Psychoanalysis of 300 patients with chronic gastritis / 中华消化杂志

ABSTRACT

Objective:To analyze the difference of psychosocial characteristics in patients with chronic gastritis.Methods:From June to December 2018, a total of 300 patients with chronic gastritis visited Xijing Hospital were consecutively enrolled. The patients were divided into chronic non-atrophic gastritis (CNAG) group, chronic atrophic gastritis (CAG) group and CAG with intestinal metaplasia group, with 100 cases in each group. Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), living events scale (LES) and Eysenck personality questionnaire (EPQ) were used for evaluation and analysis. Chi square test, analysis of variance, nonparametric rank sum test and Kruskal Wallis H test were used for statistical analysis. Results:The incidences of anxiety of the CAG group and the CAG with intestinal metaplasia group were both significantly higher than that of the CNAG group (64.0%, 64/100; 53.0%, 53/100; and 34.0%, 34/100; respectively), and the differences were statistically significant ( χ2=0.007 and 0.001, both P<0.05). The incidence of depression of the CAG with intestinal metaplasia group was significantly higher than those of CNAG group and the CAG group (24.0%, 24/100; 15.0%, 15/100 and 13.0%, 13/100; respectively), and the differences were statistically significant ( χ2=0.108 and 0.045, both P<0.05). The negative event score of LES of CAG with intestinal metaplasia group was higher than those of CNAG group and CAG group (0 (0, 6.75), 0 (0, 1.00), 0 (0, 0.75) respectively), and the differences were statistically significant ( Z=-2.619 and -3.022, both P<0.05). The proportion of patients with LES score ≥20 points (high mental stress) of CNAG group, CAG group and CAG with intestinal metaplasia group gradually increased (8.0%, 8/100; 9.0%, 9/100 and 18.0%, 18/100; respectively), and the difference was statistically significant ( χ2=0.036, P<0.05). In male patients and patients under 50 years old, the incidence of depression and the proportions of patients with LES score ≥20 points of CAG with intestinal metaplasia group were higher than those of CNAG group (22.5%, 9/40 vs. 9.6%, 5/52; 47.5%, 19/40 vs. 16.2%, 11/68; 22.5%, 9/40 vs. 7.7%, 4/52; and 20.0%, 8/40 vs. 4.4%, 3/68), and the differences were statistically significant ( χ2=0.015, 0.001, 0.043 and 0.013, all P<0.05). The results of EPQ showed that the psychoticism, extraversion or introversion, stability and concealment of CNAG group and CAG with intestinal metaplasia group, were mostly normal (43.3 to 56.7), accounting for 62.0% (62/100) and 45.0% (45/100), 56.0% (56/100) and 44.0% (44/100), 54.0% (54/100) and 44.0% (44/100), 59.0% (59/100) and 45.0% (45/100), respectively. The percentage of patients with high score (>56.7) of etraversion or introversion and concealment in CAG group and the CAG with intestinal metaplasia group were higher than those in the CNAG group (48.0%, 48/100; 23.0%, 23/100; 4.0%, 4/100 and 46.0%, 46/100; 21.0%, 21/100 and 7.0%, 7/100, respectively), and the differences were statistically significant ( χ2=0.001, 0.001, 0.001 and 0.004, all P<0.01). Conclusions:Anxiety is associated with CAG and intestinal metaplasia, while depression is associated with intestinal metaplasia. In male patients and patients under 50 years old, depression, negative event and high psychiatric stress are more significantly related to intestinal metaplasia. The mental characteristics of extroversion, emotional instability, psychoticism and concealment are closely associated with CAG.