Anxiety and depression in various functional gastrointestinal disorders: Do differences exist?

Hartono, Juanda Leo; Mahadeva, Sanjiv; Goh, Khean‐Lee

doi:10.1111/j.1751-2980.2012.00581.x

Cited by 78 publications

(59 citation statements)

References 39 publications

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“…Subjects reporting anxiety without depression had a 3.2-fold increased risk of reflux, subjects with depression without anxiety had a 1.7-fold increased risk and subjects with both anxiety and depression had a 2.8-fold increased risk, compared to subjects without anxiety or depression, suggesting anxiety and depression are strongly associated with reflux symptoms [9,10] (Figure 4). Furthermore, clinical trials have demonstrated that, adding Tricyclic antidepressant to a PPI was more effective than a doubledose of PPI in patients with FCP refractory to a conventional dose of PPI.…”

Section: Gerd and Psychological Comorbiditymentioning

confidence: 99%

Anxiety Induced Refractory Gastrointestinal Disorders

Faruqui¹

2017

JLRDT

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Million suffer from acid related disorders with little respite without treatment. Today progress made has given us a quantum leap in understanding the disease and this has translated into the development of effective treatment. Right from the use of antacids which dominated the treatment arena in the last century to the discovery of Histamine-2-receptor antagonists towards the second half of the last century, progress has been constant over the decades. Today the benefits of the PPIs (proton pump inhibitors) have percolated to countless people across the globe. At no point in history were acid disorders this effectively managed. Furthermore, the relationship between anxiety and heartburn is not an obvious one. Many of the patients that suffer from heartburn when they have anxiety already had GERD (gastroesophageal reflux disorder). However, GERD patients with psychological comorbidity tend to seek medical assistance for their acid reflux earlier than patients without comorbidity, probably due to anxiety, concern over painful symptoms and depression, prompting scientist to dwell on the approach forward. Lead by observations that are based on recent data about the contribution of psychological comorbidity to the PPI failure phenomenon, GERD patients who are not responsive to treatment should be evaluated for psychological comorbidity.Keywords: Histamine-2-receptor; GERD patients; PPI; Inflammatory reactions; Clinical condition

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Section: Gerd and Psychological Comorbiditymentioning

confidence: 99%

Anxiety Induced Refractory Gastrointestinal Disorders

Faruqui¹

2017

JLRDT

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“…78 Psychological stress increased the perception of heartburn and aggravated GERD symptoms. 79,80 Fass et al 81 have shown that acute stress can enhance the sensitivity to intraesophageal acid perception in both reflux esophagitis or NERD patients.…”

Section: Psychological Factorsmentioning

confidence: 99%

Sex and Gender Differences in Gastroesophageal Reflux Disease

Kim

2016

J Neurogastroenterol Motil

125

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It is important to understand sex and gender-related differences in gastroesophageal reflux disease (GERD) because gender-related biologic factors might lead to better prevention and therapy. Non-erosive reflux disease (NERD) affects more women than men. GERD symptoms are more frequent in patients with NERD than in those with reflux esophagitis. However, men suffer pathologic diseases such as reflux esophagitis, Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC) more frequently than women. The prevalence of reflux esophagitis is significantly increased with age in women, especially after their 50s. The mean age of EAC incidence in women is higher than in men, suggesting a role of estrogen in delaying the onset of BE and EAC. In a chronic rat reflux esophagitis model, nitric oxide was found to be an aggravating factor of esophageal injury in a male-predominant way. In addition, the expression of esophageal occludin, a tight junction protein that plays an important role in the esophageal defense mechanism, was up-regulated in women. This explains the male predominance of reflux esophagitis and delayed incidence of BE or EAC in women. Moreover, the symptoms such as heartburn, regurgitation, and extra-esophageal symptoms have been more frequently reported by women than by men, suggesting that sex and gender play a role in symptom perception. Differential sensitivity with augmented symptoms in women might have diagnostic and therapeutic influence. Furthermore, recent studies have suggested that hormone replacement therapy has a protective effect against esophageal cancer. However, an anti-inflammatory role of estrogen remains compelling, which means further study is necessary in this area.

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“…[10][11][12][13][15][16][17][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] The baseline characteristics of included studies are shown in Table 1 22,29 Sphere score in 1 study, 24 and the Beck Anxiety Inventory (BAI) in 1 study. 30 …”

Section: Baseline Characteristics Of Included Studiesmentioning

confidence: 99%

The Increased Level of Depression and Anxiety in Irritable Bowel Syndrome Patients Compared with Healthy Controls: Systematic Review and Meta-analysis

Lee

Doo

Choi

et al. 2017

J Neurogastroenterol Motil

177

151

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Background/AimsIrritable bowel syndrome (IBS) patients commonly experience psychiatric disorders, such as depression and anxiety. This meta-analysis sought to compare depression and anxiety levels between IBS patients and healthy controls. MethodsWe searched major electronic databases (PubMed, EMBASE, MEDLINE, and Cochrane library) to find comparative studies on IBS patients and healthy controls. The primary outcome was a standardized mean difference (SMD) of anxiety and depression levels; subgroup analyses were conducted according to IBS-subtypes. ResultsIn total, 2293 IBS patients and 4951 healthy controls from 27 studies were included. In random effect analysis, depression and anxiety levels were significantly higher in IBS patients (pooled SMD = 0.76; 95% CI, 0.62-0.90; P < 0.001; I 2 = 77.2% and pooled SMD = 0.84; 95% CI, 0.67-1.01; P < 0.001; I 2 = 85.6%, respectively). Both analyses' funnel plots showed symmetry. In meta-regression analysis, heterogeneity was due to the studied region and questionnaire type for both depression and anxiety. In sub-group analyses of IBS-subtype, the pooled SMDs of depression and anxiety levels (IBS with predominant constipation: 0.83 and 0.81, IBS with predominant diarrhea: 0.73 and 0.65, and IBS with mixed bowel habits: 0.62 and 0.75; P < 0.001, respectively) were significantly higher in all IBS-subtypes. ConclusionsThe present meta-analysis showed depression and anxiety levels to be higher in IBS patients than in healthy controls, regardless of IBSsubtype. However, the gender effect on psychological factors among IBS patients could not be determined and should be evaluated in prospective studies.

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Anxiety and depression in various functional gastrointestinal disorders: Do differences exist?

Cited by 78 publications

References 39 publications

Anxiety Induced Refractory Gastrointestinal Disorders

Anxiety Induced Refractory Gastrointestinal Disorders

Sex and Gender Differences in Gastroesophageal Reflux Disease

The Increased Level of Depression and Anxiety in Irritable Bowel Syndrome Patients Compared with Healthy Controls: Systematic Review and Meta-analysis

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