Mahadeva S, GOH KL. Anxiety and depression in various functional gastrointestinal
disorders: do differences exist? Journal of digestive diseases. 2012;13(5):252-7. doi: 10.1111/j.1751- 2980.2012.00581.x, PMid: 22500787
Haji Seyed Javadi A, Shafikhani A. Evaluation of depression and anxiety in patients with thalassemia: a
comparative study. The Journal of Qazvin University of Medical Sciences. 2017;21(2):21-13.
Olssøn I, Mykletun A, Dahl AA. The Hospital Anxiety and Depression Rating Scale: a cross-sectional
study of psychometrics and case finding abilities in general practice. BMC psychiatry. 2005;5(1):1. doi:
1186/1471-244X-5-46, PMid: 16351733, PMCid: PMC1343544
AzarKeyvan A, Hajibeigi B, Lankarani MM, Namdari M, Assaric S. Associates of poor physical and
mental health-related quality of life in beta thalassemia-major/intermedia. Journal of Research in Medical
Sciences. 2009;14(6):349-55. PMid: 21772908, PMCid: PMC3129078
Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. The Hospital Anxiety and Depression Scale
(HADS): translation and validation study of the Iranian version. Health and quality of life outcomes.
;1(1):1. doi: 10.1186/1477-7525-1-1, PMCid: PMC149816
Malfertheiner P, Lind T, Willich S, Vieth M, Jaspersen D, Labenz J, et al. Prognostic influence of Barrett’s
oesophagus and Helicobacter pylori infection on healing of erosive gastro-oesophageal reflux disease
(GORD) and symptom resolution in non-erosive GORD: report from the ProGORD study. Gut.
;54(6):746-51. doi: 10.1136/gut.2004.042143, PMid: 15888776, PMCid: PMC1774548
Oh J-H, Kim T-S, Choi M-G, Lee H, Jeon E-J, Choi S-W, et al. Relationship between psychological factors
and quality of life in subtypes of gastroesophageal reflux disease. Gut Liver. 2009;3(4):259-65. doi:
5009/gnl.2009.3.4.259, PMid: 20431758, PMCid: PMC2852738
Yang X-J, Jiang H-M, Hou X-H, Song J. Anxiety and depression in patients with gastroesophageal reflux
disease and their effect on quality of life. World journal of gastroenterology: WJG. 2015;21(14):4302. doi:
3748/wjg.v21.i14.4302, PMid: 25892882, PMCid: PMC4394093
Ang T-L, Fock K-M, Ng T-M, Teo E-K, Chua T-S, Tan J. A comparison of the clinical, demographic and
psychiatric profiles among patients with erosive and non-erosive reflux disease in a multi-ethnic Asian
country. World journal of gastroenterology: WJG. 2005;11(23):3558. doi: 10.3748/wjg.v11.i23.3558,
PMCid: PMC4315960
Wiklund I, Carlsson R, Wiklund I, Carlsson R, Carlsson J, Glise H. Psychological factors as a predictor of
treatment response in patients with heartburn: a pooled analysis of clinical trials. Scandinavian journal of
gastroenterology. 2006;41(3):288-93. doi: 10.1080/00365520500292970, PMid: 16497615
Wu JC. Gastroesophageal reflux disease: an Asian perspective. Journal of gastroenterology and hepatology.
;23(12):1785-93. doi: 10.1111/j.1440-1746.2008.05684.x, PMid: 19120871
Fass R. Erosive esophagitis and nonerosive reflux disease (NERD): comparison of epidemiologic,
physiologic, and therapeutic characteristics. Journal of clinical gastroenterology. 2007;41(2):131-7. doi:
1097/01.mcg.0000225631.07039.6d, PMid: 17245209
Blanchard EB, Keefer L, Galovski TE, Taylor AE, Turner SM. Gender differences in psychological distress
among patients with irritable bowel syndrome. Journal of psychosomatic research. 2001;50(5):271-5. doi:
1016/S0022-3999(01)00207-0
Bjerkeset O, Romundstad P, Evans J, Gunnell D. Association of adult body mass index and height with
anxiety, depression, and suicide in the general population The HUNT Study. American journal of
epidemiology. 2008;167(2):193-202. doi: 10.1093/aje/kwm280, PMid: 17981889
Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW, et al. Overweight, obesity, and
depression: a systematic review and meta-analysis of longitudinal studies. Archives of general psychiatry.
;67(3):220-9. doi: 10.1001/archgenpsychiatry.2010.2, PMid: 20194822
Bjørngaard JH, Carslake D, Nilsen TIL, Linthorst AC, Smith GD, Gunnell D, et al. Association of Body
Mass Index with Depression, Anxiety and Suicide—An Instrumental Variable Analysis of the HUNT
Study. PloS one. 2015;10(7):e0131708. doi: 10.1371/journal.pone.0131708, PMid: 26167892, PMCid:
PMC4500562
Hunink MM, Weinstein MC, Wittenberg E, Drummond MF, Pliskin JS, Wong JB, et al. Decision making
in health and medicine: integrating evidence and values: Cambridge University Press; 2014. doi:
1017/CBO9781139506779
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