The Clinical-Psychological Features of Functional Dyspepsia Patients with Weight Loss: A Multi-Center Study from China

Abstract

Aims: To investigate the clinical features, appetite, quality of life (QOL), and their associated psychological factors of functional dyspepsia (FD) patients with weight loss. Methods: For a multicenter study, FD patients were recruited and divided into two groups according to the degree of weight changes during the previous 12 months or less with the onset of dyspepsia symptoms: Group A (≥5%) and Group B (<5%). Patients were evaluated based on the Nepean dyspepsia index (NDI), appetite questionnaire, Hamilton Rating Scale of Anxiety/Depression (HAMA/HAMD). Results: The body mass index in Group A was lower than in Group B, while, the frequency of physician visits in Group A was higher than in Group B. There were no differences in the total scores of NDI-symptom checklist or the items of intensity and bothersomeness between them (p > 0.05), but the frequency item for Group A was significantly higher than Group B (p = 0.035). The incidence of anxiety or depression, the proportion of poor or very poor appetite for Group A was higher than those for Group B (p < 0.05). Subscale scores of the NDI-QOL for Group A were significantly lower than those for Group B (p < 0.05). Conclusions: FD patients with weight loss have lower BMI, more frequent physician visits, higher psychological disorders, poorer appetite and QoL.

Serotonin Transporter Gene (SLC6A4) Polymorphism May Be Associated with Chinese Globus Pharyngeus and Its Antidepressant Effects

“…This finding supports the existence of a relationship between psychological factors and globus [2]. Genetic variation of the serotonin transporter (5-HTT) gene is regarded as a factor likely associated with susceptibility to depressive disorders.…”

“…More than half of globus patients suffer from potential psychological disorders, such as anxiety and depression [1], and patients with functional gastrointestinal disorders (FGIDs) have psychological disorders, such as functional dyspepsia (FD) patients with weight loss [2]. Antidepressants have been used in the treatment of FGIDs and showed promising efficacy.…”

British Society of Gastroenterology guidelines on the management of functional dyspepsia

“…In tertiary care, weight loss in FD is strongly associated with early satiation, and also nausea and vomiting, but its predictive value for underlying organic disease is limited. 281 Weight loss is more strongly associated with depression, a history of abuse, and somatisation than with gastric sensorimotor function, especially in viscerally hypersensitive patients, 282 with more frequent physician visits and reduced quality of life, 283 and is more frequent in female patients with overlap of FD and IBS. 114 In patients with FD and restricted diet or weight loss it is vital to screen for ARFID, and other eating or feeding disorders, to assist with behavioural management.…”

Behavioral gastroenterology: An emerging system and new frontier of action

“…A series of refractory functional gastrointestinal disease studies by our groups in recent years revealed that the incidence of anxiety and depression are 61.5% and 63.3%, respectively, for refractory FD patients, and the severity of anxiety and depression is greater than for non-refractory FD patients[ 23 ]. Moreover, of 1057 patients, the incidence of anxiety and depression for FD patients with weight loss was 56.04% and 59.90%, respectively, and a higher incidence of anxiety and depression was found for patients of group A (lost ≥ 5% of initial body weight) than for those of group B (lost < 5% of initial body weight)[ 24 ]. Cruz Ruíz et al[ 25 ] reported that 58% of 100 IBS patients suffered anxiety, whereas 62% of those patients suffered depression, and female patients accounted for more than half.…”