Abstract
Gastrointestinal (GI) complaints are among the most common symptoms in primary care yet are frequently unexplained and often lead to costly diagnostic testing. We sought to determine the prevalence of psychiatric disorders in patients with unexplained GI complaints undergoing upper endoscopy, and the likelihood of endoscopic abnormalities in patients with and without psychiatric diagnoses. We prospectively evaluated 116 adult patients who were undergoing upper endoscopy to evaluate GI complaints. All subjects received a structured psychiatric interview prior to endoscopy using PRIME-MD, and endoscopists were blinded to the PRIME-MD results. Psychiatric disorders were detected in 70 (60%) patients. Overall, there were 113 diagnoses (some patients had multiple disorders) with the most common being somatoform (44%), depressive (29%), and anxiety (19%) disorders. Only 29 patients had major endoscopic abnormalities, including esophageal disease (14), peptic ulcer (9), severe gastritis (4), gastric cancer (1), and esophageal cancer (1). There was a much higher prevalence of psychiatric disorders in patients without major endoscopic abnormalities (74% vs. 21%, p < 0.0001). Psychiatric disease was strongly predictive of endoscopic find...Continue Reading
References
Jun 4, 1977·British Medical Journal·J Gomez, P Dally
Sep 25, 1975·The New England Journal of Medicine·L M Koran
Oct 2, 1975·The New England Journal of Medicine·L M Koran
Jan 1, 1991·Journal of Psychosomatic Research·E BennettC Tennant
Aug 1, 1990·Archives of Internal Medicine·K KroenkeA D Mangelsdorff
Aug 1, 1989·Gut·G Bleijenberg, J F Fennis
Oct 12, 1985·Lancet·K S ChannerJ R Rees
Mar 1, 1989·The American Journal of Medicine·K Kroenke, A D Mangelsdorff
Jan 1, 1989·Journal of Psychosomatic Research·K C WilsonJ P Watson
May 29, 1986·The New England Journal of Medicine·G R SmithD C Ray
Jun 1, 1988·Annals of Internal Medicine·N J Talley, S F Phillips
Oct 30, 1986·The New England Journal of Medicine·J W Beasley
Jun 1, 1967·Gut·O W Hill, L Blendis
Oct 1, 1984·The American Journal of Psychiatry·E MumfordT Cuerdon
Jan 1, 1984·Journal of Psychosomatic Research·T K Craig, G W Brown
Mar 1, 1980·The British Journal of Psychiatry : the Journal of Mental Science·A J MacDonald, I A Bouchier
Oct 11, 1980·British Medical Journal·J W FieldingV S Brookes
Nov 18, 1995·BMJ : British Medical Journal·A E SpeckensH G Rooijmans
Mar 1, 1995·Archives of General Psychiatry·G R SmithT M Kashner
Feb 7, 1994·NIH Consensus Statement
Dec 14, 1994·JAMA : the Journal of the American Medical Association·R L SpitzerJ G Johnson
Sep 1, 1994·Archives of Family Medicine·K KroenkeD Brody
May 15, 1994·Annals of Internal Medicine·W A HallE H Oldfield
Jul 14, 1994·The New England Journal of Medicine·M C JensenJ S Ross
Nov 8, 1993·Archives of Internal Medicine·K Kroenke, R K Price
May 11, 2012·Heart Views : the Official Journal of the Gulf Heart Association·Atoosheh RohaniFahimeh Zarei
Citations
Dec 10, 1999·The American Journal of Medicine·R B Lydiard, S A Falsetti
Nov 4, 2000·The New England Journal of Medicine·P G O'MalleyA J Taylor
Oct 7, 2005·Journal of Clinical Gastroenterology·Michael WilliamsMichael P Jones
May 15, 2007·Respiration; International Review of Thoracic Diseases·Marc H LavietesNeil S Cherniack
Nov 28, 2012·BMC Surgery·Fabrizio CardinCarmelo Militello
Apr 7, 2011·Internal Medicine·Tomoko ItatsuSumio Watanabe
Aug 15, 2001·Chest·M H LavietesN S Cherniack
May 27, 2008·Journal of Psychosomatic Research·Monika MussellBernd Löwe
Apr 9, 2005·Alimentary Pharmacology & Therapeutics·L A S van KerkhovenA C I T L Tan
Jan 8, 2009·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·R W O'RourkeB A Jobe
Oct 24, 2007·International Journal of Psychiatry in Medicine·Zoltán Kovács, Olga Kerékgyártó
Aug 4, 2001·Psychosomatic Medicine·C Diez-QuevedoR L Spitzer
Aug 28, 2004·The American Journal of Gastroenterology·Shelly SooPaul Moayyedi
Jun 28, 2003·International Journal of Methods in Psychiatric Research·Kurt Kroenke
Feb 18, 2011·The Cochrane Database of Systematic Reviews·Shelly SooDavid Forman
Dec 21, 2021·Frontiers in Psychiatry·Xiaoya FuWenbin Guo