Abstract
BackgroundTo develop the Patient Health Questionnaire-8 (PHQ-8) as a more reliable approach than the Somatic Symptom Scale-8 (SSS-8), evaluating somatization which might be a critical factor influencing the quality of life (QoL) in patients with functional dyspepsia (FD). Also, the effects of somatization on QoL of FD patients were assessed by these two approaches.MethodsHerein, 612 FD patients completed a questionnaire involving 25 items. 8/25 items were selected to develop the PHQ-8 by four methods of discrete degree, correlation coefficient, factor analysis, and Cronbach’s α coefficient. Reliability and validity of the PHQ-8 and the SSS-8 were compared by principal component and confirmatory factor analyses. The effects of somatization, depression, and anxiety on the Nepean Dyspepsia Index (NDI) for QoL were explored by Pearson’s correlation coefficient and linear regression analysis.ResultsThe Cronbach’s α coefficient for the PHQ-8 and the SSS-8 was 0.601 and 0.553, respectively, and the cumulative contribution rate of three extracted factors for the developed PHQ-8 and SSS-8 was 55.103% and 51.666%, respectively. Somatization evaluated by the PHQ-8 (r = 0.309, P < 0.001) and the SSS-8 (r = 0.281, P < 0.001) was found to be correlated to NDI. The model used for the PHQ-8 showed that the values of goodness-of-fit index (GFI) and adjusted GFI (AGFI) were 0.984 and 0.967, respectively, which indicated that the model fitted well. Linear regression analysis unveiled that somatization (β = 0.270, P < 0.001), anxiety (β = 0.163, P < 0.001), and depression (β = 0.136, P = 0.003) assessed by the PHQ-8 were correlated to NDI. In addition, somatization (β = 0.250, P < 0.001), anxiety (β = 0.156, P < 0.001), and depression (β = 0.155, P = 0.001) evaluated by the SSS-8 were correlated to NDI.ConclusionsPHQ-8 showed a superior reliability and validity, and somatization assessed by the developed PHQ-8 showed a greater influence on the QoL of FD patients as compared to the SSS-8. Our findings suggested that the developed PHQ-8 may show improvement in a reliable assessment of the effects of somatization on FD patients in lieu of the SSS-8.
Highlights
To develop the Patient Health Questionnaire-8 (PHQ-8) as a more reliable approach than the Somatic Symptom Scale-8 (SSS-8), evaluating somatization which might be a critical factor influencing the quality of life (QoL) in patients with functional dyspepsia (FD)
Exclusion criteria were as follows: (1) patients with organic gastrointestinal diseases, including erosive esophagitis and Barrett’s esophagus, which was diagnosed by gastroscopy; (2) patients with systemic diseases, metabolic diseases, or malignant tumors diagnosed by B-scan ultrasound, blood routine, and biochemical examinations; (3) patients with irritable bowel syndrome (IBS); (4) patients with gastroesophageal reflux disease with symptoms of acidic taste in the mouth, regurgitation, and heartburn; (5) having a history of abdominal surgery, such as cholecystectomy, intestinal resection, hysterectomy, or appendectomy; (6) patients who had recently ingested anticholinergic drugs, antispasmodic and analgesic drugs, hormones, and nonsteroidal and antiinflammatory drugs; patients whose upper abdominal symptoms disappeared after eradicating H. pylori infection; (7) pregnant and lactating women; or (8) patients with psychosis and serious somatic diseases
Demographic characteristics and somatization scores of FD patients 612 patients were diagnosed with FD according to Rome IV criteria. 17.3% (106/612) of the patients were identified with anxiety disorders, 13.6% (83/612) had comorbidity of depression, and 7.8% (48/612) were diagnosed with comorbidity of anxiety and depression
Summary
To develop the Patient Health Questionnaire-8 (PHQ-8) as a more reliable approach than the Somatic Symptom Scale-8 (SSS-8), evaluating somatization which might be a critical factor influencing the quality of life (QoL) in patients with functional dyspepsia (FD). Somatization plays a more significant role in dyspepsia symptom severity (DSS) as compared to that in gastric sensitivity, anxiety, and depression in FD patients [21] It is an independent risk factor for impaired QoL of FD patients, and a 5-year follow-up study demonstrated that proximal gastric accommodation, gastric emptying, and H. pylori infection were not found as risk factors [33]. Assessment of somatization is highly essential for studying FD patients
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