Anxiety Is Linked to New-Onset Dyspepsia in the Swedish Population: A 10-Year Follow-up Study

Gastroenterology. 2015 May;148(5):928-37. doi: 10.1053/j.gastro.2015.01.039. Epub 2015 Jan 30.


Background & aims: Functional dyspepsia (FD) is associated with anxiety but it is not clear if one causes the other. We investigated whether anxiety and depression precede the onset of FD (based on the modified Rome III criteria) and gastroesophageal reflux symptoms (GERS) in a population-based follow-up study.

Methods: Participants from the Kalixanda study (n = 3000), randomly selected from the national population register of Sweden, were given the validated Abdominal Symptom Questionnaire 1998-2001; 1000 of these participants then were selected randomly to undergo esophagogastroduodenoscopy and were given the Abdominal Symptom Questionnaire along with the Hospital Anxiety and Depression Scale questionnaire. All eligible subjects who underwent endoscopy (n = 887) were invited to participate in a follow-up study in June-August 2010 and were given the same questionnaires. Data were analyzed by logistic regression.

Results: Of the 703 subjects who completed the follow-up questionnaires (79.3%); 110 were found to have FD at baseline (15.6%) and 93 at the follow-up examination (13.3%); 48 of these were new cases of FD. GERS without organic disease was reported by 273 individuals (38.8%) at baseline and by 280 at follow-up examination (39.8%); 93 cases were new. Major anxiety was associated with FD at the follow-up evaluation (odds ratio [OR], 6.30; 99% confidence interval [CI], 1.64-24.16). Anxiety was associated with postprandial distress syndrome at baseline (OR, 4.83; 99% CI, 1.24-18.76) and at the follow-up examination (OR, 8.12; 99% CI, 2.13-30.85), but not with epigastric pain syndrome. Anxiety at baseline was associated with new-onset FD at the follow-up examination (OR, 7.61; 99% CI, 1.21-47.73), but not with GERS.

Conclusions: In a study of the Swedish population, anxiety at baseline, but not depression, increased the risk for development of FD by 7.6-fold in the next 10 years. Anxiety did not affect risk for GERS.

Keywords: Functional Disorder; Population Study; Psychological Factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety / diagnosis
  • Anxiety / epidemiology*
  • Anxiety / psychology
  • Chi-Square Distribution
  • Depression / diagnosis
  • Depression / epidemiology
  • Depression / psychology
  • Dyspepsia / diagnosis
  • Dyspepsia / epidemiology*
  • Dyspepsia / psychology
  • Endoscopy, Gastrointestinal
  • Female
  • Follow-Up Studies
  • Gastroesophageal Reflux / diagnosis
  • Gastroesophageal Reflux / epidemiology*
  • Gastroesophageal Reflux / psychology
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Prospective Studies
  • Registries
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires
  • Sweden / epidemiology
  • Time Factors