Evaluation of depression, anxiety, alexithymia, attachment, social support and somatization in functional dyspepsia

Abstract

AIM: The psychiatric and psychosocial aetiology of Functional dyspepsia is not well known. In the present study, our aim is to determine the relative contributions of psychiatric predictorsi.e. depression, anxiety, somatization, alexithymiain relation with socio-psychological factors, specifically their personal characteristics (i.e. emotional attachment) and perceived social support, in distinguishing FD from organic dyspepsia and healthy samples. MATERIAL AND METHODS: An estimated 30 functional dyspepsia, 29 organic dyspepsia patients who were admitted to our gastroenterology outpatient clinic and 27 healthy controls were enrolled to our study. Beck Depression Inventory, Toronto Alexithymia Scale, Adult Attachment Scale, State-Trait Anxiety Inventory, Multidimensional Scale of Perceived Social Support and somatization sub-scale of Symptom Checklist-90 were provided to all patients and healthy controls. All participants were examined by a gastroenterologist and a psychiatrist. RESULTS: Healthy controls were younger than organic dyspepsia group and women/men rate was lower in organic dyspepsia than other two groups. Depression score was higher in functional dyspepsia group than in healthy controls and functional dyspepsia group's attachment syle was more secure than that of the healthy control group. Somatization rate was seen higher in functional dyspepsia group with psychiatric examination. There was no significant difference seen in anxiety, alexithymia and social support between the three groups. DISCUSSION: Anxious-avoidant attachment profile as well as the higher propensity to have depressive and anxiety symptoms might be critical psychiatric and psychosocial factors underlying FD's aetiology. A multidisciplinary approach is needed in the follow up of functional dyspepsia patients. Psychological evaluation and treatment would increase the life quality of dyspepsia patients.

The associations between functional dyspepsia and potential risk factors: A comprehensive Mendelian randomization study

“…The communications between the brain and gut through enteric neurohumoral systems played important roles in the pathogenesis of FD [24]. Some psychological factors, including depression, anxiety, somatization, alexithymia and sleep disorder, were extensively investigated to identify their contributions to FD [25][26][27]. Among those factors, depression and anxiety were most frequently explored and demonstrated to be significant psychological factors associated with FD [28].…”

Predictors of anemia without active bleeding signs in patients referred for endoscopy

“…Multivariate logistic regression questioning the independent predictor role of mucosal defects, pathological findings, drugs and comorbidities in anemic patients with premalignant gastric lesions and a negative history of CKD linked to H. pylori infection, as H. pylori-positive individuals with dyspeptic symptoms shared the same clinical characteristics as the uninfected group [18]. Functional dyspepsia may be aggravated by various psychosocial factors and psychiatric conditions [19], somatization, or depression [20]. Our study confirmed the decreased risk of anemia and significant clinical and histologic gastro-duodenal changes in patients with dyspeptic symptoms.…”

Does alexithymia, independent of depressive and anxiety disorders, correlate with the severity of somatic manifestations among patients with medically unexplained physical symptoms?

“…In fact, the term MUPS is still widely used by primary health physicians and other medical disciplines (Lamahewa et al, 2019;Olde Hartman et al, 2017;van Westrienen et al, 2019;Ziadni et al, 2018) The coexistence and overlap between depression, anxiety, and alexithymia in patients with unexplained physical symptoms attending primary care facilities have been identified and discussed by psychosomatic specialists (Löwe et al, 2008). The high comorbidity rates across those three symptoms have been highlighted in recent literature tackling various pathologies such as unexplained dyspepsia or fibromyalgia (Kani et al, 2019;Melin et al, 2018).…”