Depression, young age, chronic marijuana use, and interepisodic symptoms predict psychological distress in patients with cyclic vomiting syndrome.

Abstract

Cyclic vomiting syndrome (CVS) is often triggered by stress. Patients report high degrees of psychological distress due to CVS, but there is limited data on factors associated with psychological distress. We sought to determine the degree of psychological distress and its correlation with clinical characteristics in CVS. The Brief Symptom Inventory (BSI), a validated tool to determine psychological distress, was administered prospectively to patients. The control population consisted of 719 normal subjects. Student's t test was used to compare means, and logistic regression analysis was performed to identify predictors of a GSI score ≥63, indicating high degrees of psychological distress. Scores for the regression predictors were calculated using the maximum likelihood estimate for the logistic regression model and was called the DAME score (depression, age 25-35, chronic marijuana use, and interepisodic GI symptoms). Of 87 patients, 60% were female, 92% were caucasian, and mean age was 37years. Forty-one percent of patients had high degrees of psychological distress with the highest scores for somatization. Independent predictors of psychological distress included depression, young age (25-35years), chronic marijuana use, and interepisodic dyspepsia (called the DAME score). A score of ≥7 accurately predicted psychological distress in >88% of patients. Psychological distress is common in CVS and can be predicted accurately using our proposed DAME score. Whether psychological distress is a cause or an effect of CVS needs to be determined. Addressing psychological distress can potentially improve overall healthcare outcomes in CVS.