Association of moderate level of anxiety in functional dyspeptic patients attending out door general practice in teaching hospital Kathmandu

Abstract

Introduction: Functional dyspepsia (FD) is a clinical syndrome defined by chronic or recurrent upper abdominal symptom without identifiable cause by conventional diagnostic means. Hamilton Anxiety Rating Scale (HAM-A) is used to measure the severity of anxiety symptoms with mild, moderate & severe score. Only moderate level of anxiety (HAM-A) was responsible for functional dyspepsia. As age increases, chance of anxiety induced dyspepsia was also increased. This study was conducted to determine the prevalence of moderate anxiety induced dyspepsia patients presented to General Practice OPD, TUTH among 15-39 years age.

Methods: 100 patients aged 15-39 years with relapse of dyspeptic symptom within 2 weeks after 6 weeks' treatment with proton pump inhibitor (PPI) correlated with moderate level of Hamilton Anxiety Rating Scale (HAM-A) who presented to GP OPD, TUTH were taken for study. Other causes of dyspepsia were excluded before enrolling them for the study. All of them underwent blood test for Helicobacter Pylori IgG serology, HAM-A scale of 18-24 score took as moderate anxiety which required treatment by TCA & PPI. Rest patient score of less than 18 were managed with PPI and above 24 score were referred to psychiatrist. Similarly duration of epigastric pain, sex & age of patients were also considered for analysis.

Results: Among 100 patients, 31 of them were positive for moderate anxiety (HAM-A). 27.27% male and 33.93% female had moderate level of anxiety. Though P value was not significant, there was moderate anxiety level with functional dyspepsia associated with increasing age. Duration of epigastric pain was not significantly associated with moderate anxiety.

Conclusion: Functional dyspepsia is common problem in Nepalese population, causing difficulties in their day to day life. Moderate level of anxiety (HAM-A) should be considered in management of functional dyspepsia in those with relapse of dyspepsia after discontinuation of PPL. Moderate anxiety with dyspepsia was associated with increasing age and in female gender.