Longitudinal study of the impact of psychological distress symptoms on new-onset upper gastrointestinal symptoms in World Trade Center responders.
OBJECTIVE
Research on the health of workers involved in the cleanup after the attack on the World Trade Center (WTC) on September 11, 2001, has documented high rates of psychological distress and upper gastrointestinal (GI) symptoms. The current article examines the concurrent and longitudinal associations of psychological distress with development of new-onset upper GI symptoms in a large sample of WTC responders.


METHODS
A cohort of 10,953 WTC responders monitored by the WTC Health Program participated in the study. Two occupational groups were examined, police and nontraditional responders. The cohort was free of upper GI symptoms or diagnoses at their first visit (3 years after September 11, 2001). Logistic regression was used to analyze the relationships between concurrent and preceding psychological distress symptoms of depression, generalized anxiety, panic, and probable posttraumatic stress disorder with the development of new-onset upper GI symptoms at 3-year follow-up (6 years after September 11, 2001).


RESULTS
Across both occupation groups, psychological distress symptoms at Visit 1 were significantly related to the development of GI symptoms by Visit 2 (odd ratios ranging from 1.9 to 5.4). The results for the concurrent relationships were similar. In addition, there were significant dose-response relationships between the number of co-occurring psychological distress symptoms at Visits 1 and 2, and increased new-onset upper GI symptoms at Visit 2.


CONCLUSIONS
In this large sample of WTC responders, psychological distress symptoms assessed at 3 years after 9/11 are related to reporting upper GI symptoms 6 years after 9/11.
From the Departments of Psychiatry (L.L.-K., R.K., E.B.) and Medicine (J.A.B., B.J.L.), Stony Brook University, Stony Brook, New York; Department of Medicine (L.L.-K., D.L.B., S.V.B., J.C.B., R.D.S.), Division of Gastroenterology and Hepatology, Gastrointestinal Motility Center, Stony Brook University, Stony Brook, New York; Division of Gastroenterology and Hepatology (Y.L.), Downstate Medical Center, State University of New York, Brooklyn, New York; and Gastroenterology Service (R.D.S.), Northport Veterans Affairs Medical Center, Northport, New York.
Leighann
L
Litcher-Kelly
Yvette
Y
Lam
Julie A
JA
Broihier
Douglas L
DL
Brand
Suvin V
SV
Banker
Roman
R
Kotov
Evelyn
E
Bromet
Juan Carlos
JC
Bucobo
Robert D
RD
Shaw
Benjamin J
BJ
Luft
D000328:Adult; D001008:Anxiety Disorders / Q000150:complications* / Q000453:epidemiology; D015331:Cohort Studies; D003863:Depression / Q000150:complications* / Q000453:epidemiology; D060731:Emergency Responders / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000209:etiology; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000150:complications / Q000453:epidemiology; D016495:Police / Q000706:statistics & numerical data; D012042:Registries / Q000706:statistics & numerical data*; D047851:September 11 Terrorist Attacks / Q000523:psychology* / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000453:epidemiology