A cross-sectional study of gastrointestinal symptoms, depressive symptoms and trait anxiety in young adults

• Published in: BMC psychiatry Vol. 20; no. 1; p. 535
• Main Authors: Söderquist, Fanny, Syk, Mikaela, Just, David, Kurbalija Novicic, Zorana, Rasmusson, Annica J, Hellström, Per M, Ramklint, Mia, Cunningham, Janet L
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 11-11-2020; BioMed Central; BMC
• Subjects: Anxiety; Anxiety - complications; Anxiety - epidemiology; Anxiety disorder; Anxiety disorders; Body mass index; Bulimia nervosa; Communication; Constipation; Cross-Sectional Studies; Depression (Mood disorder); Depression - epidemiology; Depressive disorder; Diagnosis; Gastrointestinal diseases; Gastrointestinal Diseases - complications; Gastrointestinal Diseases - epidemiology; Health aspects; Humans; Intestine; Irritable bowel syndrome; Irritable bowel syndromes; Likert scale; Mental depression; Morbidity; Nervous system; Pain; Pathophysiology; Patients; Permeability; Personality; Psychiatric Status Rating Scales; Psychiatry; Psychological aspects; Psychotropic drugs; Quality of life; Questionnaires; Risk factors; Severity of Illness Index; Sweden; Young Adult; Young adults; Sweden; Personality; Irritable bowel syndromes; Anxiety disorder; Depressive disorder
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-020-02940-2

>Patients with functional gastrointestinal disorders have a high psychiatric co-morbidity. This study aimed to investigate and characterise gastrointestinal symptoms in relation to depressive symptoms and trait anxiety in a well-defined population of young adult psychiatric outpatients and healthy controls.
Gastrointestinal symptoms were assessed with the Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS). Depressive symptoms were assessed with the Montgomery-Åsberg Depression Rating Scale- Self assessment (MADRS-S). Trait anxiety was estimated with three of the Swedish universities of Personality (SSP) scales: Somatic trait anxiety, Psychic trait anxiety and Stress susceptibility. Self-ratings were collected from 491 young adult psychiatric outpatients and 85 healthy controls. Gastrointestinal symptom severity was compared between patients with and without current psychotropic medication and controls. Associations between gastrointestinal symptoms, depressive symptoms and trait anxiety were assessed using Spearman's coefficients and generalized linear models adjusting for possible confounders (sex, body mass index, bulimia nervosa).
Patients, with and without current psychotropic medication, reported significantly more gastrointestinal symptoms than controls. In the generalized linear models, total MADRS-S score (p < 0.001), Somatic trait anxiety (p < 0.001), Psychic trait anxiety (p = 0.002) and Stress susceptibility (p = 0.002) were independent predictors of the total GSRS-IBS score. Further exploratory analysis using unsupervised learning revealed a diverse spectrum of symptoms that clustered into six groups.
Gastrointestinal symptoms are both highly prevalent and diverse in young adult psychiatric outpatients, regardless of current psychotropic medication. Depressive symptom severity and degree of trait anxiety are independently related to the total gastrointestinal symptom burden.