Incidence and psychological-behavioral characteristics of refractory functional dyspepsia: A large, multi-center, prospective investigation from China

AIM: To explore the incidence and psychological and behavioral characteristics of refractory functional dyspepsia (RFD) in China.

METHODS: The subjects of this study were 1341 new outpatients with functional dyspepsia (FD) who were diagnosed according to the Rome III criteria at four hospitals in Guangdong Province between June and September 2012, and 100 healthy volunteers. All subjects completed questionnaires and scales administered.

RESULTS: Three-hundred and twenty-seven of the 1341 patients with FD had RFD (24.4%). Patients with RFD had a longer disease duration and a more severe form of the disease than patients with non-refractory FD (NRFD). The prevalence of depression and anxiety symptoms was higher in patients with RFD than in patients with NRFD. The prevalence of unhealthy eating behaviors, lack of physical activity, and sleeping disorders was higher in patients with RFD than in patients with NRFD. Patients with RFD sought medical advice on more occasions and spent more money on treatment than patients with NRFD. Finally, patients with RFD had poorer quality of life than patients with NRFD.

CONCLUSION: RFD is not rare in clinical practice and should get attention by patients and doctors because of its long duration, severe symptoms, and associations with abnormal psychology and poor quality of life.

Relationship between refractory functional dyspepsia and emotional disturbance and therapeutic action of tandospirone

AIM: To investigate the relationship between refractory functional dyspepsia (RFD) and emo-tional disturbance, and observe the therapeutic action of tandospirone.

METHODS: Thirty patients with RFD were included in this study. Based on symptomatic treatment, tandospirone was used for 6 wk. HAMD and HAMA scores were obtained before and after treatment. Then the mean value of HAMD and HAMA scores was calculated to evaluate the disease status. Meanwhile, the eight common symptoms of functional dyspepsia were scored.

RESULTS: Athymia and anxiety coexisted in 24 of 30 cases (80.0%). Pure athymia was found in 1 case (3.3%), and pure anxiety occurred in 5 cases (16.7%). The HAMD and HAMA scores, as well as the mean values of them, were significantly higher in RFD patients than those in the healthy controls (26.1 ± 6.2, 21.8 ± 4.1, 24.0 ± 5.6 vs 11.6 ± 3.8, 8.6 ± 2.3, 10.1 ± 3.5, all P < 0.01). The score for the eight common symptoms of functional dyspepsia were also markedly higher than that in the controls (11.3 ± 3.6 vs 8.7 ± 1.7, P < 0.01). The above scores were also significantly different before and after treatment (P < 0.01).

CONCLUSION: RFD patients have different degrees of emotional disturbance. Tandospirone can be used in the treatment of RFD.