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Gastrointestinal symptoms in primary care: prevalence and association with depression and anxiety.
J Psychosom Res. 2008 Jun; 64(6):605-12.JP

Abstract

OBJECTIVE

Results from general population studies suggest a relationship between gastrointestinal (GI) symptoms, depression, and anxiety. However, no primary care study has investigated this issue. This study investigates the prevalence of GI symptoms in primary care and their association with depression and anxiety.

METHOD

Within a cross-sectional survey, 2091 consecutive patients from 15 primary care clinics in the United States completed self-report questionnaires regarding GI symptoms [15-item Patient Health Questionnaire (PHQ-15)], anxiety [seven-item Generalized Anxiety Disorder Scale (GAD-7)], and depression (PHQ-8). Of those, 965 randomly selected patients additionally underwent a criterion standard diagnostic telephone interview (Structured Clinical Interview for DSM-IV) for the most common anxiety disorders.

RESULTS

A total of 380 [18% (95% CI, 16.3% to 19.3%)] patients reported to be substantially bothered by at least one GI symptom in the previous 4 weeks. The prevalence of severe levels of depression (PHQ-8 score > or =15) was nearly fivefold in patients with GI symptoms compared to patients without GI symptoms (19.1% vs. 3.9%; P<.001), and the prevalence of severe levels of anxiety (GAD-7 score > or =15) was nearly fourfold in patients with GI symptoms compared to patients without GI symptoms (19.4% vs. 5.6%; P<.001). Similarly, with each additional GI symptom, the odds for an interview-based diagnosis of specific anxiety disorders increased significantly: For example, compared to patients with no GI symptom, the odds ratio (OR) (95% CI) for generalized anxiety disorder in patients with one GI symptom was 3.7 (2.0 to 6.9); in patients with two GI symptoms, OR=6.5 (3.1 to 13.6); and in patients with three GI symptoms, OR=7.2 (2.7 to 18.8).

CONCLUSION

GI symptoms are associated significantly with depression and anxiety in primary care. It is suggested to screen as a routine for anxiety and depression in patients with GI symptoms and, if indicated, to initiate specific treatment.

Authors+Show Affiliations

Department of Psychosomatic and General Internal Medicine, University of Heidelberg, Heidelberg, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18501261

Citation

Mussell, Monika, et al. "Gastrointestinal Symptoms in Primary Care: Prevalence and Association With Depression and Anxiety." Journal of Psychosomatic Research, vol. 64, no. 6, 2008, pp. 605-12.
Mussell M, Kroenke K, Spitzer RL, et al. Gastrointestinal symptoms in primary care: prevalence and association with depression and anxiety. J Psychosom Res. 2008;64(6):605-12.
Mussell, M., Kroenke, K., Spitzer, R. L., Williams, J. B., Herzog, W., & Löwe, B. (2008). Gastrointestinal symptoms in primary care: prevalence and association with depression and anxiety. Journal of Psychosomatic Research, 64(6), 605-12. https://doi.org/10.1016/j.jpsychores.2008.02.019
Mussell M, et al. Gastrointestinal Symptoms in Primary Care: Prevalence and Association With Depression and Anxiety. J Psychosom Res. 2008;64(6):605-12. PubMed PMID: 18501261.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gastrointestinal symptoms in primary care: prevalence and association with depression and anxiety. AU - Mussell,Monika, AU - Kroenke,Kurt, AU - Spitzer,Robert L, AU - Williams,Janet B W, AU - Herzog,Wolfgang, AU - Löwe,Bernd, Y1 - 2008/04/28/ PY - 2007/09/03/received PY - 2008/01/29/revised PY - 2008/02/08/accepted PY - 2008/5/27/pubmed PY - 2008/10/22/medline PY - 2008/5/27/entrez SP - 605 EP - 12 JF - Journal of psychosomatic research JO - J Psychosom Res VL - 64 IS - 6 N2 - OBJECTIVE: Results from general population studies suggest a relationship between gastrointestinal (GI) symptoms, depression, and anxiety. However, no primary care study has investigated this issue. This study investigates the prevalence of GI symptoms in primary care and their association with depression and anxiety. METHOD: Within a cross-sectional survey, 2091 consecutive patients from 15 primary care clinics in the United States completed self-report questionnaires regarding GI symptoms [15-item Patient Health Questionnaire (PHQ-15)], anxiety [seven-item Generalized Anxiety Disorder Scale (GAD-7)], and depression (PHQ-8). Of those, 965 randomly selected patients additionally underwent a criterion standard diagnostic telephone interview (Structured Clinical Interview for DSM-IV) for the most common anxiety disorders. RESULTS: A total of 380 [18% (95% CI, 16.3% to 19.3%)] patients reported to be substantially bothered by at least one GI symptom in the previous 4 weeks. The prevalence of severe levels of depression (PHQ-8 score > or =15) was nearly fivefold in patients with GI symptoms compared to patients without GI symptoms (19.1% vs. 3.9%; P<.001), and the prevalence of severe levels of anxiety (GAD-7 score > or =15) was nearly fourfold in patients with GI symptoms compared to patients without GI symptoms (19.4% vs. 5.6%; P<.001). Similarly, with each additional GI symptom, the odds for an interview-based diagnosis of specific anxiety disorders increased significantly: For example, compared to patients with no GI symptom, the odds ratio (OR) (95% CI) for generalized anxiety disorder in patients with one GI symptom was 3.7 (2.0 to 6.9); in patients with two GI symptoms, OR=6.5 (3.1 to 13.6); and in patients with three GI symptoms, OR=7.2 (2.7 to 18.8). CONCLUSION: GI symptoms are associated significantly with depression and anxiety in primary care. It is suggested to screen as a routine for anxiety and depression in patients with GI symptoms and, if indicated, to initiate specific treatment. SN - 0022-3999 UR - https://www.unboundmedicine.com/medline/citation/18501261/Gastrointestinal_symptoms_in_primary_care:_prevalence_and_association_with_depression_and_anxiety_ DB - PRIME DP - Unbound Medicine ER -