Objective: The objective of this study is to compare the psychosocial characteristics of functional dyspepsia (FD) with its subgroups, epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS), against a healthy control group, and to investigate the quality of life (QoL). Methods: All of the subjects were 210 adults, 131 patients with FD were diagnosed by gastroenterologist and 79 adults with no observable symptoms of FD were selected as the normal control group. Demographic factors were investigated. The Korean-Beck Depression Inventory-II, Korean-Beck Anxiety Inventory, Korean-Childhood Trauma Questionnaire, Multidimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale, and WHO Quality of Life Assessment Instrument Brief Form were used to assess psychological factors. A one-way analysis of variance was used to compare differences among the groups. Further, a stepwise regression analysis was conducted to determine factors affecting the QoL of the FD group. Results: Between-group differences in demographic characteristics were not significant. Depression (F=37.166, p<0.001), anxiety (F=30.261, p<0.001), and childhood trauma (F=6.591, p<0.01) were all significantly higher in FD group compared to the normal control. Among FD subgroups, EPS exhibited higher levels of both depression and anxiety than PDS. Social support (F=17.673, p<0.001) and resilience (F=8.425, p<0.001) were significantly lower in FD group than in other groups, and the values were higher in PDS than in EPS. Resilience (β=0.328, p<0.001) was the most important explanatory variable. The explained variance was 46.6%. Conclusion Significantly more symptoms of depression, anxiety, childhood trauma was observed for both FD sub-group. These groups also had less social support, resilience, and QoL than the control groups.

Objectives: ：The purpose of this study is to compare the psychosocial characteristics of patients diagnosed with functional gastrointestinal disorder (FGID) by classifying them into irritable bowel syndrome (IBS), functional dyspepsia (FD), functional constipation (FC), functional heartburn (FH) groups, and overlap group (two or more functional diseases) and to examine the factors associated with the quality of life (QoL) of patients with FGID. Methods: ：A total of 144 patients who were diagnosed with FGID were selected as the subjects. The demographical factors were investigated; Korean-Beck Depression Inventory-II (K-BDI-II), Korean-Beck Anxiety Inventory (K-BAI), Korean version of Childhood Trauma Questionnaire (K-CTQ), Multi-dimensional Scale of Perceived Social Support (MSPSS), Korean Version of Connor-Davidson Resilience Scale (K-CD-RISC), and World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF) were used to evaluate the psychosocial factors. Results: ：TThe overlap group had a significantly higher K-BDI-II score (F=11.09, p<0.001) and K-BAI score (F=8.93, p<0.001) compared to other groups. In childhood trauma, the IBS patients had a difference in emotional neglect (F=2.54, p=0.04) than the FD patients. The QoL of FGID patients had a negative correlation with depression (r=-0.196, p<0.01), anxiety (r=-0.235, p<0.01), and childhood trauma (r=-0.222, p<0.01), and a positive correlation with social support (r=0.512, p<0.01) and resilience (r=0.581, p<0.01). Conclusions ：Overlap group had a higher level of depression and anxiety, and the IBS patient group had a higher level of emotional neglect than the FD patient group in terms of childhood trauma.

Objective: The aim of this study was to investigate the predictor variables that could influence overlap syndrome in functional gastrointestinal disorders (FGID) among psychiatric patients. Methods: Data collected from 170 outpatients visiting the psychiatric clinic at a university hospital. FGIDs were screened according to the Rome III questionnaire-Korean version. Demographic factors were investigated, and psychosocial factors were evaluated using the Hospital Anxiety Depression Scale, Patient Health Questionnaire-15, Childhood Trauma Questionnaire-Korean and the Short form health survey. Chi-squared test, Student’s t-test, one-way ANOVA, and Pearson’s correlation test were used as statistical analysis methods. Results: There were no differences in the epidemiologic data between the two groups divided according to the FGID status. In those with FGID overlap syndrome, FD-NERD was most common (n=29), followed by IBS-NERD (n=20). Patients with overlap syndrome had the highest depressive, anxiety, and somatic symptoms. The overlap syndrome group had the lowest physical component summary and mental component summary. FGID symptom severity was significantly correlated with PCS and MCS in the overlap syndrome group. Conclusion Psychological factors are associated with the overlap syndrome of FGID. Acknowledging this common comorbidity may facilitate the recognition and treatment of patients with FGID.

Objectives: ：The aim of this study was to compare psychosocial characteristics of the functional gastrointestinal disorders FGID group, non-FGID group, and control group and determine factors affecting the QOL of patients with FGID. Methods: ：135 patients diagnosed with FGID were selected. 79 adults had no observable symptoms of FGID (control group) and 88 adults showed symptoms of FGID (non-FGID group). Demographic factors were investigated. The Korean-Beck Depression Inventory-II, Korean-Beck Anxiety Inventory, Korean-Childhood Trauma Questionnaire, Multidimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale, Patient Health Questionnaire-15 and WHO Quality of Life Assessment Instrument Brief Form were used to assess psychosocial factors. A one-way ANOVA was used to compare differences among groups. Pearson correlation test was performed to analyze the correlation of psychosocial factors and QOL of the FGID group. Further, a hierarchical regression analysis was conducted to determine factors affecting the QOL of the FGID group. Results: ：Between-group differences were not significant in demographic characteristics. Depression (F=48.75, p<0.001), anxiety (F=14.48, p<0.001), somatization (F=24.42, p<0.001) and childhood trauma (F=12.71, p<0.001) were significantly higher in FGID group than in other groups. Social support (F=39.95, p< 0.001) and resilience (F=17.51, p<0.001) were significantly lower in FGID group than in other groups. Resilience (β=0.373, p<0.01) was the most important explanatory variable. The explained variance was 47.2%. Conclusions ：Significantly more symptoms of depression, anxiety, childhood trauma, and somatization were observed for the FGID group. This group also had less social support, resilience, and quality of life than the non- FGID and control groups. The key factor for quality of life of the FGID group was resilience.

Objective: The purpose of this study was to analyze the symptoms of depression, anxiety, and childhood trauma in functional gastrointestinal disorder (FGID) patients who visited the brain-gut axis clinic. Methods: The study participants included 99 individuals who were diagnosed with FGID by gastroenterologists, 88 individuals who had no FGID but showed symptoms of FGID based on the Rome criteria, and 79 individuals who did not show any symptoms or were diagnosed with FGID. Symptoms of depression, anxiety, and childhood trauma were evaluated by the Korean version of Beck-depression inventory-II (K-BDI-II), Korean version of Beck anxiety inventory (K-BAI), and Korean version of childhood trauma questionnaire (K-CTQ), respectively. Results: The BDI score, BAI score, and CTQ score were significantly different between the groups. The group also had higher odds for developing anxiety as compared to the control group (odds ratio [OR] = 10.215, 95% confidence intervals [CI]: 2.49−41.76). Additionally, the FGID group had higher odds for developing symptoms of depression (OR = 5.554, 95% CI: 2.06−14.97) and experiencing physical violence (OR = 3.128, 95% CI: 1.53−6.38) than the non-FGID group. Conclusion This study showed that FGID patients were more likely to have symptoms of depression, severe anxiety, and childhood trauma, which were the risk factors of FGID.

OBJECTIVES: This study aimed to compare the psychosocial characteristics among patients with functional gastrointestinal disorder (FGID), adults with functional gastrointestinal symptoms, and normal control group and investigate factors related to quality of life (QoL) of FGID patients. METHODS: 65 patients diagnosed with FGID were selected. 79 adults were selected as normal control group based on the Rome III diagnostic criteria, and 88 adults who showed functional gastrointestinal symptoms were selected as “FGID positive group”. Demographic factors were investigated. Psychosocial factors were evaluated using the Korean-Beck Depression Inventory-II, Korean-Beck Anxiety Inventory, Korean-Childhood Trauma Questionnaire, Multi-dimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale and WHO Quality of Life Assessment Instrument Brief Form. A one-way ANOVA was used to compare differences among groups. Pearson correlation test was used to analyze correlations between QoL and psychosocial factors in patients with FGID. RESULTS: There were group differences in the education level. Depression (F=29.012, p<0.001), anxiety (F=27.954, p<0.001) and Childhood trauma (F=7.748, p<0.001) were significantly higher in FGID patient group than in both FGID-positive and normal control group. Social support (F=5,123, p<0.001), Resilience (F=9.623, p<0.001) and QoL (F=35.991, p<0.001) were significantly lower in the FGID patient group than in others. QoL of FGID patients showed a positive correlation with resilience (r=0.475, p<0.01), and showed a negative correlation with depression (r=−0.641, p<0.01), anxiety (r=−0.641, p<0.01), and childhood trauma (r=−0.278, p<0.05). CONCLUSIONS: FGID patients have distinctive psychosocial factors compared to the both FGID-positive and normal control group. Therefore, the active interventions for psychosocial factors are required in the treatment of patients with FGID.
Adult ; Anxiety ; Demography ; Depression ; Education ; Gastrointestinal Diseases ; Humans ; Psychology ; Quality of Life

BACKGROUND: The 5-level triage tool, the Korean Triage and Acuity Scale (KTAS), was developed based on the Canadian Triage and Acuity Scale and has been used for triage in all emergency medical institutions in Korea since 2016. This study evaluated the association between the decrease in level number and the change in its relative importance for disposition in the emergency department (ED). METHODS: Using the registry of the National Emergency Department Information System (NEDIS) ver. 3.1, data regarding consecutive emergency patients from March 2017 to October 2017 were reviewed retrospectively. Reconfiguring KTAS levels, a total of 15 multinomial logistic regression models (KTAS_0 to KTAS_14), including the KTAS, its variants, and covariates were constructed to determine significant factors affecting ED disposition. The relative importance of each model was obtained using a dominance analysis. RESULTS: A total of 79,771 patients were included in the analysis. In the model KTAS_0, the KTAS and 8 covariates were found to be significantly related to ED disposition. The KTAS and the decision maker of each ED visit, whether it was the physician or others, had the largest relative importance, 34.8% and 31.4%, respectively (P < 0.001). In other models of KTAS variants, including 4-level, 3-level and 2-level, the rates of the KTAS decreased to 31.8% (interquartile range [IQR], 28.9–34.2), 26.4% (IQR, 23.2–31.0), and 18.7% (IQR, 7.5–24.9), respectively (P = 0.016). On the other hand, the rates for covariates tended to be larger for smaller triage levels and so there was a significant interaction effect between the KTAS and the covariates according to the triage level (P < 0.001). CONCLUSION: The 5-level triage tool, the KTAS, had the largest relative importance among the predictors affecting ED disposition only at its original level. Therefore, it is recommended that no attempt should be made to reduce the number of levels in the triage tool.
Cohort Studies ; Emergencies ; Emergency Service, Hospital ; Hand ; Humans ; Information Systems ; Korea ; Logistic Models ; Registries ; Retrospective Studies ; Triage

Abdominal pain and treatment should be administered in accordance with the causes. A meticulous history taking and physical examination are highly useful in making a diagnosis, and blood tests, imaging modalities, and endoscopy are useful for confirming diagnosis. However, in many cases, patients have functional disorders with no obvious abnormal findings obtained even if many diagnostic tests are performed. Patients with functional disorders usually complain the vague abdominal pain located in the center and other portions of the abdominal area. Although the most representative disease is irritable bowel syndrome, functional abdominal pain syndrome is currently researched as a new disease entity of functional abdominal pain. As various receptors related to functional abdominal pain have been discovered, drugs associated with those receptors are used to treat the disorders, and additional new drugs are vigorously developed. In addition, medical therapy with pharmacological or non-pharmacological psychiatric treatment is effective for treating functional abdominal pain.
Abdominal Pain ; Diagnosis ; Diagnostic Tests, Routine ; Endoscopy ; Gastrointestinal Diseases ; Hematologic Tests ; Humans ; Irritable Bowel Syndrome ; Physical Examination

OBJECTIVES: This study aimed to investigate the psychosocial characteristics of functional gastrointestinal disorder (FGID) in patients with psychiatric disorders. METHODS: This study was conducted with 144 outpatients visiting the psychiatric clinic at a university hospital. FGIDs were screened according to the Rome III questionnaire-Korean version. Demographic factors were investigated, and psychosocial factors were evaluated using the Hospital Anxiety Depression Scale, Patient Health Questionnaire-15, Childhood Trauma Questionnaire-Korean, and State-Trait Anger Expression Inventory. Chi-squared test and student's t-test were used as statistical analysis methods. RESULTS: There were differences in education level between two groups divided according to FGID status (χ²=10.139, p=0.017). Comparing the psychiatric disorder by FGID group, irritable bowel syndrome (IBS) group showed significant differences (χ²=11.408, p=0.022). According to FGID status, IBS group showed significant differences for anxiety (t=−3.106, p=0.002), depressive symptom (t=−2.105, p=0.037), somatic symptom (t=−3.565, p < 0.001), trait anger (t=−3.683, p < 0.001), anger-in (t=−2.463, p=0.015), and anger-out (t=− 2.355, p=0.020). Functional dyspepsia group showed significant differences for anxiety (t=−4.893, p < 0.001), depressive symptom (t=−3.459, p < 0.001), somatic symptom (t=−7.906, p < 0.001), trait-anger (t=−4.148, p < 0.001), state-anger (t=−2.181, p=0.031), anger-in (t=−2.684, p=0.008), and anger-out (t=−3.005, p=0.003). Nonerosive reflux disease group showed significant differences for anxiety (t=−4.286, p < 0.001), depressive symptom (t=−3.402, p < 0.001), somatic symptom (t=−7.162, p < 0.001), trait anger (t=−2.994, p=0.003), state anger (t=−2.259, p=0.025), anger-in (t=−2.772, p=0.006), and anger-out (t=−2.958, p=0.004). CONCLUSIONS: Patients with psychiatric disorders had a high prevalence of FGID, and various psychosocial factors contributed to such differences. Therefore, the psychiatric approach can offer better understandings and treatments to patients with FGID.
Anger ; Anxiety ; Demography ; Depression ; Dyspepsia ; Education ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Outpatients ; Prevalence ; Psychology

BACKGROUND/AIMS: Stress has a role in the pathogenesis of functional dyspepsia (FD) and influences food intake in humans and animals. Prokinetic drugs have been used in FD, and some of these drugs reverse the feeding inhibition (FI) induced by acute restraint stress in rats. We aimed to evaluate the effect of DA-9701 on FI induced by acute restraint in rats. MATERIALS AND METHODS: Male Sprague-Dawley rats were divided into 6 groups: Control (no stress), Stress+vehicle, and Stress+DA-9701 at doses of 1, 3, 10, and 30 mg/kg (n=6~7). DA-9701 or vehicle was administered through gastric gavage 45 minutes before stress. After 60 minutes of stress, pre-weighed chow was given and the weight of remaining food was measured 30 and 60 minutes later. The effect of DA-9701 on FI was compared after pretreatment with WAY100635, a 5HT1A antagonist. RESULTS: The restraint stress group had significantly less food intake than the control group. After feeding, rats given 1 and 3 mg/kg of DA-9701 showed increased food intake at 60 minutes, but this was not statistically significant. Rats given 10 mg/kg of DA-9701 showed significantly increased food intake at 30 minutes and 60 minutes (P < 0.05). Interestingly, rats given 30 mg/kg of DA-9701 showed a significant decrease in food intake, similar to that of the vehicle group. The beneficial effect of 10 mg/kg of DA-9701 on FI was abolished by the pretreatment with WAY100635. CONCLUSIONS: Acute restraint stress reduced food intake in rats and pretreatment with DA-9701 improved stress-induced FI.
Animals ; Dyspepsia ; Eating ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Stress, Physiological