Gastrointestinal-Specific symptom anxiety in patients with gastroparesis: Relationships to symptom severity and quality of life

Samuel E Tanner; Helen Burton Murray; Tiffany A Brown; Zubair Malik; Henry P Parkman

doi:10.1111/nmo.14534

Gastrointestinal-Specific symptom anxiety in patients with gastroparesis: Relationships to symptom severity and quality of life

Neurogastroenterol Motil. 2023 May;35(5):e14534. doi: 10.1111/nmo.14534. Epub 2023 Feb 5.

Authors

Samuel E Tanner¹, Helen Burton Murray^{2

3}, Tiffany A Brown⁴, Zubair Malik⁵, Henry P Parkman⁵

Affiliations

¹ Department of Internal Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
² Department of Medicine, Center for Neurointestinal Health, Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA.
³ Harvard Medical School, Boston, Massachusetts, USA.
⁴ Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA.
⁵ Department of Medicine, Gastroenterology Section, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.

PMID: 36740788
DOI: 10.1111/nmo.14534

Abstract

Background: Gastrointestinal (GI)-specific anxiety has been identified as a treatment target in irritable bowel syndrome. However, GI-specific anxiety has been understudied in other GI functional/motility disorders. Among adults with gastroparesis, we aimed to: (1) initially validate a measure of GI-specific anxiety, the Visceral Sensitivity Index (VSI); and (2) evaluate the relationship between GI-specific anxiety and gastroparesis symptom severity and quality of life, compared to measures of anxiety, depression, and somatization.

Methods: Consecutive adult patients (N = 100) with gastroparesis presenting for initial consultation completed a series of self-report measures including the VSI. We conducted a confirmatory factor analysis of the VSI one-factor structure and tested internal consistency and convergent validity. We then performed hierarchical linear regression analyses to explore associations between VSI and gastroparesis symptom severity and overall quality of life.

Key results: Confirmatory factor analysis revealed that the original VSI one-factor structure overall fit well [χ² (90) = 220.1, p < 0.0001; SRMR = 0.08; RMSEA = 0.12; CFI = 0.96]. The VSI also had excellent internal consistency (α = 0.99) and convergent validity (r = 0.29-0.56; all p < 0.01). Higher GI-specific anxiety was significantly associated with greater gastroparesis symptom severity, including nausea/vomiting, fullness/satiety, and upper abdominal pain scores beyond depression, anxiety, or somatization (all p = <0.01-0.01). Additionally, higher GI-specific anxiety was significantly associated with lower mental health-related quality of life, beyond gastroparesis symptom severity, depression, anxiety, or somatization (p = 0.01).

Conclusions & inferences: The VSI is an adequate measure of GI-specific anxiety in patients with gastroparesis. Higher GI-specific anxiety was associated with increased patient-reported gastroparesis symptom severity and decreased quality of life, beyond depression/anxiety.

Keywords: brain-gut axis; gastrointestinal motility; gastroparesis; psychological distress; somatization.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adult
Anxiety
Anxiety Disorders
Gastroparesis* / diagnosis
Humans
Irritable Bowel Syndrome*
Quality of Life
Severity of Illness Index
Surveys and Questionnaires
Vomiting