Systematic Reviews
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2017; 23(7): 1298-1309
Published online Feb 21, 2017. doi: 10.3748/wjg.v23.i7.1298
Psychological controversies in gastroparesis: A systematic review
Sally Woodhouse, Geoff Hebbard, Simon R Knowles
Sally Woodhouse, Simon R Knowles, Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
Geoff Hebbard, Simon R Knowles, Department of Gastroenterology, the Royal Melbourne Hospital, Victoria 3050, Australia
Geoff Hebbard, Simon R Knowles, Department of Medicine, University of Melbourne, Parkville, Victoria 3010, Australia
Simon R Knowles, Department of Psychiatry, St Vincent’s Hospital, Fitzroy, Victoria 3065, Australia
Author contributions: Woodhouse S, Hebbard G and Knowles SR contributed to study concept and design; Woodhouse S performed the literature search; Woodhouse S and Knowles SR reviewed and analyzed the literature; Woodhouse S drafted the paper; Hebbard G and Knowles SR revised the paper.
Conflict-of-interest statement: The authors have no conflicting interests to declare.
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: Simon R Knowles, PhD, Senior Lecturer, Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia. sknowles@swin.edu.au
Telephone: +61-3-92148206 Fax: +61-3-98190574
Received: November 30, 2016
Peer-review started: December 2, 2016
First decision: December 28, 2016
Revised: January 18, 2017
Accepted: February 7, 2017
Article in press: February 8, 2017
Published online: February 21, 2017
Processing time: 82 Days and 2.6 Hours
Abstract
AIM

To systematically review literature addressing three key psychologically-oriented controversies associated with gastroparesis.

METHODS

A comprehensive search of PubMed, CINAHL, and PsycINFO databases was performed to identify literature addressing the relationship between gastroparesis and psychological factors. Two researchers independently screened all references. Inclusion criteria were: an adult sample of gastroparesis patients, a quantitative methodology, and at least one of the following: (1) evaluation of the prevalence of psychopathology; (2) an outcome measure of anxiety, depression, or quality of life; and (3) evidence of a psychological intervention. Case studies, review articles, and publications in languages other than English were excluded from the current review.

RESULTS

Prevalence of psychopathology was evaluated by three studies (n = 378), which found that combined anxiety/depression was present in 24% of the gastroparesis cohort, severe anxiety in 12.4%, depression in 21.8%-23%, and somatization in 50%. Level of anxiety and depression was included as an outcome measure in six studies (n = 1408), and while limited research made it difficult to determine the level of anxiety and depression in the cohort, a clear positive relationship with gastroparesis symptom severity was evident. Quality of life was included as an outcome measure in 11 studies (n = 2076), with gastroparesis patients reporting lower quality of life than population norms, and a negative relationship between quality of life and symptom severity. One study assessed the use of a psychological intervention for gastroparesis patients (n = 120) and found that depression and gastric function were improved in patients who received psychological intervention, however the study had considerable methodological limitations.

CONCLUSION

Gastroparesis is associated with significant psychological distress and poor quality of life. Recommendations for future studies and the development of psychological interventions are provided.

Keywords: Anxiety; Depression; Gastroparesis; Quality of life; Psychological distress

Core tip: Gastroparesis is associated with significant psychological distress and poor quality of life. Literature indicates that quality of life is lower in gastroparesis patients than population norms. Further, gastroparesis symptoms are adversely associated with increased anxiety and depression and impaired quality of life. Rates of psychopathology in gastroparesis cohorts range between 21.8% to 50%. Although a psychological intervention for gastroparesis has found improvements in depression and gastric function, it has not been replicated. Further research into potential mediating factors and the development of psychological interventions for individuals with gastroparesis is warranted.