DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20150157

Psychological disorders and personality characteristics of with gastro-esophageal reflux disease

Asma Manzoor, Shaunak A. Ajinkya, Pradeep R. Jadhav, Rakesh P. Ghildiyal

Abstract


Background: Gastro-esophageal reflux disease (GERD) can be traced back to disorders of the gastro-esophageal junction but several psychological factors interact to affect treatment outcomes. There is sparse literature from India regarding psychological co-morbidity and personality characteristics in patients with GERD.

Aim and Objectives: To study the co-morbid psychological disorders and personality profiles in patients suffering from GERD.

Methods: Two hundred patients with GERD-related symptoms were randomly screened for psychological disorders and personality characteristics using 30-item General Health Questionnaire (GHQ) and Sixteen Personality Factor Questionnaire (16PF) respectively. Patients who screened positive for presence of co-morbid psychological disorders were further interviewed using Structured Clinical Interview for DSM-IV Axis 1 Disorders (SCID-1) to find out the type of psychological disorder.

Results:The prevalenceofpsychological co-morbidity in patients with GERD-related symptoms in our sample was foundto be 40%. Major depressive disorder was the most common psychological disorder found co-morbid in these patients. Alcohol dependence was significantly observed in males; while in females, major depressive disorder and generalized anxiety disorder was more commonly seen. Regarding personality characteristics, a higher degree of neuroticism and risk-taking attitudes was found in patients of GERD with associated psychological co-morbidity

Conclusions:This study suggests that the management of GERD may include psychological evaluations and possibly interventions in standard treatment protocols.

 


Keywords


GERD, GORD, Psychological disorders, Personality traits, Co-morbidity

Full Text:

PDF

References


Sadock BJ, Sadock VA, Ruiz P. Kaplan & Sadock’s Synopsis of Psychiatry - Behavioral Sciences/ Clinical Psychiatry. 11th ed. New Delhi: Wolters Kluver India) Pvt Ltd; 2015. Chapter 13, Psychosomatic Medicine; p.465-503.

DeVault KR, Castell DO, American College of Gastroenterology. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol. 2005;100(1):190-200.

Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R, Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101(8):1900-20.

Söderholm JD. Stress-related changes in oesophageal permeability: filling the gaps of GORD? Gut. 2007;56(9):1177-80.

Fass R. Persistent heartburn in a patient on proton-pump inhibitor. Clin Gastroenterol Hepatol. 2008; 6(4):393-400.

Fass R, Gasiorowska A. Refractory GERD: what is it? Curr Gastroenterol Rep. 2008;10(3):252-7.

Camilleri M, Dubois D, Coulie B, Jones M, Kahrilas PJ, Rentz AM, et al. Prevalence and socioeconomic impact of upper gastrointestinal disorders in the United States: results of the US Upper Gastrointestinal Study. Clin Gastroenterol Hepatol. 2005;3(6):543-52.

Nebel OT, Fornes MF, Castell DO. Symptomatic gastroesophageal reflux: incidence and precipitating factors. Am J Dig Dis. 1976;21(11):953-6.

Goh KL, Wong CH. Gastroesophageal Reflux Disease:An Emerging Disease in Asia. J Gastroenterol Hepatol. 2006;2:118-23.

Ho KY, Kang JY, Seow A. Prevalence of gastrointestinal symptoms in a multiracial Asian population, with particular reference to reflux-type symptoms. Am J Gastroenterol. 1998;93(10):1816-22.

Bhatia SJ, Reddy DN, Ghoshal UC, Jayanthi V, Abraham P, Choudhuri G, et al. Epidemiology and symptom profile of gastroesophageal reflux in the Indian population: report of the Indian Society of Gastroenterology Task Force. Indian J Gastroenterol. 2011;30(3):118-27.

Sharma PK, Ahuja V, Madan K, Gupta S, Raizada A, Sharma MP. Prevalence, severity, and risk factors of symptomatic gastroesophageal reflux disease among employees of a large hospital in northern India. Indian J Gastroenterol. 2011;30(3): 128-34.

Saberi-Firoozi M, Khademolhosseini F, Yousefi M, Mehrabani D, Zare N, Heydari ST. Risk factors of gastroesophageal reflux disease in Shiraz, southern Iran. World J Gastroenterol. 2007;13(41):5486-91.

Mizyed I, Fass SS, Fass R. Gastro-oesophageal reflux disease and psychological comorbidity. Aliment Pharmacol Ther. 2009;29(4):351-8.

Nielzén S, Pettersson KI, Regnéll G, Svensson R. The role of psychiatric factors in symptoms of hiatus hernia or gastric reflux. Acta Psychiatr Scand. 1986;73(2):214-20.

Rey E, García-Alonso M, Moreno-Ortega M, Almansa C, Alvarez-Sanchez A, Díaz-Rubio M. Influence of psychological distress on characteristics of symptoms in patients with GERD: the role of IBS comorbidity. Dig Dis Sci. 2009; 54(2):321-7.

Avidan B, Sonnenberg A, Giblovich H, Sontag SJ. Reflux symptoms are associated with psychiatric disease. Aliment Pharmacol Ther. 2001;15(12): 1907-12.

Whittington J, Huppert FA. Creating invariant subscales of the GHQ-30. Soc Sci Med. 1998; 46(11):1429-40.

Russell MT, Karol D. 16PF fifth edition administrator’s manual. Champaign, IL: Institute for Personality and Ability Testing; 2002.

First MB, Spitzer RL, Gibbon M. Structured Clinical Interview for DSM IV Axis Disorders, New York: State Psychiatric Institute, Biometrics research; 1995.

Rosaida MS, Goh KL. Gastro-oesophageal reflux disease, reflux oesophagitis and non-erosive reflux disease in a multiracial Asian population: a prospective, endoscopy based study. Eur J Gastroenterol Hepatol. 2004;16(5):495-501.

Núñez-Rodríguez MH, Miranda SA. Psychological Factors in Gastroesophageal Reflux Disease Measured by SCL-90-R Questionnaire. Dig Dis Sci. 2008; 53:3071-5.

Wong WM, Lai KC, Lam KF, Hui WM, Hu WH, Lam CL, et al. Prevalence, clinical spectrum and health care utilization of gastro-oesophageal reflux disease in a Chinese population: a population-based study. Aliment Pharmacol Ther. 2003;18(6):

-604.

Jansson C, Nordenstedt H, Wallander MA, Johansson S, Johnsen R, Hveem K, et al. Severe gastro-oesophageal reflux symptoms in relation to anxiety, depression and coping in a population-based study. Aliment Pharmacol Ther. 2007; 26(5): 683-91.

Mohammed I, Nightingale P, Trudgill NJ. Risk factors for gastro-oesophageal reflux disease symptoms: a community study. Aliment Pharmacol Ther. 2005;21(7):821-7.

Chen S, Wang J, Li Y. Is alcohol consumption associated with gastroesophageal reflux disease? J Zhejiang Univ Sci B. 2010;11(6):423–428.

Wang JH, Luo JY, Dong L, Gong J, Tong M. Epidemiology of gastroesophageal reflux disease: a general population-based study in Xi'an of Northwest China. World J Gastroenterol. 2004; 10(11):1647-51.

Johnston BT, Lewis SA, Love AH. Psychological factors in gastro-oesophageal reflux disease. Gut. 1995;36(4):481-2.

Holtmann G, Kriebel R, Singer MV. Mental stress and gastric acid secretion. Do personality traits influence the response? Dig Dis Sci 1990;35(8): 998-1007.

Subic-Wrana C, Beutel ME, Knebel A, Lane RD. Theory of mind and emotional awareness deficits in patients with somatoform disorders. Psychosom Med. 2010;72(4):404-11.