title: Association of help-seeking behavior with depression and anxiety disorders among gastroenterological patients in Saudi Arabia.
abstract: OBJECTIVE
  There is a high prevalence of depression and anxiety disorders among gastroenterological outpatients. Relatively few studies have been done on the help-seeking behavior among those who suffer from gastrointestinal symptoms with or without psychiatric disorders. We aimed to characterize the help-seeking behavior of gastroenterological outpatients and to evaluate if this behavior is linked to the presence of depression and anxiety.
  
  
  METHODS
  A cross-sectional study was carried out in gastroenterology clinics in four hospitals in Riyadh between February and September 2013. A self-administrated questionnaire was developed and administered to patients. Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) questionnaires were used to diagnose depression and anxiety, respectively.
  
  
  RESULTS
  A total of 440 patients completed the study questionnaire. The average age was 36.0 ± 12.8 years and 69% of the patients were males. Complaints included abdominal pain (58%), heartburn (29%), diarrhea or constipation (25%), appetite or weight changes (22%), and nausea or vomiting (16%). Depression was diagnosed in 36%, while anxiety was diagnosed in 28% of the patients. The first intervention was use of medications (68%) and undergoing endoscopy (16%), while few patients initially used herbs or Islamic incantation (7.5%). This first intervention was done primarily (59%) in private sector hospitals rather than government sector hospitals (36%). The rates of depression and anxiety in our patients were higher among those who suffered from multiple complaints for longer durations and with less satisfaction with the offered services.
  
  
  CONCLUSIONS
  Depression and anxiety are common comorbidities in gastroenterological outpatient population, especially those who have a chronic course of multiple gastrointestinal complaints.
authors.affiliation: Department of Psychiatry, King Saud University, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Fahad D
authors.initials: FD
authors.lastname: Alosaimi
authors.forename: Omar
authors.initials: O
authors.lastname: Al-Sultan
authors.forename: Qusay
authors.initials: Q
authors.lastname: Alghamdi
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Almohaimeed
authors.forename: Sulaiman
authors.initials: S
authors.lastname: Alqannas
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D055809:Illness Behavior; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D055815:Young Adult