Department of Psychiatry, Taipei Veterans General Hospital, Yuli Branch, Hualien 981002, Taiwan.
Institute of Medical Sciences, Tzu Chi University, Hualien 970374, Taiwan.
Int J Environ Res Public Health. 2021 Jun 2;18(11):5964. doi: 10.3390/ijerph18115964.
Given the frequent concomitance between depression and gastroesophageal reflux disease (GERD), it is important to evaluate the change of depression in patients with GERD, especially considering the presence of esophageal mucosal breaks (MB). This study aimed to examine the change in the levels of depression in patients with GERD during proton-pump inhibitors (PPI) therapy. We designed a prospective cohort study to explore the profile of the alteration in depression with respect to the impact of esophageal MB. This study recruited 172 eligible patients with GERD between February 2016 and May 2018. The change in depression was defined as the difference between the respective Taiwanese Depression Questionnaire (TDQ) scores obtained at baseline and after PPI therapy. Multivariate linear regression models were used to estimate the factors associated with the change in depression. The results revealed statistically significant improvements in the TDQ score (mean score: baseline = 13.2, after PPI therapy = 10.9, < 0.01, Cohen's d = 0.30) during PPI therapy for GERD. Moreover, the MB was an independent variable associated with changes in the TDQ score [B = 3.31, 95% confidence interval (CI): (1.12, 5.51), < 0.01] and the improvement in depression [odds ratio = 0.38, 95% CI: (0.17, 0.86), = 0.02]. Our findings revealed that depressive symptoms improved slightly following PPI therapy. Moreover, MB was an unfavorable prognostic factor for the improvement in depression.
鉴于抑郁和胃食管反流病（GERD）经常同时发生，评估 GERD 患者的抑郁变化非常重要，尤其是考虑到食管黏膜破损（MB）的存在。本研究旨在研究质子泵抑制剂（PPI）治疗期间 GERD 患者抑郁水平的变化。我们设计了一项前瞻性队列研究，以探讨抑郁变化与食管 MB 影响之间的关系。这项研究招募了 172 名符合条件的 GERD 患者，时间为 2016 年 2 月至 2018 年 5 月。抑郁的变化定义为基线时和 PPI 治疗后各自的台湾抑郁问卷（TDQ）得分之间的差异。多变量线性回归模型用于估计与抑郁变化相关的因素。结果显示，GERD 患者在 PPI 治疗期间 TDQ 评分（平均评分：基线=13.2，PPI 治疗后=10.9，<0.01，Cohen's d=0.30）有统计学意义的显著改善。此外，MB 是与 TDQ 评分变化相关的独立变量[B=3.31，95%置信区间（CI）：（1.12，5.51），<0.01]和抑郁改善[比值比=0.38，95%CI：（0.17，0.86），=0.02]。我们的研究结果表明，PPI 治疗后抑郁症状略有改善。此外，MB 是抑郁改善的不利预后因素。
