Gastrointestinal‐Specific symptom anxiety in patients with gastroparesis: Relationships to symptom severity and quality of life

Abstract

Background: Gastrointestinal (GI)-specific anxiety has been identified as a treatment target in irritable bowel syndrome. However, GI-specific anxiety has been understudied in other GI functional/motility disorders. Among adults with gastroparesis, we aimed to: (1) initially validate a measure of GI-specific anxiety, the Visceral Sensitivity Index (VSI); and (2) evaluate the relationship between GI-specific anxiety and gastroparesis symptom severity and quality of life, compared to measures of anxiety, depression, and somatization.Methods: Consecutive adult patients (N = 100) with gastroparesis presenting for initial consultation completed a series of self-report measures including the VSI. We conducted a confirmatory factor analysis of the VSI one-factor structure and tested internal consistency and convergent validity. We then performed hierarchical linear regression analyses to explore associations between VSI and gastroparesis symptom severity and overall quality of life.Key Results: Confirmatory factor analysis revealed that the original VSI one-factor structure overall fit well [χ 2 (90) = 220.1, p < 0.0001; SRMR = 0.08; RMSEA = 0.12; CFI = 0.96]. The VSI also had excellent internal consistency (α = 0.99) and convergent validity (r = 0.29-0.56; all p < 0.01). Higher GI-specific anxiety was significantly associated with greater gastroparesis symptom severity, including nausea/vomiting, fullness/satiety, and upper abdominal pain scores beyond depression, anxiety, or somatization (all p = <0.01-0.01). Additionally, higher GI-specific anxiety was significantly associated with lower mental health-related quality of life, beyond gastroparesis symptom severity, depression, anxiety, or somatization (p = 0.01). Conclusions & Inferences:The VSI is an adequate measure of GI-specific anxiety in patients with gastroparesis. Higher GI-specific anxiety was associated with increased patient-reported gastroparesis symptom severity and decreased quality of life, beyond depression/anxiety.

Scoping review: the social and emotional impacts of gastroparesis

“…When we consider psychological factors that may influence functioning with a chronic digestive disease, we typically separate generalized anxiety or depression from symptom specific anxiety or depression, where the primary source or focus of distress is around the symptoms themselves. Consistent with the literature in esophageal conditions, symptom specific anxiety was associated with greater severity of gastroparesis symptoms and was more strongly correlated than depression, anxiety, or somatization ( 27 ). Similarly, one study found illness perception to be the mediating factor in the relationship between symptom severity and psychological distress ( 31 ).…”

“…Quality of life in gastroparesis seems to be affected by a combination of symptom severity, depression, symptom anxiety, and coping styles ( 5 , 10 , 13 , 20 , 27 , 31 ). The most common health related social need expressed by gastroparesis patients was mental health, followed closely by financial strain and food security ( 20 ).…”