title: Predictors of depression in patients presenting with dyspeptic symptoms in a GI clinic.
abstract: BACKGROUND
  The association between dyspepsia, H. pylori and psychological distress has remained a topic of intense debate over the past several decades. In Pakistan, where depression is highly prevalent and dyspepsia is possibly present in a high percentage of population, little data exist about these common health problems. This study was conducted to determine the frequency and predictors of depression among patients presenting with dyspeptic symptoms in the Gastrointestinal (GI) Clinic of a tertiary care hospital in Pakistan.
  
  
  METHODS
  Two hundred and sixty-nine consecutive patients were enrolled in the study based on their presenting symptoms in the GI clinic at Shifa International Hospital, Islamabad. Subjects with prior history of peptic ulcer disease (PUD), gallstones and HCV infections were excluded from the study. Demographic and socioeconomic variables as well as dyspeptic symptoms and important causes of dyspeptic symptoms were recorded. Depression was analysed based on the Urdu version of Beck's Depression Inventory-II (BDI-II). The data were analysed using SPSS-10 for univariate and multivariate analyses.
  
  
  RESULTS
  Mild depression was associated with lower education status (p < 0.001), lesser income (p < 0.018), and lower socioeconomic status (0 < 0.009) as well as rural residence (p < 0.026). Smoking, alcohol-use, H. pylori infection, gender and dyspepsia were not found to have any association with depression. On multivariate analysis, education and income group remained significantly associated with mild depression. Clinically significant depression was found to be associated with lower education and rural residence.
  
  
  CONCLUSIONS
  Depression among dyspeptic patients was found to be associated with socioeconomic status rather than dyspeptic symptoms or important risk factors associated with dyspeptic symptoms.
authors.affiliation: Department of Microbiology, Quaid-i-Azam University Islamabad, Pakistan.
authors.forename: Khalid
authors.initials: K
authors.lastname: Mehmood
authors.forename: Zobia
authors.initials: Z
authors.lastname: Hameed
authors.forename: Saleeta
authors.initials: S
authors.lastname: Shoukat
authors.forename: Fariha
authors.initials: F
authors.lastname: Hasan
authors.forename: Ali Yawar
authors.initials: AY
authors.lastname: Alam
authors.forename: Abdul
authors.initials: A
authors.lastname: Hameed
authors.forename: Abdul
authors.initials: A
authors.lastname: Nadir
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D004415:Dyspepsia / Q000453:epidemiology / Q000523:psychology*; D004522:Educational Status; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016481:Helicobacter Infections / Q000523:psychology; D016480:Helicobacter pylori; D006801:Humans; D016015:Logistic Models; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics; D012307:Risk Factors; D012959:Socioeconomic Factors