Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2017; 23(1): 127-134
Published online Jan 7, 2017. doi: 10.3748/wjg.v23.i1.127
Health-related quality of life in gastroesophageal reflux patients with noncardiac chest pain: Emphasis on the role of psychological distress
Lei Zhang, Lei Tu, Jie Chen, Jun Song, Tao Bai, Xue-Lian Xiang, Rui-Yun Wang, Xiao-Hua Hou
Lei Zhang, Lei Tu, Jie Chen, Jun Song, Tao Bai, Xue-Lian Xiang, Xiao-Hua Hou, Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Rui-Yun Wang, Division of Gerontology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Author contributions: Zhang L and Tu L contributed equally to this study; Hou XH designed the study; Tu L and Chen J contributed to data collection; Zhang L, Song J, Bai T and Xiang XL organized and analyzed the data; Zhang L and Wang RY drafted the paper.
Supported by the Key Clinical Construction Projects of Gastroenterology of the National Health and Family Planning Commission of China.
Institutional review board statement: This study was approved by the Local Ethical Committee for Clinical Studies in Humans of Huazhong University of Science and Technology, China [(2011) No, 025].
Informed consent statement: Patients provided informed verbal consent to participate in this study and complete the survey. All clinical data for questionnaires were obtained anonymously and innocuously.
Conflict-of-interest statement: All authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Xiao-Hua Hou, MD, PhD, Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan 430022, Hubei Province, China. houxh@medmail.com
Telephone: +86-27-85726057 Fax: +86-27-85726057
Received: August 3, 2016
Peer-review started: August 5, 2016
First decision: September 5, 2016
Revised: September 18, 2016
Accepted: October 19, 2016
Article in press: October 19, 2016
Published online: January 7, 2017
Abstract
AIM

To investigate the effects of depression and anxiety on health-related quality of life (QoL) in gastroesophageal reflux disease (GERD) patients and those suffering from cardiac (CCP) and noncardiac (NCCP) chest pain in Wuhan, China.

METHODS

In this cross-sectional study, a total of 358 consecutive patients with GERD were enrolled in Wuhan, China, of which 176 subjects had complaints of chest pain. Those with chest pain underwent coronary angiography and were divided into a CCP group (52 cases) and NCCP group (124 cases). Validated GERD questionnaires were completed, and the 36-item Short-Form Health Survey and Hospital Anxiety/Depression Scale were used for evaluation of QoL and psychological symptoms, respectively.

RESULTS

There were similar ratios and levels of depression and anxiety in GERD with NCCP and CCP. However, the QoL was obviously lower in GERD with CCP than NCCP (48.34 ± 17.68 vs 60.21 ± 20.27, P < 0.01). In the GERD-NCCP group, rather than the GERD-CCP group, the physical and mental QoL were much poorer in subjects with depression and/or anxiety than those without anxiety or depression. Anxiety and depression had strong negative correlations with both physical and mental health in GERD-NCCP (all P < 0.01), but only a weak relationship with mental components of QoL in GERD-CCP.

CONCLUSION

High levels of anxiety and depression may be more related to the poorer QoL in GERD patients with NCCP than those with CCP. This highlights the importance of evaluation and management of psychological impact for improving QoL in GERD-NCCP patients.

Keywords: Gastroesophageal reflux, Anxiety, Chest pain, Depression, Quality of life

Core tip: Comorbid anxiety and depression and reduced QoL are common problems in gastroesophageal reflux disease (GERD) and those suffering from cardiac (CCP) and noncardiac (NCCP) chest pain. In this study, the effects of depression and anxiety on QoL in Chinese GERD subjects with chest pain were assessed. These data demonstrated that high levels of anxiety and depression may have greater negative impact on poorer QoL in GERD patients with NCCP relative to those with CCP. Evaluation and management of the psychological impact could be of great benefit for improving QoL in GERD-NCCP patients.