Gastric dysmotility in major depression

Abstract

Somatic symptoms of the gastrointestinal tract occur frequently in major depressive disorder (MDD) and might be associated with the known autonomic imbalance in the disease. Hence, we have investigated gastric electrical activity in patients suffering from major depression before and after treatment by means of electrogastrography (EGG) to investigate a putative association with either the disease state and its symptoms or its relation to the treatment. EGG readings before and after ingestion of a test meal of 27 patients suffering from major depression were recorded before and after treatment with antidepressants and compared with age-matched controls. Abdominal symptoms were rated by a specific Autonomic Nervous Symptom-score. We found a significantly increased amount of tachygastria before and after medication, indicating increased sympathetic modulation. A significant difference was observed for the instability coefficients before and after medication, indicating gastric dysmotility in our patients prior to treatment. The elevated approximate entropy measure points to increased complexity and dysregulation. Furthermore, we have observed a correlation between subjective sensation of sweating and dry mouth with the sympathetic parameter tachygastria. Our results suggest that major depression is associated with gastric dysrhythmia possibly caused by increased sympathetic modulation. Linear and non-linear EGG measures emphasize a possible role of the autonomic nervous system in the development of gastric symptoms. The treatment with antidepressants seems to increase the activity of the sympathetic nervous system, without aggravating gastric symptoms. The association of increased sympathetic modulation with somatic symptoms was indicated by correlation analysis with these symptoms.