A cross-sectional study of gastrointestinal symptoms, depressive symptoms and trait anxiety in young adults

Abstract

Background >Patients with functional gastrointestinal disorders have a high psychiatric co-morbidity. This study aimed to investigate and characterise gastrointestinal symptoms in relation to depressive symptoms and trait anxiety in a well-defined population of young adult psychiatric outpatients and healthy controls. Methods Gastrointestinal symptoms were assessed with the Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS). Depressive symptoms were assessed with the Montgomery-Åsberg Depression Rating Scale- Self assessment (MADRS-S). Trait anxiety was estimated with three of the Swedish universities of Personality (SSP) scales: Somatic trait anxiety, Psychic trait anxiety and Stress susceptibility. Self-ratings were collected from 491 young adult psychiatric outpatients and 85 healthy controls. Gastrointestinal symptom severity was compared between patients with and without current psychotropic medication and controls. Associations between gastrointestinal symptoms, depressive symptoms and trait anxiety were assessed using Spearman’s coefficients and generalized linear models adjusting for possible confounders (sex, body mass index, bulimia nervosa). Results Patients, with and without current psychotropic medication, reported significantly more gastrointestinal symptoms than controls. In the generalized linear models, total MADRS-S score (p < 0.001), Somatic trait anxiety (p < 0.001), Psychic trait anxiety (p = 0.002) and Stress susceptibility (p = 0.002) were independent predictors of the total GSRS-IBS score. Further exploratory analysis using unsupervised learning revealed a diverse spectrum of symptoms that clustered into six groups. Conclusion Gastrointestinal symptoms are both highly prevalent and diverse in young adult psychiatric outpatients, regardless of current psychotropic medication. Depressive symptom severity and degree of trait anxiety are independently related to the total gastrointestinal symptom burden.

Disrupted Cerebellar-Default Mode Network Functional Connectivity in Major Depressive Disorder With Gastrointestinal Symptoms

“…Approximately 30–70% patients with MDD had concomitant GI symptoms ( Zhao et al, 2018 ; Huang et al, 2021 ). Consistent with the abovementioned findings from somatic symptoms, higher frequency of GI symptoms and higher GI symptom burden were linked to greater depressive severity and increased risk of suicide ideation ( Soderquist et al, 2020 ; Huang et al, 2021 ). Although a lot of efforts have been made to explore the underlying mechanisms of somatic symptoms in MDD, few focuses have been put on GI symptoms.…”

Fecal Short-Chain Fatty Acid Ratios as Related to Gastrointestinal and Depressive Symptoms in Young Adults

“…Our results indicate that shifts in SCFA ratios are associated with both IBS and depression. We have previously explored the correlation between GI and depressive symptoms in young adults and shown high correlations ( 5 ). Our results indicate that the associations between SCFAs and depressive symptoms are both stronger than and independent from GI symptoms.…”

“…Postprandial serotonin levels in plasma are altered in irritable bowel syndrome (IBS) compared with controls; elevated serotonin was found when diarrhea predominant and low when constipation is predominant ( 4 ). Young adult patients seeking psychiatric care reported more gastrointestinal (GI) symptoms than controls and the level of GI symptoms were associated with depressive symptom severity and trait anxiety ( 5 ). We have also shown links between IBS symptoms and circulating levels of melatonin as well as symptoms of anxiety and depression ( 5 – 7 ).…”

“…Young adult patients seeking psychiatric care reported more gastrointestinal (GI) symptoms than controls and the level of GI symptoms were associated with depressive symptom severity and trait anxiety ( 5 ). We have also shown links between IBS symptoms and circulating levels of melatonin as well as symptoms of anxiety and depression ( 5 – 7 ). The intestinal microbiota influences both neural, endocrine signaling and local and systemic immune responses.…”

Anxiety and Gastrointestinal Symptoms Related to COVID-19 during Italian Lockdown

“…Literature supports the association between anxiety and gastrointestinal symptoms (GISs) [ 10 , 11 ]. In subjects with functional gastrointestinal disorders, such as dyspepsia and irritable bowel syndrome, the presence of anxiety seems to play a major role in the genesis and the perception of symptoms [ 12 ]. The gastrointestinal tract and the nervous system are intimately connected via bidirectional signaling mechanisms characterized by neural, endocrine, and immune pathways, in a context knows as the “gut–brain axis” [ 13 ].…”