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OBJECTIVE@#To assess the efficacy and safety of Guanxin Danshen Dripping Pills (GXDS) in the treatment of depression or anxiety in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI).@*METHODS@#From September 2017 to June 2019, 200 CHD patients after PCI with depression and anxiety were included and randomly divided into GXDS (100 cases) and placebo control groups (100 cases) by block randomization and a random number table. Patients in the GXDS and control groups were given GXDS and placebo, respectively, 0.4 g each time, 3 times daily for 12 weeks. The primary outcomes were scores of Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Scale (GAD-7) and the Seattle Angina Pectoris Scale (SAQ). The secondary outcomes included 12 Health Survey Summary Form (SF-12) scores and the first onset time and incidence of major adverse cardiovascular events (MACEs). Other indices including blood pressure, blood lipids, microcirculation and inflammatory-related indices, etc. were monitored at baseline, week 4, and week 12.@*RESULTS@#In the full analysis set (200 cases), after treatment, the PHQ-9 and GAD-7 scores in the GXDS group were considerably lower than those in the control group (P<0.05). Compared with the baseline, the total PHQ-9 scores of the experimental and control groups decreased by 3.97 and 1.18, respectively. The corrected mean difference between the two groups was -2.78 (95% CI: -3.47, -2.10; P<0.001). The total GAD-7 score in the GXDS group decreased by 3.48% compared with the baseline level, while that of the placebo group decreased by 1.13%. The corrected mean difference between the two groups was -2.35 (95% CI: -2.95, -1.76; P<0.001). The degree of improvement in SAQ score, SF-12 score, endothelin and high-sensitive C-reactive protein levels in the GXDS group were substantially superior than those in the placebo group, and the differences between the two groups were statistically significant (P<0.05). Similar results were obtained in the per protocol population analysis of 177 patients. Three cases of MACES were reported in this study (1 in the GXDS group and 2 in the placebo group), and no serious adverse events occurred.@*CONCLUSIONS@#GXDS can significantly alleviate depression and anxiety, relieve symptoms of angina, and improve quality of life in patients with CHD after PCI. (Registration No. ChiCTR1800014291).
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Humans , Percutaneous Coronary Intervention/adverse effects , Quality of Life , Depression , Coronary Disease/drug therapy , Drugs, Chinese Herbal/therapeutic use , Angina Pectoris/drug therapy , Prognosis , Anxiety , Treatment Outcome , Double-Blind MethodABSTRACT
Background Some studies have shown that PM2.5 exposure is closely related to central nervous system diseases that lead to cognitive dysfunction and change the composition of intestinal flora. However, there are few studies on the role of intestinal flora in PM2.5-induced depression- and anxiety-like behaviors in mice. Objective To observe the effects of PM2.5 exposure on depression- and anxiety-like behaviors and the composition of intestinal flora in mice, and to explore the role of intestinal flora in regulating 5-hydroxytryptamine (5-HT) in depression- and anxiety-like behaviors in mice exposed to PM2.5. Methods Eight-week-old male SPF C57BL/6J mice were randomly divided into control group (NS group), probiotic group (LGG group), PM2.5 group (PM group), and combined exposure group (PML group), 6 mice in each group. Mice in the PM group and the PML group were exposed to PM2.5 in a dynamic exposure cabinet for 6 h per day, 6 d a week for 7 consecutive weeks, and the PM2.5 concentrations were approximately 8 times higher than the outdoor concentration. The LGG group and the PML group were orally administered with Lactobacillus rhamnosus while the NS group and the PM group were orally administered with the same amount of saline. Elevated plus maze test and open field test were used to detect depression and anxiety in mice. Fecal samples of mice were collected to evaluate intestinal flora abundance, diversity, and structure between groups using high-throughput sequencing of 16S rRNA. ELISA was employed to detect the levels of 5-HT in serum and hippocampus. Spearman correlation was used to analyze the correlations of differential intestinal flora with 5-HT level in hippocampus and depression- and anxiety-like behavior indicators in mice. Results The percentage of open-arm entry [M(P25, P75)] in the PM group was 0.0% (0.0%, 33.3%), lower than those in the NS group [47.7% (25.0%, 50.8%) ] and the PML group [46.9% (40.0%, 50.0%)], and the differences were statistically significant (P<0.05). The total travelled distance and the time spent in central area (\begin{document}$\bar x \pm s $\end{document}) in the PM group were (2.01±0.90) m and (10.31±1.99) s respectively, shorter than those of the NS group [(3.80±0.89) m, (14.47±3.07) s], the total travelled distance in the PML group [(2.73±1.12) m] was shorter than those of the NS group and the LGG group [(4.21±1.08) m], and the differences were statistically significant (P<0.05). Compared to the NS group, the Simpson index of the PM group significantly increased (P<0.05). Compared to the LGG group, the Simpson index of the PML group significantly decreased (P<0.05). The results of Beta diversity analysis showed that there were differences in the composition of intestinal flora among the four groups of mice. Compared with the NS group and the LGG group, the abundances of Erysipelotrichaceae and Dubosiella in the PM group and the PML group increased, while the abundances of Prevotellaceae_UCG-001 decreased, and the differences were statistically significant (P<0.05). In hippocampus, the level of 5-HT in the PM group [(135.02±10.31) μg·g−1] was lower than those in the NS group [(178.77±43.15) μg·g−1] and the LGG group [(224.85±22.98) μg·g−1], and the level of 5-HT in the PML group [(161.27±15.81) μg·g−1] was lower than that in the LGG group (P<0.05). 5-HT level in hippocampus was significantly positively correlated with the relative abundance of Prevotellaceae_UCG-001 (r=0.6090, P=0.012). The percentage of open-arm entry was significantly negatively correlated with the relative abundance of Dubosiella (r=−0.4630, P=0.023). Conclusion Atmospheric PM2.5 exposure may cause depression- and anxiety-like behaviors in mice. The observed behavior dysfunction may be associated with the changes in diversity and relative abundance of intestinal flora as well as the decrease of 5-HT level. Such depression- and anxiety-like behaviors are alleviated after adding probiotics.
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ObjectiveTo observe the efficacy and safety of sertraline combined with low-dose olanzapine in the treatment of depression and anxiety comorbidity and its effect on sleep quality， so as to provide references for the related clinical treatment. MethodsA total of 121 patients who met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） for depressive episode and generalized anxiety disorder in The Third People's Hospital of Tianshui and the Sanatorium for Mental Illness of Veterans in Tianshui from October 2019 to August 2020 were enrolled， and they were divided into two groups according to the random number table method. Study group （n=61） received sertraline combined with low-dose olanzapine， while control group （n=60） received sertraline only. Then the disease severity degree， sleep quality and adverse reactions were assessed using Hamilton Depression Scale - 17 item （HAMD-17）， Hamilton Anxiety Scale （HAMA）， Pittsburgh Sleep Quality Index （PSQI） and Treatment Emergent Symptom Scale （TESS） at the baseline， 1st， 2nd， 4th， 6th and 8th weekend， respectively. ResultsPost-treatment HAMD-17， HAMA and PSQI scores in both groups were lower than those before treatment （P<0.05）. At each time point after treatment， HAMD-17， HAMA and PSQI scores of study group were lower than those of control group， with statistical significance （P<0.05）. ConclusionSertraline alone and its combination with low-dose olanzapine are both effective in the treatment of depression and anxiety comorbidity， while the combination therapy achieves better efficacy and higher safety in alleviating anxiety and insomnia symptoms.
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Introduction: Depression and anxiety are the most prevalentpsychological disorders among end-stage renal diseasepatients and are associated with various conditions that resultin poorer health outcomes, e.g. reduced quality of life andsurvival. Along with the psychological problems of patientsundergoing hemodialysis, sleep quality also plays a negativerole in patient health status. Frequent reports have documentedthat patients having complicated health and mental status maylead to poor health quality and may lead to mortality. Weaimed to investigate the prevalence of depression and anxietyamong patients undergoing renal dialysis therapy.Material and methods: A total of 95 patient’s data werecollected by using DASS questionnaire. DASS questionnairescores were evaluated, result was tabulated and interpreted.Scoring of questionnaire test is based on the a 0 – 3 scale whichindicates various range of depression, anxiety and stress scale.Results: Our study indicate that among 95 patients, manyof the patient having mild psychological problems includesdepression, anxiety and stress. Maximum range of 13.68%of patients have found out with anxiety and stress and nodepression state. But there were patients with no sign ofanxiety, stress and depression. Previous studies state thatpsychological variables include depression, stress, and,anxiety took part to get more health complications along withsleep disorders. But by providing right time health care andmental support, it is possible to get back patient health tonormal state. Our result concluded that none of the patient hasfound with complicated mental and health issues.Conclusion: Current study contributed that, among 95patient’s data analysis we have found out few number ofpatient with mild psychological abnormalities. But theseproblems did not reach to highly complicated state. So ourresearch study aimed to suggest nephrologists to aware ofthe quality of life in their patients and should consider thescreening of patients for various symptoms to improve thequality of life.
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OBJECTIVE: The aims of the present study were to explore the occurrence of childhood trauma and importantly to determine the impacts of childhood trauma on psychosocial features in a Chinese sample of young adults. METHODS: A survey was carried out in a group of 555 university students by using Childhood Trauma Questionnaire (CTQ), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Dysfunctional Attitudes Questionnaire (DAS), Eysenck Personality Questionnaire (EPQ), and Social Support Rating Scale (SSRS). The moderate-severe cut-off scores for CTQ were used to calculate the prevalence of childhood trauma, and then psychosocial features were compared between individuals with and without childhood trauma. RESULTS: A proportion of 18.6% of university students had self-reported childhood trauma exposures. Subjects with childhood trauma reported higher scores of SDS, SAS, DAS, and psychoticism and neuroticism dimensions of EPQ (t=4.311–5.551, p < 0.001); while lower scores of SSRS and extraversion dimension of EPQ (t=-4.061– -3.039, p < 0.01). Regression analyses further revealed that scores of SAS and DAS were positively (Adjusted B=0.211–0.230, p < 0.05), while scores of SSRS were negatively (Adjusted B=-0.273– -0.240, p < 0.05) associated with specific CTQ scores. CONCLUSION: Childhood trauma is still a common social and psychological problem. Individuals with childhood trauma show much more depression, anxiety, distorted cognition, personality deficits, and lower levels of social support, which may represent the social and psychological vulnerability for developing psychiatric disorders after childhood trauma experiences.
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Humans , Young Adult , Anxiety , Asian People , Cognition , Depression , Extraversion, Psychological , PrevalenceABSTRACT
Objective To study the treatment of elderly depression and anxiety in the treatment of depression and anxiety. Methods 76 cases of senile depression and anxiety co-morbidity were selected from our hospital from January 2016 to January 2017, and were randomly divided into control group and experimental group, with 38 cases in each group. The patients in the control group were treated with escitalopram, and the patients in the experimental group were treated with ascitalopram. The treatment time for both groups was two months. Comparative analysis was made on the clinical indicators of the experimental group and the control group. Results After treatment, the score of HAMD score and HAMA score in the experimental group was significantly lower than that in the control group, and the score of the experimental group was significantly lower than that in the control group, the differences were statistically significant (P< 0.05). The effective treatment efficiency of the patients in the experimental group was 86.84 ％ compared with the control group (73.68％), the differences were statistically significant (P< 0.05). There were 9 cases and 10 cases of adverse reactions between the experimental group and the control group, but there was no significant difference in the incidence of adverse reactions. Conclusion The liver capsule joint resolve depression escitalopram citalopram treatment of senile depression and anxiety comorbidities better clinical effect, can significantly improve the condition, improve the treatment efficiency, further promotion and application of clinical significance.
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Objective To investigate the influence of maternal and child care bedside on early development of newborns and maternal depression and anxiety,lactation.Methods From January 2013 to June 2015,120 cases of healthy full -term newborns and maternal admitted in our hospital were randomly divided into control group and observation group,60 cases in each group.The two groups of newborns and mothers were given routine care,including care and neonatal umbilical buttocks care,maternity care,including genital or abdominal incision dressing,newborns were routinely vaccinated.In the control group,the newborns were taken to a public bath chamber concentrated bath. The observation group was implemented maternal and child care bedside manner Based on this,at the bedside of the newborn bathing and massage,swimming daily with newborns.Anxiety score (SAS)and depression scale score (SDS)for depression and anxiety were evaluated before and after the two groups of mothers nursing,and maternal milk yield variation were observed at different time,measured neonatal neurological assessment score (NBNA)and height,body mass index,head circumference growth.Results After treatment,the SAS and SDS scores of mothers of the two groups were decreased compared with before treatment,which in the observation group decreased more significantly, the differences were statistically significant (t =3.46,4.21,all P <0.05).After care,the maternal milk productions of the two groups started to grow,which of the observation group were always increased better than the control group, the differences were statistically significant (χ2 =9.34,4.53,6.79,all P <0.05).The newborn NBNA scores,head circumference,height,improvement in the quality index of growth in the observer group were better than the control group,the differences were statistically significant (t =1.98,1.65,2.73,3.63,all P <0.05).Conclusion Maternal and child bedside care can significantly improve maternal depression and anxiety scores,increase maternal lactation, and has a certain role in promoting early neonatal development,it is worth clinical application.
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Objective To investigate the clinical efficacy of rhubarb acupoint sticking joint shuganjieyu diet in the treatment of chronic functional constipation patients with depressive anxiety.Methods 120 patients of chronic functional constipation with depression anxiety were selected,they were randomly divided into control group and obser-vation group,60 cases in each group.The patients in the control group were given promoting gastrointestinal motility drugs mosapride capsules,and orally given laxatives rhubarb with sodium bicarbonate.The patients in the observation group were treated with topical rhubarb acupoint,and orally given medicated shuganjieyu diet.7 days for a course of treatment,the patients were treated for four courses.The clinical efficacy of the two groups,defecation interval and fecal nature,SAS,SDS scale score changes and quality of life (PAC -QOL)scale score changes before and after treatment and adverse reactions during treatment were recorded.Results The total effective rate of the observation group was 90.00%,which of the control group was 91.67%,the difference between the two groups was not significant (χ2 =0.32,P >0.05).Before treatment,the bowel movement and stool ratings between the two groups had no statis-tically significant differences (t =0.23,0.33,all P >0.05).After treatment,the two points of the two groups were significantly decreased,but the differences between the two groups were not significant (t =0.18,0.41,all P >0.05).Before treatment,the SAS,SDS scale scores between the two groups had no statistically significant differences (t =0.78,0.69,all P >0.05).After treatment,the SAS,SDS scores of the two groups were significantly decreased, which of the observation group decreased more significantly than those of the control group (t =4.18,4.72,all P 0.05).After treatment,the dimensions of the two groups showed a decline trend,and those of the observation group decreased more significantly than the control group (t =2.10,3.56,2.76, 2.34,all P <0.05).In the control group during the treatment,2 cases of diarrhea,three cases of dry mouth,the patients were improved after given symptomatic treatment.No serious adverse event occurred during therapy in the observation group.Conclusion Rhubarb acupoint joint shuganjieyu diet in the treatment of chronic functional constipation patients with depression anxiety has significant clinical effect,which can significantly improve patients'depression and anxiety scores,quality of life,and without significant adverse reactions,it is worthy of clinical applica-tion.
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Objective:To explore the related risk factors of antepartum depression and anxiety,and to provide the theoretical support for early screening,clinical intervention and prevention of antepartum depression and anxiety.Methods:At the time of 28 weeks of prenatal examination,the Edinburgh Postnatal Depression Scale (EP-DS),Self-Rating Anxiety Scale (SAS)were used to survey 2112 pregnant women who were selected from Maternal and Child Health Hospital of Kunming City.Non conditional logistic regression analysis was used to explore the re-lated risk factors of prenatal depression and anxiety.Results:At the 28 weeks of pregnancy,the detection rate of de-pression symptoms and anxiety symptoms were 25.4% and 6.6%.Logistic regression analysis showed that the risk factors for perinatal depression symptoms were younger age (OR =0.80,95%CI:0.68 -0.94),not stick to work during pregnancy (OR =1.18,95%CI:1.02 -1.36),not satisfied with the living environment (OR =1.50,95%CI:1.23 -1.83),expectations for boys (OR =0.86,95%CI:0.77 -0.96),not only daughter (OR =1.37,95%CI:1.06 -1.76),unplanned pregnancy (OR =1.38,95%CI:1.10 -1.72).The risk factors for perinatal anxiety symp-toms were being not satisfied with the living environment (OR =1.64,95%CI:1.19 -2.26),not harmonious with her husband (OR =2.01,95%CI:1.20 -3.37),unplanned pregnancy (OR =1.50,95%CI:1.05 -2.14).Conclu-sion:It suggests that the pregnant women with younger age,less working during pregnancy,being not satisfied with the living environment,having more expectations for boys,being not only daughter,with unplanned pregnancy are more likely to suffer from antepartum depression;those being not satisfied with living environment,having harmoni-ous relation with her husband,and with unplanned pregnancy are more likely to suffer from antepartum anxiety.
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A total of 192 poststroke patients with depression and anxiety were assigned randomly into study group (n =96) and control group (n =96).The study group received both capsules Shugan-jieyu and paroxetine while the control group paroxetine alone.Compared with the control group,scores of both Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were significantly different at the end of week 2 and 6 in the study group (P ＜ 0.05).The HAMD and HAMA deduction rate and the scores of mangled extremity severity,mini-mental state examination and modified Barthel index at the end of week 6 of the study group were better than those of the control group (all P ＜ 0.05).The combined use of capsules Shugan-jieyu and paroxetine could improve symptoms of depression and anxiety,offer a higher safety and accelerate the rehabilitation of extremity function.
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Objective To investigate the relationship between coexisting depression and anxiety (CDA)and quality of life of female nurses in general hospitals.Methods Seven hundred and ninety-three female nurses completed Zung' s Self-rating Depression Scale (SDS),Zung' s Self-rating Anxiety Scale (SAS) and the World Health Organization' s Quality of Life Questionnaire-Brief Version (WHOQOL-BREF).According to the cut-off scores of SDS and SAS,all subjects were divided into 4 groups (non-depression and non-anxiety,pure depression,pure anxiety,and CDA).Group differences in SDS,SAS and WHOQOL-BREF scores were compared.Results Of these 4 groups,CDA group had the highest SDS and SAS scores (P ＜ 0.001) (SDS scores:(34.3 ±5.4),(47.1 ±4.0),(39.4 ± 2.4) and (49.7 ±4.2)) and the lowest WHOQOL-BREF scores (P≤0.033)(WHOQOL-BREF physical domain scores:(15.6 ± 2.0),(13.8 ± 2.0),(13.6 ± 1.6) and (12.1 ± 2.0)).The corresponding stratification analysis (controlling for confounding factors) showed consistent results.Conclusion CDA nurses have the most severe depressive and anxious symptoms and the worst quality of life,and thus are the key target population of mental health service.
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OBJETIVO: Avaliar em portadores de doença de Crohn (DC) a incidência de oscilação do humor (OH) e os possíveis fatores associados à mesma. MÉTODOS: Estudo prospectivo longitudinal com 50 pacientes (60% sexo feminino; média de idade de 40,6 a) com diagnóstico de DC acompanhados por 16 meses. A atividade clínica foi avaliada pelo índice de atividade da DC. Utilizaram-se os instrumentos de autoavaliação do estado psicológico (Inventário de Depressão de Beck e subescala de ansiedade da Escala Hospitalar de Ansiedade e Depressão) para diagnóstico de transtorno de humor. Os instrumentos foram aplicados na inclusão no estudo e, a seguir, em intervalos de quatro meses. RESULTADOS: O fenótipo inflamatório foi o mais comum (86%), 36% tinham história prévia de cirurgia relacionada com DC; 82% estavam em remissão clínica na inclusão. OH ocorreu em 58% dos pacientes; 28% evoluíram com sintomas depressivos e/ou ansiosos a partir do humor normal de base e 30% normalizaram o humor depressivo e/ou ansioso de base. Em 38% dos pacientes com OH não houve mudança na atividade clínica da doença (p = 0,015), enquanto 20% tiveram alteração na atividade da DC. Sexo feminino e ausência de cirurgia prévia relacionada com complicações da DC foram associadas à maior incidência de OH (p = 0,04 para ambos). CONCLUSÃO: Neste estudo, verificou-se elevada incidência (58%) de OH em pacientes com DC. O sexo feminino e ausência de cirurgia prévia por complicações da DC foram associadas à maior incidência de OH. Avaliação psicológica periódica pode ser útil para detecção e abordagem de OH em pacientes com DC.
OBJECTIVE: To assess the incidence of mood swings (MS) and possible associated factors in patients with Crohn's disease (CD). METHODS: Prospective longitudinal study of 50 patients (60% females; mean age 40.6 years) with a diagnosis of CD over a 16-month follow-up. Clinical activity was assessed by the CD activity index. Psychological status self-report tools (Beck Depression Inventory and the anxiety subscale of the Hospital Anxiety and Depression Scale) were used for mood disorder diagnosis. The tools were applied at baseline and at four-month intervals thereafter. RESULTS: The inflammatory phenotype was the most common (86%); 36% had a previous history of surgery related to CD; 82% were in clinical remission at baseline. MS occurred in 58% of patients; 28% had progression of depression and/or anxiety symptoms from baseline normal mood, and 30% had baseline depressive and/or anxious mood normalized. In 38% of patients with MS, no change in the disease clinical activity could be found (p = 0.015), whereas 20% had a change in CD activity. Female gender and absence of previous surgery related to CD complications were associated with higher MS incidence (p = 0.04 for both). CONCLUSION: In this study, a high MS incidence (58%) was found in patients with CD. Female gender and absence of previous surgery from CD complications were associated with a higher MS incidence. Periodic psychological assessment could be useful to detect and approach MS in patients with CD.
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Crohn Disease/psychology , Mood Disorders/epidemiology , Anxiety/epidemiology , Anxiety/etiology , Brazil/epidemiology , Crohn Disease/epidemiology , Depression/epidemiology , Depression/etiology , Follow-Up Studies , Incidence , Longitudinal Studies , Mood Disorders/psychology , Prospective Studies , Psychiatric Status Rating Scales , Sex Factors , Socioeconomic FactorsABSTRACT
Objective:To study the efficacy of paroxetine and psychotherapy in patients with poststroke de- pression and anxiety.Methods:81 patients who met the CCMD-3 criteria of depression and anxiety after acute brain stroke were recruited and randomized into 3 groups.Group A was treated with routine antistroke medication and paroxetine;Group B was treated with routine antistroke medications,paroxetine plus psychotherapy;Group C(con- trol)was treated with routine antistroke medication.All patients were treated for 6 weeks and evaluated with SSS, HAMD,HAMA as measures of efficacy and side effects.Results:The comorbidity rate of poststroke depression and anxiety was 65.9%.According to the reduction of SSS,HAMD and HAMA scores,and increase of BI score,signifi- cant improvement has been showed in all patients.There was significant difference among group A,B and the control group(P
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Objective To investigate the efficacy of esomeprazole (Esomeprazole) and flupentixol and melitracen (Deanxit) in treatment of non-erosive gastroesophageal reflux disease (NERD) with depression and anxiety.Methods The diagnosis of NERD was based on the results of esorneprazole scale (reflux diagnostic ques- tionnaires,RDQ) and endoscopy,the degree and frequency of symptoms were graded and scored.Hamilton de- pression scale was used to evaluate depression and anxiety status.Sixty-three patients were randomly divided into group A (esomeprazole 20 mg qd),B (Deanxit 1 tab qd),C (esomeprazole 20 mg qd and Deanxit 1 tab qd) with each group 21 patients,and treated for four weeks.The efficacy was evaluated by the symptom scores.Results There were some effects of esomeprazole or Deanxit alone on the improvement of symptoms of NERD.Although the effect of Deanxit was not as good as esomeprazole,there was not difference for relieving heartburn and sub- sternal pain between two groups in time point of each week after treatment (P＞0.05).esomeprazole was better for relieving acid regurgitation than Deanxit (P＜0.01).Combined treatment of esomeprazole with Deanxit was better and faster for relieving the symptoms of NERD than esomeprazole or Deanxit alone (relieving rate 81% in group C,23.8% in group A and 14.3% in group B,P＜0.01).The total efficacy rate of group C (100%) was higher than that of group A (80.9%) or group B (61.9%,P＜0.01),but there were not difference of relieving rate and total efficacy rate between group A and B (P＞0.05).Conclusions There was better efficacy of com- bined treatment of esomeprazole and low-dose Deanxit in treating NERD with depression and anxiety.These re- sults suggest that depression and anxiety have some effects on the pathogenesis and progress of NERD.
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Functional gastrointestinal diseases(FGIDs) mainly include functional dyspepsia (FD),irritable bowel syndrome (IBS),functional constipation (FC) and functional abdominal pain syndrome (FAPS).In gastroenterology outpatient,42%～61% FGIDs patients have psychological factors,mostly depression and anxiety.The personality of these patients are almost introvert.Negative life events can be an incentive to lead to depression and anxiety which can aggravate the functional gastrointestinal symptoms.Clinical manifestations include long-term abdominal discomfort,abdominal pain (some with no fixed position),abdominal distension,anorexia,change in bowel habits,retrosternal and upper abdominal burning pain or overlapping symptoms.Some have obvious emotional performance.Dyspepsia symptom score of FD patients with mental disorders are higher than those who have no emotional performance and the gastric emptying decrease greatly than the latter.FGIDs treated by systemic therapy but with no improvement in symptoms may have somatization,compulsion,interpersonal tension,depression,anxiety and other psychological disorders.So psychological evaluation should be carried out to make early recognition for refractory functional gastrointestinal disorders.