Anxiety and depression in patients with Barrett's esophagus: estimates of disorder rates and associations with symptom load and treatment-seeking

Eur J Gastroenterol Hepatol. 2021 Jun 1;33(6):825-831. doi: 10.1097/MEG.0000000000001960.

Abstract

Background: Patients with Barrett's esophagus (BE) may experience psychological burden from living with a chronic medical condition, which has been identified as the most important risk factor for esophageal adenocarcinoma. The aim of this study was to estimate rates of depression and anxiety in a large sample of patients with BE.

Methods: A total of 794 patients with endoscopically and histologically confirmed diagnosis of BE completed validated screening instruments for depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7). Screening rates in the study sample were compared to general population estimates. Multivariable regression analyses were used to model associations between outcome variables and respondents' sociodemographic characteristics, BE-related symptom load and incidence of inpatient treatment due to BE in the last 12 months.

Results: Rates of positive screens were 14.2% for depression and 9.9% for anxiety. For several age by sex subgroups, rates of depression and anxiety were about three to five times higher in the study sample than in the general population. BE-related reflux and pain symptoms showed strong associations with higher levels of depressive and anxiety symptoms, while the effect of treatment was small.

Conclusion: Study results indicate that a relevant proportion of patients with BE is at an increased risk for depression and anxiety, compared to general population controls. Lacking information on patients' disease characteristics limited generalizability of results.

MeSH terms

  • Anxiety / diagnosis
  • Anxiety / epidemiology
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology
  • Barrett Esophagus* / diagnosis
  • Barrett Esophagus* / epidemiology
  • Depression / diagnosis
  • Depression / epidemiology
  • Esophageal Neoplasms* / diagnosis
  • Esophageal Neoplasms* / epidemiology
  • Humans
  • Risk Factors