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Published online before print June 7, 2007
Psychosom Med 2007, doi:10.1097/PSY.0b013e3180600a4a
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© 2007 by American Psychosomatic Society

Original Article


Received August 18, 2006
Returned for revision December 11, 2006

Relationship Between Anxiety and Gastric Sensorimotor Function in Functional Dyspepsia

Lukas Van Oudenhove , MD, Joris Vandenberghe , MD, Brecht Geeraerts , MSc, Rita Vos , MSc, Philippe Persoons , MD, Koen Demyttenaere , MD, PhD, Benjamin Fischler , MD, PhD, Jan Tack , MD, PhD


Address correspondence and reprint requests to: Lukas Van Oudenhove, MD, E-mail: Lukas.VanOudenhove{at}med.kuleuven.be.


  Abstract

Objective: To investigate the relationship between anxiety and gastric sensorimotor function in patients with (hypersensitive) functional dyspepsia (FD). Comorbidity between FD and anxiety disorders is high. In FD, epigastric pain is associated with gastric hypersensitivity and neuroticism, a personality trait related to anxiety. Experimentally induced anxiety in healthy volunteers is associated with changes in sensorimotor function of the proximal stomach. Methods: A total of 139 patients with FD (n = 102 women) underwent a barostat investigation to determine gastric compliance, meal accommodation, and thresholds for discomfort and pain. Anxiety was measured by the State-Trait Anxiety Inventory (STAI) scale (anxiety as a stable personality trait) and the STAI-State scale (momentary anxiety). The anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A) was filled out to detect comorbid anxiety disorders. Results: Hyper- and normosensitive patients had similar anxiety scores, but gastric compliance was significantly lower in hypersensitive patients (11.4 versus 32.8 ml/mm Hg; p < .001). In the whole patient group, no significant correlations between STAI scores and gastric sensorimotor function were found. In hypersensitive patients (n = 53, 43 women), state anxiety was negatively correlated with discomfort threshold ({rho} = -.49; p = .001), pain threshold ({rho} = -.48; p = .02), and gastric compliance ({rho} = -.46; p = .002). These results were confirmed by multiple linear and logistic regression analyses. Conclusion: In hypersensitive patients with FD, state anxiety is significantly and negatively correlated with discomfort threshold, pain threshold, and compliance. These results strengthen the hypothesis that anxiety is important in FD, especially in hypersensitive patients.

Key Words: functional dyspepsia, hypersensitivity, barostat, anxiety, central nervous system, brain-gut axis.




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L Van Oudenhove, J Vandenberghe, B Geeraerts, R Vos, P Persoons, B Fischler, K Demyttenaere, and J Tack
Determinants of symptoms in functional dyspepsia: gastric sensorimotor function, psychosocial factors or somatisation?
Gut, December 1, 2008; 57(12): 1666 - 1673.
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Copyright © 2007 by the American Psychosomatic Society