DCPR-R in IBS & GERD: A Multicenter China Study

Unveiling the Psychosomatic Landscape of IBS adn GERD in China

A recent multicenter, cross-sectional study conducted across 20 comprehensive tertiary hospitals in China sheds light on the prevalence and characteristics of psychosomatic syndromes in⁢ patients diagnosed‍ with Irritable Bowel Syndrome (IBS) and ⁣IBS overlapping with Gastroesophageal Reflux Disease (GERD). The study, strategically distributed ⁤across eastern, central, western, and northeastern regions of China, aimed to assess the distinctions of DCPR-R psychosomatic syndromes and other psychological measures in this patient population.

Study Design and Patient Recruitment

The study’s design took into account the population and socioeconomic conditions of mainland China’s four administrative regions. The eastern region, known for ⁤its large population and advanced economic development, was represented by ‍9 hospitals, while the central, western, and northeastern regions ⁤had 5, ‍4, and 2 hospitals, respectively. Researchers sought to evaluate the prevalence of DCPR-R psychosomatic syndromes, ⁢alongside psychological measures like the‍ PSI, PSSS, WHO-5 Well-being Index, Euthymia Scale, PHQ-9, ⁢and GAD-7.

The study⁣ population consisted of adult⁣ patients⁣ visiting gastroenterology departments between 2022 and⁣ 2023 who met the established criteria for IBS. The study was ethically approved and registered with the ‍Chinese Clinical Trials ‍Registry on January 30, 2022 (No ChiCTR2200055990).

Inclusion and Exclusion Criteria

Stringent inclusion and exclusion⁤ criteria were implemented to ensure ⁣the integrity of the study.‍ To be included, IBS patients had to be between ⁤18 and 75 years old, meet the Rome ⁤IV ⁤IBS diagnostic criteria, and provide informed consent. According to ⁣the study,the Rome IV IBS diagnostic criteria is a key factor in diagnosing IBS. Exclusion criteria encompassed⁣ a range ⁣of conditions, including:

• Presence of organic⁣ gastrointestinal diseases confirmed by diagnostic tests.
• Concurrent metabolic disorders, such as diabetes or thyroid ⁢dysfunction.
• Coexistence of malignant tumors and significant organ dysfunction.
• Abuse or dependence on psychoactive substances.
• Pregnancy⁣ or lactation.
• Inability to participate in effective interviews due to physical or mental health conditions.

IBS Diagnosis Criteria

The diagnosis of IBS was firmly rooted in the Rome IV ‍criteria, which includes “abdominal pain occurring at least 1 day/week in the past 3 months, along with at least two of the following: (1) symptoms associated with defecation, (2) changes in stool frequency, or (3) changes in stool form.” These symptoms must have first appeared 6 months before diagnosis and⁤ met the specified diagnostic criteria over the last 3 months.

GERD Diagnostic Criteria

GERD symptoms were evaluated using ⁢the GerdQ scale, a self-administered tool assessing reflux symptoms over the past week. This questionnaire considers factors such ⁢as “frequency of reflux, frequency of‍ burning sensations in the stomach, frequency of nausea,⁣ frequency of upper abdominal pain, frequency of sleep‍ disturbances, and frequency of use of over-the-counter (OTC) medications.” A GerdQ ⁤score of ≥ 8 was used as the diagnostic indicator for⁣ GERD, aligning with findings that suggest this cutoff provides optimal specificity and sensitivity.

DCPR-R Psychosomatic⁣ Syndrome Assessment

The DCPR-R comprehensive scale played a crucial role in evaluating⁤ 14 psychosomatic syndromes. ‍These syndromes encompass ⁣a wide spectrum, including “stress (allostatic‍ load), illness behaviors (health ‍anxiety, disease phobia, hypochondriasis, thanatophobia, denial of illness, persistent somatization, conversion symptoms, and anniversary reaction), psychological manifestations⁤ (somatic symptoms secondary to mental disorders, demoralization, demoralization with despair and irritable ⁤mood), and personality attributes (type A behavior and alexithymia).”⁤ A structured interview based on ⁢the DCPR-R‍ was conducted to identify the presence of these syndromes in each‍ participant.The reliability for ⁤the DCPR-R categories was high, with Cronbach’s⁣ α coefficients ‍ranging from 0.757 to 0.889.

Psychological Measurements

Several psychological measurements were employed to gain⁤ a comprehensive understanding of the patients’ mental well-being:

• PSI (psychosocial Index): Assessed stress, well-being, psychological distress, ⁤abnormal illness behavior, and quality of life.
• PSSS (Psychosomatic Symptom Scale): Identified psychosomatic symptoms, with a score of ≥ 10 for ⁤males and ≥ 11 for females suggesting a potential psychosomatic disorder.
• WHO-5 Well-being Index: Measured subjective well-being over the past 2 weeks, serving as a screening tool for depression.
• Euthymia Scale: Assessed mood resilience, with lower scores ‍possibly indicating depression.
• PHQ-9 (Patient Health Questionnaire-9): Screened and⁢ assessed ‍depression severity, with higher scores indicating more ⁢severe depression.
• GAD-7 (Generalized Anxiety Disorder 7-item scale): Assessed⁤ generalized anxiety, with varying cut-offs indicating different levels of⁢ severity.

Statistical Analysis

The study utilized descriptive ⁤statistics to summarize patient characteristics, clinical features, and psychological status. Autonomous samples t-tests and Wilcoxon tests were used for continuous variables,while chi-square tests ⁢or Fisher’s exact tests were used for categorical variables. Univariate and multivariate ⁤logistic regression analyses were conducted to assess associations between various factors and DCPR-R⁢ syndromes. A p-value < 0.05 ‍was considered statistically significant.

this study provides valuable insights into the complex interplay between IBS, GERD, and psychosomatic⁢ syndromes in a Chinese patient population. The findings may contribute to a better understanding and management of these conditions.