title: Anxiety is associated with uninvestigated and functional dyspepsia (Rome III criteria) in a Swedish population-based study.
abstract: OBJECTIVE
  The Rome III criteria for functional dyspepsia have been changed to include 2 distinct syndromes: postprandial distress syndrome and epigastric pain syndrome. We investigated risk factors for functional dyspepsia among the functional dyspepsia subgroups defined by the Rome III criteria.
  
  
  METHODS
  We performed a cross-sectional population-based study in a primary care setting (the Kalixanda study). A random sample (n = 2860) of the adult population from 2 northern Swedish municipalities (n = 21,610) was surveyed using a validated postal questionnaire to assess gastrointestinal symptoms (response rate, 74.2%; n = 2122). A randomly selected subgroup (n = 1001) of responders was invited to undergo an esophagogastroduodenoscopy (participation rate, 73.3%) including biopsy specimen collection, Helicobacter pylori culture and serology, and symptom assessments.
  
  
  RESULTS
  Of the 1001 subjects examined by endoscopy, 202 (20.2%; 95% confidence interval [CI], 17.7-22.7) were classified as having uninvestigated dyspepsia and 157 (15.7%; 95% CI, 13.4-18.0) as having functional dyspepsia. Major anxiety (Hospital Anxiety and Depression Scale score > or = 11) was associated with uninvestigated dyspepsia (odds ratio [OR], 3.01; 95% CI, 1.39-6.54), as was obesity (body mass index > or = 30 kg/m(2)) (OR, 1.86; 95% CI, 1.15-3.01). Major anxiety was associated with functional dyspepsia and postprandial distress syndrome (OR of 2.56 [95% CI, 1.06-6.19] and 4.35 [95% CI, 1.81-10.46], respectively), as was use of nonsteroidal anti-inflammatory drugs (OR, 2.49 [95% CI, 1.29-4.78] and 2.75 [95% CI, 1.38-5.50], respectively). Depression was not associated with any dyspepsia group.
  
  
  CONCLUSIONS
  Anxiety but not depression is linked to uninvestigated dyspepsia, functional dyspepsia, and postprandial distress syndrome but not to epigastric pain syndrome.
authors.affiliation: Care Sciences and Society, Department of Neurobiology, Center for Family and Community Medicine, Karolinska Institutet, Stockholm, Sweden. pertti.aro@fimnet.fi
authors.forename: Pertti
authors.initials: P
authors.lastname: Aro
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Talley
authors.forename: Jukka
authors.initials: J
authors.lastname: Ronkainen
authors.forename: Tom
authors.initials: T
authors.lastname: Storskrubb
authors.forename: Michael
authors.initials: M
authors.lastname: Vieth
authors.forename: Sven-Erik
authors.initials: SE
authors.lastname: Johansson
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Bolling-Sternevald
authors.forename: Lars
authors.initials: L
authors.lastname: Agréus