title: State and trait anxiety and depression in patients affected by gastrointestinal diseases: psychometric evaluation of 1641 patients referred to an internal medicine outpatient setting.
abstract: OBJECTIVE
  To evaluate state and trait form of anxiety and current depression in patients affected by gastrointestinal diseases.
  
  
  METHODS
  We studied 1641 outpatients with gastrointestinal disorders, consecutively referred to our Internal Medicine outpatients from 1997 to 2005. State and trait anxiety were assessed by the State and Trait Anxiety Inventory. Current depression was assessed by the Zung self-rating depression scale.
  
  
  RESULTS
  Among patients, 1379 (84.1%) showed state anxiety, 1098 (67%) showed trait anxiety and 442 (27%) showed current depression. The number of gastrointestinal diseases was directly correlated to state anxiety (p < 0.001) and trait anxiety (p = 0.04). Females showed higher levels of anxiety and depression than males (p < 0.001). State anxiety was related to food allergies (p < 0.001), small intestinal bacterial overgrowth (SIBO) (p = 0.001), Hp infection (p = 0.01) and ulcerative colitis in active phase (p = 0.03). Trait anxiety was related to irritable bowel syndrome (IBS) (p < 0.001), Helicobacter pylori (Hp) infection (p = 0.001), food allergies (p = 0.001) and SIBO (p = 0.001). Current depression was related to IBS (p < 0.001) and coeliac disease (p = 0.01), SIBO (p = 0.02). A predicted probability of 0.77 +/- 0.16 to have state anxiety, of 0.66 +/- 0.12 to have trait anxiety and of 0.39 +/- 0.14 to have depression was found in these patients.
  
  
  CONCLUSIONS
  Most of the patients who seek medical consultation for gastrointestinal problems show an associated affective disorder. These patients should be managed by a team including gastroenterologists, psychologists and/or psychiatrists, or by a gastroenterologist having expertise in the treatment of psychological disorders.
authors.affiliation: Institute of Internal Medicine, Catholic University of Rome, Rome, Italy. g.addolorato@rm.unicatt.it
authors.forename: G
authors.initials: G
authors.lastname: Addolorato
authors.forename: A
authors.initials: A
authors.lastname: Mirijello
authors.forename: C
authors.initials: C
authors.lastname: D'Angelo
authors.forename: L
authors.initials: L
authors.lastname: Leggio
authors.forename: A
authors.initials: A
authors.lastname: Ferrulli
authors.forename: L
authors.initials: L
authors.lastname: Abenavoli
authors.forename: L
authors.initials: L
authors.lastname: Vonghia
authors.forename: S
authors.initials: S
authors.lastname: Cardone
authors.forename: V
authors.initials: V
authors.lastname: Leso
authors.forename: A
authors.initials: A
authors.lastname: Cossari
authors.forename: E
authors.initials: E
authors.lastname: Capristo
authors.forename: G
authors.initials: G
authors.lastname: Gasbarrini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology / Q000209:etiology*; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D055815:Young Adult