Psychiatric disorder in essential dyspepsia

We wanted to examine the prevalence of psychiatric morbidity in patients diagnosed as having essential dyspepsia, as well as the short-term course of dyspeptic symptoms, following drug treatment of the psychiatric condition. Seventy-four patients with essential dyspepsia presenting to the gastroenterology outpatient department of a medical college were investigated for the presence of psychiatric disorder. The response to an open trial of pharmacotherapy in 50 patients with a psychiatric disorder and no other demonstrable pathology was assessed. These patients met the criteria for a DSM-III-R diagnosis, most commonly major depressive disorder (26) or generalized anxiety disorder (10). The mean age of those with a psychiatric disorder alone was significantly higher than that of those with another demonstrable pathology. With treatment, 16 patients with no demonstrable pathology other than psychiatric disorder (depression: 12; anxiety: 4) showed improvement over a period of 6 weeks in psychiatric as well as dyspepsia ratings. The difference was however statistically significant only for the group with major depressive disorder. We concluded that, despite differences in the characteristics of the population studied, a psychiatric diagnosis is associated with at least a proportion of cases with essential dyspepsia and emerges as a likely explanation.