Li Ping, Wang Fei, Ji Guo-Zhong, Miao Lin, You Sihong, Chen Xia
The Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Digestive Endoscopy Institute, Nanjing Medical University, Jiangjiayuan, Nanjing, China.
Medicine (Baltimore). 2018 Feb;97(5):e9783. doi: 10.1097/MD.0000000000009783.
Persisting gastroesophageal reflux disease (GERD) symptoms affect mental state and social activities and mental disorders likewise play a crucial role on GERD symptoms. The aim of this study was to analyze the data of Symptom Checklist by 90-Revised (SCL-90-R) questionnaire in patients with persisting GERD symptom and to explore the impact of psychological factors on them.The patients accepted SCL-90-R questionnaire survey, following endoscopy, high-resolution manometry (HRM) and ambulatory impedance-pH monitoring. Based on these results, we divided patients into different groups. The result of SCL-90-R was also compared by degree of acid reflux, symptoms, symptom duration, and gender.The data from 438 patients were analyzed. All patients were divided into reflux esophagitis (RE) (63, 14.38%); nonerosive gastroesophageal disease (NERD) (106, 24.20%); functional heartburn (FH) (123, 28.08%), and hypersensitive esophagus (HE) (67, 15.29%); depression (DES) (5, 1.14%); hypertensive (10, 3.42%); weak peristalsis (14, 3.20%); achalasia (50, 11.42%). There were significant differences between varied groups judging by DEP, anxiety (ANX), paranoia ideation (PAR), psychoticism (PSY), and global severity index (GSI) domains (all P < .05). The patients with ≥2 years symptom duration presented more scores in DEP, ANX, and PSY (all P < .05). Compared to typical symptoms (n = 185), GERD typical plus atypical symptoms (n = 253) had higher scores of somatization (SOM), ANX, PSY and GSI (all P < .05). Women were found to have significantly higher scores than men in all domains (all P < .05).Our results find significant differences between varied patients with different diagnosis in DEP, ANX, PAR, PSY domains, and GSI. Long symptom duration, typical plus atypical symptoms, and female are more risky for psychological disorders.
持续性胃食管反流病(GERD)症状会影响精神状态和社交活动,而精神障碍对GERD症状同样起着关键作用。本研究旨在分析持续性GERD症状患者的90项症状自评量表修订版(SCL-90-R)问卷数据,并探讨心理因素对其的影响。患者在接受内镜检查、高分辨率测压(HRM)和动态阻抗-pH监测后,接受SCL-90-R问卷调查。基于这些结果,我们将患者分为不同组。还根据酸反流程度、症状、症状持续时间和性别对SCL-90-R的结果进行了比较。对438例患者的数据进行了分析。所有患者分为反流性食管炎(RE)(63例,14.38%);非糜烂性胃食管病(NERD)(106例,24.20%);功能性烧心(FH)(123例,28.08%),以及高敏食管(HE)(67例,15.29%);抑郁症(DES)(5例,1.14%);高血压(10例,3.42%);蠕动减弱(14例,3.20%);贲门失弛缓症(50例,11.42%)。根据抑郁(DEP)、焦虑(ANX)、偏执观念(PAR)、精神病性(PSY)和总体严重程度指数(GSI)领域判断,不同组之间存在显著差异(所有P<0.05)。症状持续时间≥2年的患者在DEP、ANX和PSY方面得分更高(所有P<0.05)。与典型症状患者(n=185)相比,GERD典型加非典型症状患者(n=253)在躯体化(SOM)、ANX、PSY和GSI方面得分更高(所有P<0.05)。发现女性在所有领域的得分均显著高于男性(所有P<0.05)。我们的结果发现,不同诊断的患者在DEP、ANX、PAR、PSY领域和GSI方面存在显著差异。症状持续时间长、典型加非典型症状以及女性更容易出现心理障碍。