title: Anxiety Is Linked to New-Onset Dyspepsia in the Swedish Population: A 10-Year Follow-up Study.
abstract: OBJECTIVE
  Functional dyspepsia (FD) is associated with anxiety but it is not clear if one causes the other. We investigated whether anxiety and depression precede the onset of FD (based on the modified Rome III criteria) and gastroesophageal reflux symptoms (GERS) in a population-based follow-up study.
  
  
  METHODS
  Participants from the Kalixanda study (n = 3000), randomly selected from the national population register of Sweden, were given the validated Abdominal Symptom Questionnaire 1998-2001; 1000 of these participants then were selected randomly to undergo esophagogastroduodenoscopy and were given the Abdominal Symptom Questionnaire along with the Hospital Anxiety and Depression Scale questionnaire. All eligible subjects who underwent endoscopy (n = 887) were invited to participate in a follow-up study in June-August 2010 and were given the same questionnaires. Data were analyzed by logistic regression.
  
  
  RESULTS
  Of the 703 subjects who completed the follow-up questionnaires (79.3%); 110 were found to have FD at baseline (15.6%) and 93 at the follow-up examination (13.3%); 48 of these were new cases of FD. GERS without organic disease was reported by 273 individuals (38.8%) at baseline and by 280 at follow-up examination (39.8%); 93 cases were new. Major anxiety was associated with FD at the follow-up evaluation (odds ratio [OR], 6.30; 99% confidence interval [CI], 1.64-24.16). Anxiety was associated with postprandial distress syndrome at baseline (OR, 4.83; 99% CI, 1.24-18.76) and at the follow-up examination (OR, 8.12; 99% CI, 2.13-30.85), but not with epigastric pain syndrome. Anxiety at baseline was associated with new-onset FD at the follow-up examination (OR, 7.61; 99% CI, 1.21-47.73), but not with GERS.
  
  
  CONCLUSIONS
  In a study of the Swedish population, anxiety at baseline, but not depression, increased the risk for development of FD by 7.6-fold in the next 10 years. Anxiety did not affect risk for GERS.
authors: Centre for Family Medicine, Karolinska Institutet, Stockholm, Sweden. Electronic address: pertti.aro@fimnet.fi.
authors: Pertti
authors: P
authors: Aro
authors: Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia.
authors: Nicholas J
authors: NJ
authors: Talley
authors: Centre for Family Medicine, Karolinska Institutet, Stockholm, Sweden.
authors: Sven-Erik
authors: SE
authors: Johansson
authors: Centre for Family Medicine, Karolinska Institutet, Stockholm, Sweden.
authors: Lars
authors: L
authors: Agréus
authors: Centre for Family Medicine, Karolinska Institutet, Stockholm, Sweden; Institute of Health Sciences, Medical Faculty, University of Oulu, Finland; Primary Health Care Centre, Tornio, Finland.
authors: Jukka
authors: J
authors: Ronkainen
mesh_terms: D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D016009:Chi-Square Distribution; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D004415:Dyspepsia / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
keywords: Functional Disorder; Population Study; Psychological Factors