State and trait anxiety and depression in patients affected by gastrointestinal diseases: psychometric evaluation of 1641 patients referred to an internal medicine outpatient setting
G. Addolorato
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorA. Mirijello
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorC. D’Angelo
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorL. Leggio
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorA. Ferrulli
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorL. Abenavoli
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorL. Vonghia
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorS. Cardone
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorV. Leso
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorA. Cossari
Department of Economics and Statistics, University of Calabria, Rende, Italy
Search for more papers by this authorE. Capristo
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorG. Gasbarrini
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorG. Addolorato
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorA. Mirijello
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorC. D’Angelo
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorL. Leggio
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorA. Ferrulli
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorL. Abenavoli
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorL. Vonghia
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorS. Cardone
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorV. Leso
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorA. Cossari
Department of Economics and Statistics, University of Calabria, Rende, Italy
Search for more papers by this authorE. Capristo
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorG. Gasbarrini
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
Search for more papers by this authorDisclosure The authors have declared that they have no interest which might be perceived as posing conflict or bias.
Summary
Objectives: To evaluate state and trait form of anxiety and current depression in patients affected by gastrointestinal diseases.
Methods: We studied 1641 outpatients with gastrointestinal disorders, consecutively referred to our Internal Medicine outpatients from 1997 to 2005. State and trait anxiety were assessed by the State and Trait Anxiety Inventory. Current depression was assessed by the Zung self-rating depression scale.
Results: Among patients, 1379 (84.1%) showed state anxiety, 1098 (67%) showed trait anxiety and 442 (27%) showed current depression. The number of gastrointestinal diseases was directly correlated to state anxiety (p < 0.001) and trait anxiety (p = 0.04). Females showed higher levels of anxiety and depression than males (p < 0.001). State anxiety was related to food allergies (p < 0.001), small intestinal bacterial overgrowth (SIBO) (p = 0.001), Hp infection (p = 0.01) and ulcerative colitis in active phase (p = 0.03). Trait anxiety was related to irritable bowel syndrome (IBS) (p < 0.001), Helicobacter pylori (Hp) infection (p = 0.001), food allergies (p = 0.001) and SIBO (p = 0.001). Current depression was related to IBS (p < 0.001) and coeliac disease (p = 0.01), SIBO (p = 0.02). A predicted probability of 0.77 ± 0.16 to have state anxiety, of 0.66 ± 0.12 to have trait anxiety and of 0.39 ± 0.14 to have depression was found in these patients.
Conclusions: Most of the patients who seek medical consultation for gastrointestinal problems show an associated affective disorder. These patients should be managed by a team including gastroenterologists, psychologists and/or psychiatrists, or by a gastroenterologist having expertise in the treatment of psychological disorders.
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