Background and Aim Functional dyspepsia (FDA is the most common
type of dyspepsia encountered in primary care and gastroenterology
practice. Patients with FD would have a greater prevalence of treatable
psychiatric disorders. The aim of this trial was to study the
prevalence of psychiatric disorders and somatic symptoms in patients
with functional dyspepsia and to compare them with those with duodenal
ulcer disease(DU). Patients and Methods: in this prospective randomized
controlled study, we selected 100 consecutive FD patients and
the same number of endoscopically proven DU patients(as a control
group). Patients were subjected to full history taking, complete clinical
examination, laboratory investigations, esophagogastroduodenoscopy
and psychiatric evaluation through General Health Questionnaire
(GHQ), Hospital Anxiety Depression Scale (HADS) and Structured Psychiatric
Interview (PSEI0). Results: Patients with FD were significantly
younger, more likely to be females, less tendency to smoke, had more
frequent dyspeptic symptoms, a longer disease history and lower incidence
of H. pylon infection than duodenal ulcer patients. Psychiatric
morbidity was significantly higher in FD patients than DU patients
(65% compared to 26%). Prevalence of psychiatric disorders was as follow-
somatoform disorders 36%, mixed anxiety depressive disorder
21%,generalized anxiety disorder 17%,and depressive episode 4% in FD
patients. As regard DU patients; somatoform disorders 8%, mixed anxiety
disorder 10% and generalized disorder 8%. Using stepwise logistic
regression model, it had been shown that, somatoform autonomic dysfunction
and arrdety symptoms of (HADS) were independently associated
with functional dyspepsia and the best predictors of diagnosing functional
dyspepsia or duodenal ulcer. Conclusion: Psychiatric disorders
are strongly associated with functional dyspepsia that warrant psychiatric
intervention that may benefit FD patients specially those with chronic
symptoms. |
