A prospective study evaluating emotional disturbance in subjects undergoing defecating proctography

Area of Science:

• Gastroenterology
• Psychiatry
• Radiology

Background:

• Functional gastrointestinal disorders (FGIDs) are often associated with psychiatric comorbidities.
• Defecating proctography (DP) is a diagnostic tool used to evaluate structural abnormalities in the anorectum.

Purpose of the Study:

• To investigate the association between psychiatric illnesses and FGIDs using DP and validated questionnaires.
• To determine if psychiatric comorbidities are more prevalent in patients with normal DP findings.

Main Methods:

• Prospective evaluation of 45 subjects referred for DP.
• Utilized Hospital Anxiety and Depression Scale (HADS), State Trait Anxiety Inventory (STAI), Patient Health Questionnaire-15 (PHQ-15), and PTSD questionnaires.
• Categorized subjects into DP positive (structural defects) and DP negative (normal study) groups.

Main Results:

• 20 subjects (44.4%) were classified as DP negative.
• DP negative subjects had a higher prevalence of sexual abuse history (P=0.036).
• DP negative subjects scored significantly higher on HADS anxiety and depression, STAI state anxiety, PHQ-15, and had higher PTSD prevalence (P<0.05 for all).

Conclusions:

• Patients with normal DP findings exhibit a high prevalence of psychiatric disorders.
• A history of sexual abuse and psychosocial distress are significant factors in this patient group.
• Appropriate screening for sexual abuse history and psychosocial distress is recommended for patients with negative DP results.