Gastrointestinal Symptoms During Depressive Episodes in 3256 Patients with Major Depressive Disorders: Findings from the NSSD

Jia Huang; Yiyun Cai; Yousong Su; Min Zhang; Yifan Shi; Na Zhu; Feng Jin; Daihui Peng; Yiru Fang

doi:10.1016/j.jad.2021.02.039

Gastrointestinal Symptoms During Depressive Episodes in 3256 Patients with Major Depressive Disorders: Findings from the NSSD

J Affect Disord. 2021 May 1:286:27-32. doi: 10.1016/j.jad.2021.02.039. Epub 2021 Feb 17.

Authors

Jia Huang¹, Yiyun Cai², Yousong Su¹, Min Zhang¹, Yifan Shi¹, Na Zhu³, Feng Jin¹, Daihui Peng⁴, Yiru Fang⁵

Affiliations

¹ Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
² Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
³ Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, 200122, China.
⁴ Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China. Electronic address: pdhsh@126.com.
⁵ Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China. Electronic address: yirufang@aliyun.com.

PMID: 33667753
DOI: 10.1016/j.jad.2021.02.039

Abstract

Background: Little is known how often depressive episodes are accompanied by gastrointestinal symptoms in major depressive disorders (MDD). The authors sought to determine the frequency and clinical correlates of gastrointestinal symptoms during episodes of depressive disorder.

Methods: 3,256 MDD patients from the National Survey on Symptomatology of Depression (NSSD), which was designed to investigate the magnitude of symptoms of current major depressive episodes in China, were enrolled and assessed for gastrointestinal symptoms in this study. Illness characteristics were compared in patients with a different frequency of gastrointestinal symptoms. Pearson correlation analysis and multiple linear regression analysis were employed to investigate the associations between gastrointestinal symptoms and psychological characteristics in the patients.

Results: More than 70% of the subjects with depressive episodes had concomitant gastrointestinal symptoms. A higher frequency of gastrointestinal symptoms was associated with an increased risk of suicide ideation, suicide attempts, anxious mood, depressed mood, insomnia, feeling a failure, poor concentration, body pain, hopelessness, anger, and irritability. Pearson correlation analysis indicated moderate but significant associations between gastrointestinal symptoms and psychological characteristics (p<0.001). Multiple linear regression analysis showed that suicide ideation (β=0.161, p<0.001), anxiety mood (β=0.166, p = 0.006), insomnia (β =0.262, p<0.001), anger (β=0.144, p<0.001), feeling a failure (β =0.365, p<0.001), and body pain (β=0.581 p<0.001) were independently associated with gastrointestinal symptoms in MDD patients.

Conclusion: Gastrointestinal symptoms were one of the most prevalent clinical presentations of MDD. The associations between gastrointestinal symptoms and psychological characteristics may prove useful in expanding our understanding of how gastrointestinal symptoms contributes to MDD.

Keywords: Chinese; Gastrointestinal symptoms; Gut-brain-axis; Major depressive disorder; Psychological characteristics.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

China / epidemiology
Depressive Disorder, Major* / epidemiology
Humans
Irritable Mood
Suicidal Ideation
Suicide, Attempted