10 Years of Anxiety and Upper Endoscopy Correlation

A recent 10-year Swedish study (Aro P, et al. Gastroenterol 2015; 148: 928-37) provided further evidence of a link between anxiety, but not depression, and functional dyspepsia (FD).

This study took a group of 1000 individuals who had been randomly selected to undergo upper endoscopy, the Abdominal Symptom Questionnaire, and the Hospital Anxiety and Depression Scale Questionnaire (1998-2001).  Among the 887, who completed the initial portion of the study, 703 subjects were available for followup study in 2010.

FD was defined in this study based on the Rome III definition: weekly bothersome postprandial fullness or early satiety; epigastric pain or burning without organic findings on endoscopy.  FD was further divided into postprandial distress syndrome which consisted of postprandial fullness or early satiety or epigastric pain syndrome.

Key findings:

  • At baseline, 15.6% of subjects had FD.  At followup, 13.3% had FD including 48 new cases.
  • Anxiety at baseline was associated with new-onset FD at the followup evaluation with an odds ratio of 7.6.
  • Anxiety was also associated with postprandial distress syndrome at baseline with an odds ratio of 4.83.

Take-home point: Anxiety often precedes functional dyspepsia.  This association was not evident with depression.

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