Impact of depression and anxiety disorders on gastrointestinal symptoms and its prevalence in the general population

Abstract

High rates of psychiatric disorder have been documented in patients with gastrointestinal (GI) symptoms. The aim of this study was to examine the prevalence of gastrointestinal (GI) symptoms among the general adult population and to determine if psychological distress such as depression and anxiety disorder is associated with gastrointestinal disorders. This is a cross sectional study conducted during the period September 2009 to May 2010 at the Primary Health Care Centers of the Supreme Council of Health, State of Qatar. A total of 1208 patients aged 20 years and above were approached and 934 patients (77.3%) participated in this study. The study was based on a face to face interview with designed diagnostic screening questionnaires for GI symptoms, Patient Health Questionnaire (PHQ-9) for depression and General Anxiety Disorders (GAD-7) for anxiety. The questionnaire consists of questions about symptoms and signs of anxiety and depression disorders. Also, socio-demographic characteristics, life style habits and family history of patients were collected. Of the studied subjects, 62.1% were males and 37.9% were females. Out of 934 subjects interviewed, the prevalence of gastrointestinal symptoms was 41.1%. Most of the sufferers with GI symptoms were male patients (69.8%) and in the age group 45-54 years (39.6%). The prevalence of severe levels of depression was nearly twofold (8.6%) in GI patients compared to their counterparts (4.5%). The prevalence rate of anxiety was higher in sufferers of GI symptoms (21.4%). Mental health severity (mean +/- SD) was significantly higher in male patients with GI symptom compared to females; depression (7.9 +/- 4.2 vs. 6.9 +/- 4.5, p < 0.001) and anxiety 7.0 +/- 3.6 vs. 6.1 +/- 3.6, p=0.001). More than depression, anxiety was more common in patients of GI symptoms of constipation (22.3%), upper dysmotility (21.4%) and diarrhoea (20.7%). The present study findings revealed that the prevalence rate of gastrointestinal disorders is high in the primary care settings. Also, GI symptoms are associated significantly with depression and anxiety. Anxiety was more common than depression in GI patients.