Psychiatric Morbidity and Somatic Symptoms in Patients with Functional Dyspepsia: A Comparative Study with Duodenal Ulcer Patients

Patients with functional dyspepsia (FD) would have a greater prevalence of treatable psychiatric disorders, higher scores on measures of psychiatric symptomatology and characteristic symptoms distinguishing them from those with duodenal ulcer (DU). The aim of the work is to study the prevalence of psychiatric disorders and somatic symptoms in patients with functional dyspepsia and in comparison to those of duodenal ulcer disease. We selected 100 consecutive FD patients and the same number of DU patients at their routine consultation at the outpatient’s clinic of internal medicine of private general hospital at Abu Dhabi; UAE. Patients were subjected to full history, complete clinical examination, laboratory investigations, esophagogastroduodenoscopy and psychiatric evaluation through General Health Questionnaire (GHQ), Hospital Anxiety Depression Scale (HADS) and Structured Psychiatric Interview (PSE10). Patients with functional dyspepsia were significantly younger, more likely to be females, less tendency to smoke and use alcohol, had more frequent dyspeptic symptoms, a longer disease history and lower incidence of H.pylori infection than duodenal ulcer patients. Psychiatric morbidity was significantly higher in FD patients than DU patients (65% compared to 26%). Prevalence of psychiatric disorders was as follow: somatoform disorders 36%, mixed anxiety depressive disorder 21%, generalized anxiety disorder 17%, and depressive episode 4% in FD patients. As regard DU patients; somatoform disorders 8%, mixed anxiety disorder 10% and generalized disorder 8%. Using stepwise logistic regression model, it has been shown that, somatoform autonomic dysfunction and anxiety symptoms of (HADS) were independently associated with functional dyspepsia and the best predictors of diagnosing functional dyspepsia or duodenal ulcer. Psychiatric disorders are strongly associated with functional dyspepsia that warrants psychiatric intervention that may benefit FD patients specially those with chronic symptoms. Introduction