Abstract
BackgroundDepression, anxiety and stress (DAS) have been shown to be co-morbid with dyspepsia. Local data on the factors associated with these co-morbidities could inform the role of psychiatric intervention in affected patients.AimThe aim of this study was to describe the frequency of undiagnosed DAS and their associated protective and risk correlates in a sample of patients undergoing endoscopies for dyspepsia.SettingThe study was conducted at a regional hospital’s gastro-intestinal unit in KwaZulu-Natal province.MethodA cross-sectional survey was conducted on 201 in- and outpatients with symptoms of dyspepsia awaiting endoscopy. Information on DAS symptomatology (using the DASS-21 screening questionnaire, as well as socio-demographic and clinical data) were collected.AnalysesFollowing a descriptive analysis of the participants’ socio-demographic and clinical details, linear regression models were fitted to identify potential risk and protective correlates linked to DAS symptomatology.ResultsThe mean age of participants (N = 201) was 48.89 years, of whom approximately two-thirds (n = 133; 66.17%) were women, 97% (n = 195) were African and 64.68% (n = 130) resided in rural areas. Anxiety was the most prevalent symptom category (n = 149; 74.13%) versus depression (n = 96; 47.76%) and stress (n = 68; 33.83%) in each category of symptom (mild to extremely) severity. In the severe and extremely severe range, anxiety existed without co-morbid depression or stress in 61.19% of anxious patients. Alcohol use was significantly associated with all three symptom categories (p < 0.01).ConclusionsGiven high frequencies of depression and anxiety in patients undergoing endoscopies for dyspepsia, screening for common mental disorders is essential.
Highlights
The high prevalence of psychological distress among hospital outpatients in South Africa necessitates an understanding of the comorbid depressive and anxiety disorders in those with chronic medical illness[1] if their associated clinical and financial burdens are to be addressed
In the severe and extremely severe range, anxiety existed without co-morbid depression or stress in 61.19% of anxious patients
Dyspepsia refers to a group of upper gastrointestinal symptoms with functional dyspepsia (FD) that are characterised by chronic pain and burning and early satiety, and for which no organic basis has been established.[4]
Summary
The high prevalence of psychological distress among hospital outpatients in South Africa necessitates an understanding of the comorbid depressive and anxiety disorders in those with chronic medical illness[1] if their associated clinical and financial burdens are to be addressed. Dyspepsia is one chronic medical illness that is often overlooked in developing country settings. Depression, anxiety and stress (DAS) have been shown to be co-morbid with dyspepsia. Local data on the factors associated with these co-morbidities could inform the role of psychiatric intervention in affected patients
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