Severe gastro-oesophageal reflux symptoms in relation to anxiety, depression and coping in a population-based study.
BACKGROUND
The association between psychiatric disorders and gastro-oesophageal reflux symptoms is uncertain, and few population-based studies are available.


OBJECTIVE
To examine the association between psychiatric and psychological factors and reflux symptoms.


METHODS
Population-based, cross-sectional, case-control study based on two health surveys conducted in the Norwegian county Nord-Trondelag in 1984-1986 and 1995-1997. Reflux symptoms were assessed in the second survey, including 65,333 participants (70% of the county's adult population). 3153 subjects reporting severe reflux symptoms were defined as cases and 40,210 subjects without symptoms were defined as controls. Data were collected in questionnaires. Odds ratio with 95% confidence intervals were estimated using unconditional logistic regression, in adjusted models.


RESULTS
Subjects reporting anxiety without depression had a 3.2-fold (95% CI: 2.7-3.8) increased risk of reflux, subjects with depression without anxiety had a 1.7-fold (95% CI: 1.4-2.1) increased risk and subjects with both anxiety and depression had a 2.8-fold (95% CI: 2.4-3.2) increased risk, compared to subjects without anxiety/depression. We observed a weak inverse association between one measure of covert coping and risk of reflux and a weak positive association between another coping measure and risk of reflux.


CONCLUSIONS
This population-based study indicates that anxiety and depression are strongly associated with reflux symptoms, while no consistent association regarding coping and reflux was found.
Jansson
C
C
Unit of Esophageal and Gastric Research, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. catarina.jansson@ki.se
Nordenstedt
H
H
Wallander
M-A
MA
Johansson
S
S
Johnsen
R
R
Hveem
K
K
Lagergren
J
J
D000223:Adaptation, Psychological / Q000502:physiology*; D001007:Anxiety / Q000150:complications*; D015992:Body Mass Index; D003866:Depressive Disorder / Q000150:complications* / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000523:psychology*; D006356:Heartburn / Q000523:psychology; D006801:Humans; D008297:Male; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology