Anxiety and depression in various functional gastrointestinal disorders: Do differences exist?

OBJECTIVE: To examine the differences in the prevalence and severity of anxiety and depression in patients with functional dyspepsia (FD), nonerosive reflux disease (NERD), irritable bowel syndrome (IBS) and healthy controls. METHODS: Consecutive patients undergoing an index endoscopic examination for various symptoms were interviewed. All the three functional gastrointestinal disorders (FGIDs) were diagnosed according to the Rome III criteria. Anxiety and depression were diagnosed using a locally validated version of the hospital anxiety and depression scale. RESULTS: A total of 248 patients were recruited (62 in FD, NERD, IBS and control groups each) with no differences in the basic characteristics. There was a higher prevalence of anxiety and depression in FD, NERD and IBS groups than that in the control group (43.5%, 45.2% and 67.7% vs 14.5%, P < 0.001; and 22.6%, 33.9% and 38.7% vs 6.5%, P < 0.0001). Using the cutoff score (> 8) for anxiety or depression, IBS patients had a higher rate of anxiety than FD (P = 0.01) and NERD (P = 0.02), while no significant differences in depression rates were observed among all three groups. CONLUSION: Anxiety is more common in patients with IBS than in those with FD and NERD, indicating a possible causal link in the former.