Psychological dysfunction is associated with symptom severity but not disease etiology or degree of gastric retention in patients with gastroparesis
William L Hasler, Henry P Parkman, Laura A Wilson, Pankaj J Pasricha, Kenneth L Koch, Thomas L Abell, William J Snape, Gianrico Farrugia, Linda Lee, James Tonascia, Aynur Unalp-Arida, Frank Hamilton, NIDDK Gastroparesis Clinical Research Consortium, Pankaj Jay Pasricha, Linda Nguyen, Nighat Ullah, William Snape, Robin Bishop, Nata DeVole, Mary Greene, Sue Louiseau, Amy Marincek, Shelly Parker, Eve Pillor, Courtney Ponsetto, Katerina Shetler, Gianrico Farrugia, Cheryl Bernard, Matt Lurken, Henry P Parkman, Siva Doma, Javier Gomez, Steven Kantor, Vanessa Lytes, Amiya Palit, Zeeshan Ramzan, Priyanka Sachdeva, Kellie Simmons, Richard W McCallum, Reza Hejazi, Irene Sarosiek, Denise Vasquez, Natalia Vega, William Hasler, Michelle Atkinson, Radoslav Coleski, Thomas Abell, JoAnne Fordham, Olivia Henry, Archana Kedar, Valerie McNair, Susanne Pruett, Margaret Smith, Danielle Spree, Kenneth Koch, Lynn Baxter, Jorge Calles, Samantha Culler, Judy Hooker, Paula Stuart, Frank Hamilton, Steven James, Rebecca Torrance, Rebekah Van Raaphorst, James Tonascia, Patricia Belt, Ryan Colvin, Michele Donithan, Mika Green, Milana Isaacson, Wana Kim, Linda Lee, Alison Lydecker, Pamela Mann, Laura Miriel, Alice Sternberg, Aynur Ünalp-Arida, Mark Van Natta, Ivana Vaughn, Laura Wilson, Katherine Yates, William L Hasler, Henry P Parkman, Laura A Wilson, Pankaj J Pasricha, Kenneth L Koch, Thomas L Abell, William J Snape, Gianrico Farrugia, Linda Lee, James Tonascia, Aynur Unalp-Arida, Frank Hamilton, NIDDK Gastroparesis Clinical Research Consortium, Pankaj Jay Pasricha, Linda Nguyen, Nighat Ullah, William Snape, Robin Bishop, Nata DeVole, Mary Greene, Sue Louiseau, Amy Marincek, Shelly Parker, Eve Pillor, Courtney Ponsetto, Katerina Shetler, Gianrico Farrugia, Cheryl Bernard, Matt Lurken, Henry P Parkman, Siva Doma, Javier Gomez, Steven Kantor, Vanessa Lytes, Amiya Palit, Zeeshan Ramzan, Priyanka Sachdeva, Kellie Simmons, Richard W McCallum, Reza Hejazi, Irene Sarosiek, Denise Vasquez, Natalia Vega, William Hasler, Michelle Atkinson, Radoslav Coleski, Thomas Abell, JoAnne Fordham, Olivia Henry, Archana Kedar, Valerie McNair, Susanne Pruett, Margaret Smith, Danielle Spree, Kenneth Koch, Lynn Baxter, Jorge Calles, Samantha Culler, Judy Hooker, Paula Stuart, Frank Hamilton, Steven James, Rebecca Torrance, Rebekah Van Raaphorst, James Tonascia, Patricia Belt, Ryan Colvin, Michele Donithan, Mika Green, Milana Isaacson, Wana Kim, Linda Lee, Alison Lydecker, Pamela Mann, Laura Miriel, Alice Sternberg, Aynur Ünalp-Arida, Mark Van Natta, Ivana Vaughn, Laura Wilson, Katherine Yates
Abstract
Objectives: Gastroparesis patients may have associated psychological distress. This study aimed to measure depression and anxiety in gastroparesis in relation to disease severity, etiology, and gastric retention.
Methods: Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) scores for state (Y1) and trait (Y2) anxiety were obtained from 299 gastroparesis patients from 6 centers of the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Clinical Research Consortium. Severity was investigator graded as grades 1, 2, or 3 and patient reported by Gastroparesis Cardinal Symptom Index (GCSI) scores. Antiemetic/prokinetic medication use, anxiolytic and antidepressant medication use, supplemental feedings, and hospitalizations were recorded. BDI, Y1, and Y2 scores were compared in diabetic vs. idiopathic etiologies and mild (≤20%) vs. moderate (>20-35%) vs. severe (>35-50%) vs. very severe (>50%) gastric retention at 4 h.
Results: BDI, Y1, and Y2 scores were greater with increasing degrees of investigator-rated gastroparesis severity (P<0.05). BDI, Y1, and Y2 scores were higher for GCSI >3.1 vs. ≤3.1 (P<0.05). Antiemetic and prokinetic use and ≥6 hospitalizations/year were more common with BDI ≥20 vs. <20 (P<0.05). Anxiolytic use was more common with Y1≥46; antidepressant use and ≥6 hospitalizations/year were more common with Y2≥44 (P<0.05). BDI, Y1, and Y2 scores were not different in diabetic and idiopathic gastroparesis and did not relate to degree of gastric retention. On logistic regression, GCSI >3.1 was associated with BDI ≥20 and Y1≥46; antiemetic/prokinetic use was associated with BDI≥20; anxiolytic use was associated with Y1≥46; and antidepressant use was associated with Y2≥44.
Conclusions: Higher depression and anxiety scores are associated with gastroparesis severity on investigator- and patient-reported assessments. Psychological dysfunction does not vary by etiology or degree of gastric retention. Psychological features should be considered in managing gastroparesis.
Source: PubMed