A Study of Anger, Alexithymia, and Depression in the Functional Dyspepsia

BACKGROUND: Functional dyspepsia (FD) is a commonly encountered disturbance of gut function and has been shown to be associated with psychological disturbance such as depression and anxiety. Of particular importance to clinicians are the relationship between anger, alexithymia, and depression. In this study, we investigated anger, alexithymia, and depression in patients with functional dyspepsia. METHODS: Thirty patients who visited Wonkwang University Hospital from January 2001 to June 2001, were diagnosed with functional dyspepsia by a gastroenterologist and compared with 37 healthy control group. Medical investigation of FD including gastrofiberscopy, esophageal manometry, and ambulatory 24-hours intraesophageal reflux test were negative. All subjects were evaluated for depression, anxiety, anger and anger expression, and alexithymia. The measures included Beck Depression Inventory (BDI), Spielberger State-Trait Anxiety Inventory (STAI), Spielberger State-Trait Anger Expression Scale (STAXI), and Toronto Alexithymia Scale (TAS). RESULTS: The FD patients reported significantly more symptoms of depression, more difficulty describing feeling to others in TAS, less anger-in and anger-out expression in STAXI than the control subjects. Depressive symptoms in FD were positively correlated with state anxiety, trait anxiety, alexithymia, state anger, trait anger, and anger-in expression. In multiple regression model, state anger and trait anxiety together accounted for 69.1% of the depression in FD. CONCLUSION: The FD patients reported more depressive symptoms, and the depressive symptoms were related to anxiety, anger and anger-in, and alexithymia. These finding lend support that FD is a syndrome in which biopsychosocial process and affect dysregulation may play a role in features of FD.

A clinical research of tsutsugamushi disease occurred in and around Jeoung-up in the autumn of 2000

BACKGROUND: In korea, tsutsugamushi disease is one of the common diseases which occurs in more than 40% among acute febrile diseases during Autumn. The diagnosis is confirmed with Rickettsia tsutsugamushi antibody, and is characterised by fever, chill, headache, myalgia, skin rash, escha and lymphadenopathy. METHODS: We have conducted a survey on 16 clinically and serologically confirmed cases of Tsutsugamushi disease occurring during the period of October -November, 2000. RESULTS: Of 16 cases,7 were males and 9 were females with an average age of 67.76. Most patients had fever, chill, headache, myalgia, sore throat, cojunctival injection, cough, abdominal, pain, nausea, vomiting, hematuria in order of frequency. The physical findings were eachar (81.257) and skin rash (62.77) . Serologically 7 cases (43.75%) of 16 cases were confirmed positively R.tsutsugamushi antibody. General hematologic findings were decreased platelet count (37.57) , increased or decreased WBC (31.25% and 25% each other) , and anemia (25%) , Test for liver function included elevated AST, ALT (68.76%) , alkaline phosphatase (62.6%) , hypoalbuminemia (12.6%) , and hyperbilirubinemia(6.25) . Urinalysis showed hematuria (50%) , proteinuria (50%) , and pyuria (12.67) . Doxyrcycline therapy decreased fever in 2.85 days and after 5-6 days patients were discharged with improvement of almost all symptoms. CONCLUSION: Primary care physician in a community should always consider tsutsugamushi disease when he encounters patients with acute febrile disease in late Autumn and early winter and expect good prognosis with early diagnosis and treatment.