Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 14, 2016; 22(42): 9437-9444
Published online Nov 14, 2016. doi: 10.3748/wjg.v22.i42.9437
Prevalence of depression and anxiety in patients with chronic digestive system diseases: A multicenter epidemiological study
An-Zhong Zhang, Qing-Cai Wang, Kun-Ming Huang, Jia-Guo Huang, Chang-Hong Zhou, Fu-Qiang Sun, Su-Wen Wang, Feng-Ting Wu
An-Zhong Zhang, Department of Gastroenterology, Shandong Provincial Hospital Affiliate to Shandong University, Jinan 250021, Shandong Province, China
Qing-Cai Wang, Department of Gastroenterology, Taian City Central Hospital, Taian 271000, Shandong Province, China
Kun-Ming Huang, Department of Gastroenterology, Central Hospital of Zibo, Zibo 255036, Shandong Province, China
Jia-Guo Huang, Department of Gastroenterology, Laiwu City People’s Hospital, Laiwu 271100, Shandong Province, China
Chang-Hong Zhou, Qingdao Municipal Hospital, Qingdao 266071, Shandong Province, China
Fu-Qiang Sun, Department of Gastroenterology, Affiliated Hospital of Jining Medical University, Jining 272100, Shandong Province, China
Su-Wen Wang, Department of Gastroenterology, Jinan Central Hospital, Jinan 250013, Shandong Province, China
Feng-Ting Wu, Department of Gastroenterology, Dongying City People’s Hospital, Dongying 257091, Shandong Province, China
Author contributions: Zhang AZ and Wang QC designed the research; Huang KM, Huang JG, Zhou CH and Wu FT performed the research; Sun FQ contributed new reagents or analytic tools; Wang SW analyzed the data; Zhang AZ and Wu FT wrote the paper.
Institutional review board statement: The study was reviewed and approved by the Science and Research Office of Taian Central Hospital (Shandong).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
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: Dr. Qing-Cai Wang, Professor, Department of Gastroenterology, Taian City Central Hospital, No. 29 Longtan Road, Taian 271000, Shandong Province, China. wqczs@163.com
Telephone: +86-13375388366 Fax: +86-538-8223227
Received: July 6, 2016
Peer-review started: July 7, 2016
First decision: August 8, 2016
Revised: August 31, 2016
Accepted: September 28, 2016
Article in press: September 28, 2016
Published online: November 14, 2016

To investigate the prevalence of depression and anxiety in patients with chronic digestive system diseases.


A total of 1736 patients with chronic digestive system diseases were included in this cross-sectional study, including 871 outpatients and 865 in-patients. A self-designed General Information for Patients of the Department of Gastroenterology of General Hospitals questionnaire was used to collect each patient’s general information, which included demographic data (including age, sex, marital status, and education) and disease characteristics (including major diseases, disease duration, principal symptoms, chronic pain, sleep disorder, and limited daily activities).


The overall detection rate was 31.11% (540/1736) for depression symptoms alone, 27.02% (469/1736) for anxiety symptoms alone, 20.68% (359/1736) for both depression and anxiety symptoms, and 37.44% (650/1736) for either depression or anxiety symptoms. Subjects aged 70 years or above had the highest detection rate of depression (44.06%) and anxiety symptoms (33.33%). χ2 trend test showed: the higher the body mass index (BMI), the lower the detection rate of depression and anxiety symptoms (χ2trend = 13.697, P < 0.001; χ2trend = 9.082, P = 0.003); the more severe the limited daily activities, the higher the detection rate of depression and anxiety symptoms (χ2trend = 130.455, P < 0.001, χ2trend = 108.528, P < 0.001); and the poorer the sleep quality, the higher the detection rate of depression and anxiety symptoms (χ2trend = 85.759, P < 0.001; χ2trend = 51.969, P < 0.001). Patients with digestive system tumors had the highest detection rate of depression (57.55%) and anxiety (55.19%), followed by patients with liver cirrhosis (41.35% and 48.08%). Depression and anxiety symptoms were also high in subjects with comorbid hypertension and coronary heart disease.


Depression and anxiety occur in patients with tumors, liver cirrhosis, functional dyspepsia, and chronic viral hepatitis. Elderly, divorced/widowed, poor sleep quality, and lower BMI are associated with higher risk of depression and anxiety.

Keywords: Depression, Anxiety, Chronic digestive system diseases, Psychiatric illnesses

Core tip: Depressive and anxiety disorders are common psychiatric illnesses. Depression and anxiety can not only lower the quality of life but also affect the therapeutic effects on somatic diseases. Research has shown that detection rates of depression and anxiety symptoms are high in patients with chronic digestive system diseases, especially in patients with digestive system tumors, liver cirrhosis, functional dyspepsia, and chronic viral hepatitis. Elderly patients, divorced/widowed patients, patients with a low degree of education, limited daily activities, poor sleep quality, or a lower body mass index are at higher risk for depression and anxiety symptoms.