Gastroesophageal reflux diseases: The relationship between the hospital anxiety and depression scale and its severity

Abstract

[Aim] Gastroesophageal reflux diseases(GERD) is a clinical entity in which refluxing gastric contents produce symptoms, and impairs the quality of life. Patients with GERD tend to be have impaired feeling of well-being and functional status, yet the impact of GERD on quality of life including emotional functioning has not carefully studied. We examined whether GERD and its severity were related to anxiety and depression as assessed by the hospital anxiety and depression (HAD) scale. [Methods] We studied 97 patients who visited our department with reflux symptom. Inclusion criteria was primary symptom of heartburn without other organic diseases. A control group compromised 106 patients referred to our department without symptom. All patients completed self report HAD questionnaires and GERD symptom questionnaires including the grading of GERD symptom. GERD patients were asked whether their daily activities were interrupted because of GERD symptom, and were asked to rate their overall health related quality of life as excellent, good, or poor. [Results] The GERD patients gave higher HAD scores than the normal group(anxiety score: mean 5.44 vs. 3.59, depression score: mean 5.30 vs. 3.69, p < 0.01). The severer the GERD symptom was, the higher HAD score tended to be(mean anxiety score: excellent 3.59, good 6.97, poor 6.22, mean depression score: excellent 4.23, good 5.71, poor 7.66). There was a significant correlation between HAD score and GERD severity(anxiety: r=0.328, p < 0.01, depression: r=0.320, p < 0.01). [Conclusion] This study confirms that anxiety and depression scores are higher in patients with GERD symptom than in controls. The severity of GERD symptom has close relationship to the mental health. This research was made possible by grant from Astra Japan.