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Association of gastroesophageal reflux disease with anxiety, depression, and sleep disorders

1 Department of Pharmacology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
2 Department of Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
3 Department of Pharmacy Practice, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India

Correspondence Address:
S Shanmugapriya,
Department of Pharmacology, PSG Institute of Medical Sciences and Research, Off Avinashi Road, Peelamedu, Coimbatore - 641 004, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmedsci.jmedsci_51_20

Background: Gastroesophageal reflux disease (GERD) is commonly associated with impaired quality of life. Chronic symptoms in this highly prevalent disorder could potentially lead to psychological manifestations such as anxiety, depression, and sleep disorders. Aim: The purpose of the study was to evaluate the magnitude of association of GERD symptoms based on health-related quality of life (GERD-HRQL) with anxiety, depression, and sleep quality using Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI). Methods: This was a cross-sectional study done at a tertiary care hospital in 241 participants. Cases were patients diagnosed with GERD, and the control group was participants who did not have GERD, devoid of all gastrointestinal symptoms according to GERD-HRQL. Data on age, gender, body weight, smoking/alcohol intake, and medication history were obtained from 98 cases and 143 matched control subjects. The three questionnaires, namely, GERD-HRQL, HADS, and PSQI questionnaires were administered by a trained blinded interviewer. Results: There was a statistically significant difference (P < 0.001) in the mean score of cases in the HADS depression scale (7.35 ± 3.65); the HADS anxiety scale (9.33 ± 4.51) and the mean global PSQI sleep score (4.62 ± 1.96) compared to the controls. Using Pearson's correlation, heart burn (P = 0.036), and regurgitation scores (P = 0.026), including the global quality of life score (P = 0.003), correlated significantly with the anxiety score. We found a statistically significant correlation between heart burn and poor sleep (P = 0.012) but not for regurgitation (P = 0.772). Conclusions: This study highlights the increased risk of anxiety, depression, sleep disorder in GERD, and the significant correlation between HRQL, especially heartburn with anxiety and poor sleep quality. This enlightens that specific screening and treatment strategies targeting such psychological manifestations are imperative for overall improved quality of life in GERD patients.


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    -  Shanmugapriya S
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