The Association of Mood Disorders, Psychoactive Drugs and Gastroesophageal Reflux Disease (GERD): A National Population-based Study

Abstract

Objective: This study was to examine the association of mood disorders and psychoactive drugs with GERD. Method: In this study, we retrospectively analyzed 2003-2006 Taiwan National Health Insurance Research Database (NHIRD). The case cohort included patients who were first diagnosed with a mood disorder in 2004 but did not have a previous diagnosis of GERD, and the control cohort included patients who did not have mental disorders. Both cohorts were followed over a period of two years. Mood disorders were classified as major depressive disorder or bipolar disorder, and psychoactive drugs were classified as antidepressant drugs or antipsychotic drugs. We also calculated the average daily frequency (ADF) of psychoactive drugs use before the occurrence of GERD in patients. Logistic regression was used in this study to investigate the association of mood disorders and ADF of psychoactive drugs use with GERD. Results: The incidence of GERD was 4.14% in the case cohort and 1.60% in the control cohort. The risk of GERD in patients with bipolar disorder and major depressive disorder compared with control were 1.94 and 2.48 (p＜0.001). The risk of GERD in the patients who took antipsychotic drugs or antidepressant drugs with an ADF of one or more times compared with an ADF of less than one were 1.77 and 2.55 (p＜0.001). Conclusion: Mood disorders and use of psychoactive drugs were highly associated with GERD. In addition, a patient's ADF of antidepressant use should be carefully observed, regardless of whether the patient has a mental disorder. When ADF of a patient is one or more, then the patient should be followed up for any esophageal irritability.