Anxiety, depression and psychotropic medication use in patients with persistent upper and lower gastrointestinal symptoms

Abstract

Background: Limited information is available about anxiety, depression and psychotropic medication use in patients referred for gastrointestinal endoscopy. Aim: To determine anxiety and depression and its association with endoscopic findings in a representative sample of patients with persistent gastrointestinal symptoms prior to endoscopy.

State and trait anxiety and depression in patients affected by gastrointestinal diseases: psychometric evaluation of 1641 patients referred to an internal medicine outpatient setting

“…Moreover, our data also seem to be in line with the few data reported in patients affected by organic gastrointestinal diseases. In particular using hospital anxiety and depression scale (HADS) psychometric scale in a large cohort of patients, Van Kerkhoven et al (2) recently showed the presence of anxiety and depression in subjects referred to digestive endoscopy outpatient setting. In this study evaluating patients referred for lower gastrointestinal endoscopy, there were no differences in anxiety and depression between patients with functional disorders and those with organic causes for their symptoms.…”

“…Anxiety and depression represent a common feature in patients affected by gastrointestinal diseases (1,2). In some cases as in patients with functional gastrointestinal disorders, anxiety and depression are present particularly as a personality trait (3) and they seem to play a main role in the genesis and/or the perception of symptoms (1).…”

The Patient Health Questionnaire 12 Somatic Symptom scale as a predictor of symptom severity and consulting behaviour in patients with irritable bowel syndrome and symptomatic diverticular disease

“…Previous studies have tended to emphasize that irritable bowel syndrome (IBS) patients are significantly more anxious and depressed than healthy controls 3–6 and have a higher incidence of previous psychiatric disease 7, 8 . Although this is true, anxiety is a major driver for any consultation 9, 10 and hence it is perhaps not surprising that anxiety is not a useful aid in differential diagnosis as it fails to distinguish clearly IBS patients from patients with other gastrointestinal (GI) diseases such as colon cancer, coeliac disease, peptic ulcer, 11 inflammatory bowel disease 12 or indeed most general medical conditions 13, 14 …”

Psychopathology is associated with dyspeptic symptom severity in primary care patients with a new episode of dyspepsia

“…However, a majority of dyspeptic patients seeking medical attention are managed in primary care. Patients referred to secondary care are known to have more severe dyspeptic symptoms and symptoms of psychological disturbances 18, 19 . For this reason, results from secondary care studies suggesting an association between psychological factors and dyspepsia cannot automatically be applied to the primary care population.…”