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WASHINGTON -- The severity of minor psychiatric disorders such as anxiety and depression did not predict the presence of gastroesophageal reflux disease (GERD), according to a study presented here.
Consequently, one of the authors encouraged practitioners to use the more "objective" method of pH monitoring to diagnose GERD, rather than relying on the presence of the psychiatric disorders as a tip to order tests.
"If you consider the severity, that was the link," as opposed to the mere existence of the psychiatric problems, Fernando Herbella, MD, of the Federal University of São Paulo in Brazil, told MedPage Today at .
Herbella and colleagues aimed to evaluate the influence of minor psychiatric disorders in the diagnosis of GERD. Anxiety severity among all patents was found to correlate negatively, although not statistically significantly, with GERD scores on the , along with the severity of depression among females. There were also no significant correlations between GERD and the psychiatric disorders.
"As symptoms are unreliable for establishing the presence of GERD, objective evidence of the presence of pathologic reflux should be present before initiating treatment," the researchers said.
Nearly half the patients evaluated for GERD did not have the disease upon objective evaluation, Herbella noted, while patients both with and without GERD showed similar levels of the psychiatric disorders. In fact, there were no differences detected in (HADS) scores between GERD-positive (n=136) and GERD-negative (n=109) patients.
The team did find a negative correlation between DeMeester scores and anxiety regarding esophageal symptoms: About one-half (47%) of the GERD-positive patients were female, compared with 60% of the GERD-negative patients. A DeMeester score above 14.7 signaled the presence of GERD.
The study was co-conducted across three surgery departments, Herbella explained; the lead author was Rafael Laurino Neto, MD, also of Federal University. The team prospectively evaluated 245 adults suspected of having GERD: 54% were female, and the mean age was 44. A total of 140 participants had esophageal symptoms, 77 had extra-esophageal symptoms, and 28 had no symptoms.
The 14-question HADS was used to evaluate the psychiatric disorders (featuring seven questions focused on anxiety and seven on depression).
Herbella said that the next step is to work with psychiatric medical professionals and mine the data for possible explanations for the lack of or presence of correlations found in this study.
Primary Source
Digestive Disease Week
Neto RL, et al "Minor psychiatric disorders and objective diagnosis of gastroesophageal reflux diseases" DDW 2018, Abstract 659.