Functional dyspepsia in depression: A population-based cohort study

Eur J Clin Invest. 2021 Jun;51(6):e13506. doi: 10.1111/eci.13506. Epub 2021 Feb 18.

Abstract

Background: Patients with functional dyspepsia (FD) are more likely to have persistent depression, yet whether depression and antidepressant treatments are associated with subsequent risk of FD remain unclear.

Methods: Using population-based insurance administrative data of Taiwan, an 11-year historic cohort study was assembled, comparing cases aged 18 and above with the diagnosis of depressive disorder, to a propensity score-matched sample of adults without depression. Incident FD as a primary diagnosis was ascertained. Hazard ratios of FD were calculated using Cox regression models by age, gender, other comorbidities, nonsteroidal anti-inflammatory medications, antidepressants and antidiabetic agents.

Results: A total of 20,197 people with depressive disorder and 20,197 propensity score-matched comparisons without depression were followed up. The incidence of FD was 1.7-fold greater in the depressive cohort than in comparisons (12.9 versus 7.57 per 1000 person-years), with an adjusted hazard ratio (aHR) of 2.16 (95% confidence interval (CI) 1.93~2.41). Increased risks were significant regardless of comorbidities or medication uses, the highest in the untreated depression group compared to the group without depression, with an aHR of 2.51(95% CI 2.15~2.93).

Conclusions: This population-based study showed that patients with depressive disorder are at elevated risk of FD. Antidepressant treatment could reduce the risk of FD.

Keywords: antidepressant treatment; depressive disorders; functional dyspepsia; longitudinal study; propensity score matching.

MeSH terms

  • Adult
  • Aged
  • Antidepressive Agents / therapeutic use
  • Cohort Studies
  • Depressive Disorder / drug therapy
  • Depressive Disorder / epidemiology*
  • Dyspepsia / epidemiology*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Propensity Score
  • Proportional Hazards Models
  • Taiwan / epidemiology

Substances

  • Antidepressive Agents