Introduction: The association between symptoms of gastroparesis and treatment of concomitant anxiety or depression remains understudied.
Methods: Eligible patients identified from review of ICD codes associated with gastroparesis and anxiety or depression from our hospital underwent structured telephone interviews. The PAGI-SYM scale– which characterizes the severity of gastrointestinal symptoms and PAGI-QOL – which examines the impact of symptoms to quality of life were utilized to assess patient outcomes. Scores vary from 0 (none or absent) to 5 (very severe). A total score for each questionnaire was computed. Spearman rank correlation was used to determine associations between PAGI scores and treatment follow up and compliance for anxiety and depression which was patient reported. A p-value < 0.05 was considered statistically significant.
Results: 33 patients were included for analysis. The mean age was 48.4±10.6 and 88% were female. 70% were African American while 24% were Caucasian. 91% were diagnosed with depression, 9% had anxiety alone while 67% had both. More than half followed up with a psychiatrist (53%) with 82% taking medications for their anxiety or depression. However, only 55% of the patients were compliant with their psychiatric medications. Based on the PAGI-SYM score, postprandial fullness, bloating and upper abdominal pain were within the 3 range (affected a good bit of time) while the rest of the symptoms were reported as < 3. The mean total PAGI-SYM score was 3.1±1.3. Most of the PAGI-QOL scale scores were also within the 3 range and the most affected scale was diet (3.5±1.3) while the least affected was relationships (2.2±1.7). The mean total PAGI-QOL score was 3.1±1.2 (see Figure 1). There was a significant positive correlation between PAGI-QOL scores and PAGI-SYM (Rho:0.52, p=0.006) with higher symptom scores associated with greater negative effects on quality of life. However, there were no significant correlations between PAGI-QOL and PAGI-SYM scores with patients receiving treatment for psychiatric illness, medication compliance, and follow-up with a psychiatrist in our cohort.
Discussion: Gastrointestinal symptoms in patient with gastroparesis negatively impact on quality of life, however there were no significant correlations between symptom severity or QOL and psychiatrist follow up, treatment, or medication use for anxiety or depression in this patient cohort. Additional studies involving larger cohorts are needed.
