The status and risk factors for anxiety/depression in patients with atrophic chronic gastritis: a cross-sectional study

Abstract

Background: Atrophic chronic gastritis (ACG) is a preneoplastic condition of gastric carcinoma.Numerous studies have shown anxiety and depression can affect gastrointestinal function, which may promote gastrointestinal disorders development and progression. Thus, we hypothesized that anxiety and depression may enhance the development and progression of ACG. In this study, we aimed to analyse risk factors for anxiety and depression in ACG patients and integrate these risk factors to construct an effective clinical prediction model. Methods:In total, 118 ACG patients were included from July 2021 to May 2022. Anxiety and depression were assessed utilizing the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Data were collected on demographic characteristics, lifestyle, and dietary habits. Risk factors for anxiety and depression were explored with univariate analysis and multivariate stepwise logistic regression, and risk prediction models were built.Results: Among 118 ACG patients, 36.4% had anxiety, 25.4% had depression, and 21.2% had both anxiety and depression. Poor sleep quality [odd ratio (OR) 4.32, 95% confidence interval (CI): 1.60-11.65, P=0.004] was positively associated with risk of anxiety, while smoking (OR 0.15, 95% CI: 0.03-0.68, P=0.014) and weekly exercise time (OR 0.89, 95% CI: 0.79-0.99, P=0.037) were negatively associated with risk of anxiety.The area under the receiver operating characteristic (ROC) curve was 80.3%, 95% CI: [0.722-0.885].

Risk factors for anxiety and depression in patients with gastrointestinal disorders—the role of the gut-brain axis

“…In addition to its central expression, both CRF and its receptors are also expressed in the gastrointestinal tract (16) and involved in gastrointestinal secreto-motor functions, intestinal permeability and visceral hypersensitivity (16), besides being a crucial mediator in the body's stress reaction and therefore being strongly involved in the pathogenesis of depression and anxiety (17). CRF may be involved in the association between abdominal pain and both depression and anxiety (odds ratio of 5.42) identified by Wu et al (4) as CRF elevations are related to mood abnormalities and CRF receptor 1 activation is involved in the induction of visceral hypersensitivity (16,17). CRF has pleotropic actions and is additionally, besides its role in mood disturbances, implicated in sleep regulation (18).…”

“…The association of changes in the dynamic bi-directional connection between gut and brain with the development of mental and gastrointestinal diseases has become more evident in the last years (2). The gut-brain axis with its diverse neural, endocrine and immune signaling pathways (3) might explain the numerous observations of high prevalence of mood disorders, such as anxiety and depression, in the presence of gastrointestinal abnormalities, which gave rise to the examinations that were very recently published by Wu et al under the title "The status and risk factors for anxiety/depression in patients with atrophic chronic gastritis: a cross-sectional study" (4).…”

Advantages And Disadvantages of Combining Chinese and Western Medicine in The Treatment of Chronic Atrophic Gastritis

“…Prolonged exposure to adverse emotions can cause immune dysfunction and affect the normal function of the stomach. It also induces the release of norepinephrine from sympathetic cells, which affects the blood supply to the gastric mucosa and diminishes its protective effect [3,6]. Sleep deprivation, in turn, leads to abnormal corticotropin-releasing factor (CRF) regulation and impaired medial prefrontal cortex activity, exacerbating patients' dysphoria [3].…”

“…It also induces the release of norepinephrine from sympathetic cells, which affects the blood supply to the gastric mucosa and diminishes its protective effect [3,6]. Sleep deprivation, in turn, leads to abnormal corticotropin-releasing factor (CRF) regulation and impaired medial prefrontal cortex activity, exacerbating patients' dysphoria [3]. In conclusion, multiple factors influence the development of chronic atrophic gastritis.…”

“…The burden of gastric cancer is particularly severe in China, where the incidence, a number of deaths and DALY in 2017 were among the highest in the world [1]. In 2020, there will be about 1.09 million new gastric cancer cases and nearly 770,000 deaths worldwide, including approximately 480,000 new gastric cancer cases and approximately 370,000 deaths in China [2][3]. The Correa gastric cancer cascade sequence of "chronic non-atrophic gastritis-chronic atrophic gastritis-intestinal epithelial hyperplasia-anisotropic hyperplasia-gastric cancer" has been generally accepted by most, but its specific pathogenesis has not been established [2,4].…”