Department of Medicine II, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.
LWL-Clinic for Forensic Psychiatry, Herne, Germany.
J Affect Disord. 2018 Jan 15;226:196-202. doi: 10.1016/j.jad.2017.09.049. Epub 2017 Sep 28.
Patients suffering from major depressive disorder (MDD) often complain about somatic symptoms. Cardiac complaints have been examined predominantly. However, gastrointestinal complaints are also reported frequently and are associated with worse outcomes. The research concerning changes in gastric motility of these patients is rather sparse. The aim of our study was to determine dysfunction of gastric motility and gastrointestinal symptoms in MDD. The duration and severity of MDD were examined regarding its influence over gastric emptying.
Gastric emptying was determined by a C-acetate breath test in patients with MDD (n = 29) and healthy control subjects (n = 51). Prior to this, depressive illness was operationalized using external and self-assessment scales (HAMD-21, MADRS, BDI, CGI). Whether the severity or duration of MDD influenced the gastric emptying parameters was examined using Spearman's correlation. In addition, autonomic complaints were recorded by means of an ANS score. Each ANS score item was determined using a Mann-Whitney U or Kruskal-Wallis test concerning the gastric emptying parameters.
There was a significant difference in the parameters of the maximum gastric emptying rate (T) and gastric half emptying time T between patients with MDD and healthy control subjects (T 66.21min vs 53.35min, p < 0.006, T 207.59min vs 133.27min, p < 0.005). There was a significant negative correlation between T and the severity of MDD determined with the depression rating scales BDI (Spearman's rank - 0.521, p = 0.013) and HAMD-21 (r - 0.384, p = 0.048). No correlation was found between the duration of MDD and the maximum gastric emptying rate (r - 0.125, p = 0.519) and gastric half emptying time (r - 0.62, p = 0.749).
Gastrointestinal motility is significantly impaired in patients with MDD compared to healthy control subjects. Autonomic complaints were indicated frequently in MDD patients. The duration of MDD had no influence over the time of gastric emptying. There was a significant negative correlation between the severity of MDD and T, indicating that the T was reached earlier with the progression of MDD. The slowing of gastric motility in MDD patients is likely a result of a dysfunction of the autonomic nervous system.
患有重度抑郁症（MDD）的患者常抱怨躯体症状。主要检查了心脏方面的不适。但是，胃肠道不适也经常被报道，且与更差的结局相关。关于这些患者胃动力变化的研究相对较少。我们研究的目的是确定 MDD 患者胃动力功能障碍和胃肠道症状。检查 MDD 的持续时间和严重程度对胃排空的影响。
通过 C-乙酸盐呼吸试验测定 MDD 患者（n=29）和健康对照者（n=51）的胃排空情况。在此之前，使用外部和自我评估量表（HAMD-21、MADRS、BDI、CGI）将抑郁障碍进行量化。使用 Spearman 相关分析检查 MDD 的严重程度或持续时间是否影响胃排空参数。此外，通过自主神经评分记录自主神经投诉。根据胃排空参数，使用 Mann-Whitney U 或 Kruskal-Wallis 检验确定每个自主神经评分项目。
MDD 患者与健康对照者之间最大胃排空率（T）和胃半排空时间 T 的参数存在显著差异（T 66.21min 比 53.35min，p <0.006，T 207.59min 比 133.27min，p <0.005）。T 与 BDI（Spearman 秩-0.521，p=0.013）和 HAMD-21（r=-0.384，p=0.048）等抑郁评定量表确定的 MDD 严重程度之间存在显著负相关。MDD 持续时间与最大胃排空率（r=-0.125，p=0.519）和胃半排空时间（r=-0.62，p=0.749）之间无相关性。
与健康对照者相比，MDD 患者的胃肠道动力明显受损。MDD 患者经常出现自主神经投诉。MDD 的持续时间对胃排空时间没有影响。MDD 严重程度与 T 之间存在显著负相关，表明随着 MDD 的进展，T 更早达到。MDD 患者胃动力减慢可能是自主神经系统功能障碍的结果。
