Objective To study the influence of hierarchical psychological nursing on anxiety, depression, 5-hydroxytryptamine (5-HT) and Galanin (GAL) of patients with gastroesophageal reflux disease. Methods A total of 238 gastroesophageal reflux disease patients were divided into study group(n=119) and control group(n=119) by random number table. Two groups of patients were given the same routine care. Based on this, patients in the control group were given conventional psychological nursing, the study group were given hierarchical psychological nursing. SAS and SDS were used to evaluate the two group patients mental status before and after different mental care. Enzyme linked immunosorbent assay (ELISA) was used to evaluate the contents of 5-HT and GAL of the two groups. Results After 4 weeks of hierarchical psychological nursing, SAS and SDS scores of the study group were (41.47±9.37) and (42.13±12.36). Those scores of the control group were (45.68±14.81) and (48.15±14.21). The differences were significant (t=2.62, 3.49; P<0.05). After 4 weeks of hierarchical psychological nursing, 5-HT and GAL contents of the study group were (166.05±63.66)ng/ml and (23.18±8.74)pg/ml. Those contents of the control group were (146.30±63.75)ng/ml and (25.45±9.03)pg/ml. The differences were significant (t=2.39, 1.97; P<0.05). Conclusions Hierarchical psychological nursing can decrease anxiety and depression of patients with gastroesophageal reflux disease and help the contents of GAL and 5-HT return to normal level gradually. It is worthy of clinical promotion and popularization. Key words: Anxiety; Depression; Serotonin; Gastroesophageal reflux disease; Hierarchical psychological nursing; Galanin