Prospective Study
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World J Gastroenterol. Apr 14, 2015; 21(14): 4302-4309
Published online Apr 14, 2015. doi: 10.3748/wjg.v21.i14.4302
Anxiety and depression in patients with gastroesophageal reflux disease and their effect on quality of life
Xiao-Jun Yang, Hong-Mei Jiang, Xiao-Hua Hou, Jun Song
Xiao-Jun Yang, Hong-Mei Jiang, Xiao-Hua Hou, Jun Song, Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Xiao-Jun Yang, Department of Gastroenterology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400037, China
Author contributions: Yang XJ wrote the paper; Jiang HM performed the research and collected the data; Yang XJ and Hou XH analyzed the data; Song J designed the research.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jun Song, MD, Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefangdadao, Wuhan 430022, Hubei Province, China. song111jun@126.com
Telephone: 86-23-67953337 Fax: 86-27-85726930
Received: July 26, 2014
Peer-review started: July 31, 2014
First decision: August 15, 2014
Revised: October 26, 2014
Accepted: December 8, 2014
Article in press: December 8, 2014
Published online: April 14, 2015
Processing time: 262 Days and 14.5 Hours
Abstract

AIM: To explore the role of psychological factors in gastroesophageal reflux disease (GERD) and their effect on quality of life (QoL) of GERD patients.

METHODS: A total of 279 consecutive patients with typical symptoms and 100 healthy controls were enrolled in the study. All of the participants were evaluated with the Zung Self-Rating Anxiety Scale (ZSAS), the Zung Self-Rating Depression Scale (ZSDS) and the SF-36 questionnaire. The scores for anxiety, depression and QoL of the two groups were analyzed. The correlation between psychological factors and QoL was also analyzed.

RESULTS: Compared with healthy controls (34.70 ± 8.00), the scores of ZSAS in the non-erosive reflux disease (NERD) group (48.27 ± 10.34) and the reflux esophagitis (RE) group (45.38 ± 10.27) were significantly higher (P < 0.001). The mean ZSAS score of the NERD group was significantly higher than that of the RE group (P = 0.01). Compared with healthy controls (37.61 ± 8.44), the mean ZSDS scores were significantly higher in the NERD group (49.65 ± 11.09, P < 0.001) and the RE group (46.76 ± 11.83, P < 0.001). All dimensions of the SF-36 form were negatively correlated with the SAS and SDS scores in patients with NERD and RE (P < 0.05). According to the SF-36 form, vitality, mental health and social functioning were significantly correlated with symptoms of depression in patients with NERD and RE. General health was obviously affected by symptoms of depression in patients with NERD (P < 0.05).

CONCLUSION: Anxiety and depression may play an important role in the occurrence of GERD and especially that of NERD. The QoL of patients with GERD is reduced by anxiety and depression.

Keywords: Anxiety; Depression; Gastroesophageal reflux disease; Zung Self-Rating Anxiety Scale; Zung Self-Rating Depression Scale; SF-36; Quality of life

Core tip: In our study, the degree of anxiety and depression in non-erosive reflux disease (NERD) and reflux esophagitis patients was significantly higher than that of healthy controls, especially for the NERD group. The quality of life was negatively correlated with the degree of anxiety and depression.