Sanna Livia, Stuart Amanda L, Berk Michael, Pasco Julie A, Girardi Paolo, Williams Lana J
BMC Psychiatry. 2013 Jul 24;13:194. doi: 10.1186/1471-244X-13-194.
Psychopathology seems to play a role in reflux pathogenesis and vice versa, yet few population-based studies have systematically investigated the association between gastro-oesophageal reflux disease (GORD) and psychopathology. We thus aimed to investigate the relationship between GORD-related symptoms and psychological symptomatology, as well as clinically diagnosed mood and anxiety disorders in a randomly selected, population-based sample of adult women.
This study examined data collected from 1084 women aged 20-93 yr participating in the Geelong Osteoporosis Study. Mood and anxiety disorders were identified using the Structured Clinical Interview for DSM-IV-TR Research Version, Non-patient edition (SCID-I/NP), and psychological symptomatology was assessed using the General Health Questionnaire (GHQ-12). GORD-related symptoms were self-reported and confirmed by medication use where possible and lifestyle factors were documented.
Current psychological symptomatology and mood disorder were associated with increased odds of concurrent GORD-related symptoms (adjusted OR 2.1, 95% CI 1.3-3.5, and OR 3.0, 95% CI 1.7-5.6, respectively). Current anxiety disorder also tended to be associated with increased odds of current GORD-related symptoms (p = 0.1). Lifetime mood disorder was associated with a 1.6-fold increased odds of lifetime GORD-related symptoms (adjusted OR 1.6, 95% CI 1.1-2.4) and lifetime anxiety disorder was associated with a 4-fold increased odds of lifetime GORD-related symptoms in obese but not non-obese participants (obese, age-adjusted OR 4.0, 95% CI 1.8-9.0).
These results indicate that psychological symptomatology, mood and anxiety disorders are positively associated with GORD-related symptoms. Acknowledging this common comorbidity may facilitate recognition and treatment, and opens new questions as to the pathways and mechanisms of the association.
精神病理学似乎在反流发病机制中起作用，反之亦然，但很少有基于人群的研究系统地调查胃食管反流病（GORD）与精神病理学之间的关联。因此，我们旨在调查在一个随机抽取的成年女性人群样本中，GORD相关症状与心理症状学之间的关系，以及临床诊断的情绪和焦虑障碍。
本研究检查了参与吉朗骨质疏松症研究的1084名年龄在20 - 93岁女性的数据。使用《精神疾病诊断与统计手册》第四版修订版研究版非患者版结构化临床访谈（SCID - I/NP）确定情绪和焦虑障碍，并使用一般健康问卷（GHQ - 12）评估心理症状学。GORD相关症状通过自我报告，并在可能的情况下通过用药情况进行确认，同时记录生活方式因素。
当前的心理症状学和情绪障碍与并发GORD相关症状的几率增加有关（调整后的比值比分别为2.1，95%置信区间1.3 - 3.5，以及3.0，95%置信区间1.7 - 5.6）。当前的焦虑障碍也倾向于与当前GORD相关症状的几率增加有关（p = 0.1）。终生情绪障碍与终生GORD相关症状的几率增加1.6倍有关（调整后的比值比1.6，95%置信区间1.1 - 2.4），终生焦虑障碍与肥胖但非肥胖参与者终生GORD相关症状的几率增加4倍有关（肥胖者，年龄调整后的比值比4.0，95%置信区间1.8 - 9.0）。
这些结果表明，心理症状学、情绪和焦虑障碍与GORD相关症状呈正相关。认识到这种常见的共病情况可能有助于识别和治疗，并就这种关联的途径和机制提出了新的问题。
