What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Psychiatric disorders (n=576). Intervention: Psychiatric outpatient status vs. Healthy controls. Primary outcome: Total GSRS-IBS score (median) (p=<0.001).

November 11, 2020Open Access

A cross-sectional study of gastrointestinal symptoms, depressive symptoms and trait anxiety in young adults

Q: What are the key findings of this study?

Young adult psychiatric outpatients reported significantly higher gastrointestinal symptom burden (median GSRS-IBS score 30) compared to healthy controls (median 22), which independently correlated with depressive symptoms and trait anxiety.

Key Result

Young adult psychiatric outpatients reported significantly higher gastrointestinal symptom burden (median GSRS-IBS score 30) compared to healthy controls (median 22), which independently correlated with depressive symptoms and trait anxiety.

Study Design

Type

Cross-Sectional (n=576)

Multicenter

Structured PICO

Population

576 young adults (491 psychiatric outpatients aged 18-25 and 85 healthy controls under 30), 73.4% female, assessed for gastrointestinal symptoms, depressive symptoms, and trait anxiety.

Comparator

Healthy controls

Outcome

Gastrointestinal symptom severity measured by the Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS)patient reported

Gastrointestinal symptoms are highly prevalent in young adult psychiatric outpatients and are independently associated with depressive symptom severity and trait anxiety.

Main Result

Absolute Event Rate: 30% vs 22%

p-value: p=<0.001

Limitations

Cross-sectional design restricts the possibility to examine temporal relationships or causal inference.
Patient group is not delimited to a single diagnosis.
Possible state effect when completing personality questionnaires with ongoing depressive symptoms.
Control group was significantly older than the patient group.
Gastrointestinal symptoms were self-reported.
Medication compliance could not be fully determined.

Abstract

BACKGROUND: >Patients with functional gastrointestinal disorders have a high psychiatric co-morbidity. This study aimed to investigate and characterise gastrointestinal symptoms in relation to depressive symptoms and trait anxiety in a well-defined population of young adult psychiatric outpatients and healthy controls. METHODS: Gastrointestinal symptoms were assessed with the Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS). Depressive symptoms were assessed with the Montgomery-Åsberg Depression Rating Scale- Self assessment (MADRS-S). Trait anxiety was estimated with three of the Swedish universities of Personality (SSP) scales: Somatic trait anxiety, Psychic trait anxiety and Stress susceptibility. Self-ratings were collected from 491 young adult psychiatric outpatients and 85 healthy controls. Gastrointestinal symptom severity was compared between patients with and without current psychotropic medication and controls. Associations between gastrointestinal symptoms, depressive symptoms and trait anxiety were assessed using Spearman's coefficients and generalized linear models adjusting for possible confounders (sex, body mass index, bulimia nervosa). RESULTS: Patients, with and without current psychotropic medication, reported significantly more gastrointestinal symptoms than controls. In the generalized linear models, total MADRS-S score (p < 0.001), Somatic trait anxiety (p < 0.001), Psychic trait anxiety (p = 0.002) and Stress susceptibility (p = 0.002) were independent predictors of the total GSRS-IBS score. Further exploratory analysis using unsupervised learning revealed a diverse spectrum of symptoms that clustered into six groups. CONCLUSION: Gastrointestinal symptoms are both highly prevalent and diverse in young adult psychiatric outpatients, regardless of current psychotropic medication. Depressive symptom severity and degree of trait anxiety are independently related to the total gastrointestinal symptom burden.

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