title: Risk factors for impaired health-related quality of life in functional dyspepsia.
abstract: BACKGROUND
  The influence of patient characteristics on HRQoL in functional dyspepsia is poorly understood.
  
  
  OBJECTIVE
  To determine the contribution of gastric sensorimotor function, psychosocial factors & 'somatization' to HRQoL in functional dyspepsia.
  
  
  METHODS
  In 259 tertiary care functional dyspepsia patients, we studied gastric sensorimotor function with barostat. We measured psychosocial factors and 'somatization' using self-report questionnaires. HRQoL was assessed using the SF-36 physical and mental composite scores (PCS, MCS). Bivariate associations between gastric sensorimotor function, psychosocial factors and 'somatization' on the one hand and PCS and MCS on the other were estimated. Variables significantly associated with PCS or MCS in bivariate analysis were entered into hierarchical multiple linear regression models.
  
  
  RESULTS
  Mean PCS was 40.1 ± 9.5; mean MCS was 45.1 ± 10.8. 'Somatization' (P < 0.0001) and chronic fatigue (P = 0.002) were significantly associated with impaired PCS (R² = 0.52, P < 0.0001). The effects of abuse history and depression were 'mediated' by 'somatization'. Trait anxiety (P = 0.02), alexithymia (P = 0.06), depression (P = 0.06), positive affect (P < 0.0001), negative affect (P = 0.002) and generalised anxiety disorder (P = 0.01) were significantly associated with impaired MCS (R² = 0.67, P < 0.0001).
  
  
  CONCLUSIONS
  'Somatization' is the most important risk factor for impaired physical HRQoL in functional dyspepsia; it 'mediates' the effect of abuse history and depression. Mental HRQoL is mainly explained by psychosocial factors.
authors.affiliation: Department of Pathophysiology, University of Leuven, Belgium. lukas.vanoudenhove@med.kuleuven.be
authors.forename: L
authors.initials: L
authors.lastname: Van Oudenhove
authors.forename: J
authors.initials: J
authors.lastname: Vandenberghe
authors.forename: R
authors.initials: R
authors.lastname: Vos
authors.forename: L
authors.initials: L
authors.lastname: Holvoet
authors.forename: K
authors.initials: K
authors.lastname: Demyttenaere
authors.forename: J
authors.initials: J
authors.lastname: Tack
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology*; D001530:Belgium; D003863:Depression / Q000150:complications / Q000523:psychology*; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology*; D004415:Dyspepsia / Q000150:complications / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000150:complications / Q000523:psychology*; D011795:Surveys and Questionnaires