P1340 - Major Depressive Disorder and Generalized Anxiety Disorder Are Associated With Gastroesophageal Reflux Disease and Its Complications: A Nationwide Study

Monday, October 25, 2021

10:30 AM – 4:15 PM PT

Location: Shoreline Exhibit Hall

Has Audio

Presenting Author(s)

JD

Josue Davila, MD

MetroHealth Medical Center
Cleveland, OH, United States

Josue Davila, MD¹, Nabil El Hage Chehade, MD¹, Sherif Saleh, MD¹, Fahmi Shibli, MD¹, Sophie Trujillo, DO¹, Yuhan Fu, DO¹, Ronnie Fass, MD²
¹MetroHealth Medical Center, Cleveland, OH; ²Esophageal and Swallowing Center, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH

Introduction: Gastroesophageal reflux disease (GERD) symptoms range from mild to severe and distressing. Published studies have shown that GERD negatively affects patients’ quality of life. However, few studies have investigated the association between various psychiatric disorders and GERD. Our aim was to investigate the potential association between psychiatric diseases and GERD and its different complications.

Methods: Data was analyzed from a large database (Explorys Inc.) that provides electronic health records of patients from 26 major integrated US health care systems. Adult patients with diagnosis of GERD from January 1999-May 2021 were included. Psychiatric history, gender, age, smoking status, alcohol intake, and obesity were covariates of interest. Univariate analysis was used for statistical analysis.

Results: 6,613,490 patients with GERD were identified. In univariate analysis, the odds ratio (OR) of GERD in patients with major depressive disorder (MDD) was 2.40 (95% CI [2.39-2.41], P=0.001). Similarly, there was an increased association between generalized anxiety disorder (GAD) (OR 1.92), bipolar disorder (OR 1.44), schizophrenia (OR 1.40) and GERD. In terms of GERD complications, MDD was associated with an increased risk of esophagitis (OR 2.06, 95% CI [2.04, 2.07], P=0.001) and Barrett’s esophagus (BE) (OR 1.68, 95% CI [1.66, 1.70], P=0.001). The risk of esophagitis and BE was also higher among patients with GAD with an OR of 1.80 and 1.44, respectively. Interestingly, the risk of BE in schizophrenics was significantly decreased (OR 0.67, 95% CI [0.64- 0.70], P=0.001).

Discussion: MDD and GAD, the most common psychiatric conditions, are associated with an increased risk of GERD, esophagitis, and BE. Schizophrenia increases the risk of GERD and esophagitis but is less associated with BE. Further research is needed to evaluate the potential association between antidepressants and antipsychotics use with GERD.

Outcome	Disorder	Odds Ratio	95% CI	P- value
GERD	MDD	2.40	[2.39, 2.41]	< 0.001
	GAD	1.92	[1.91, 1.94]	< 0.001
	Bipolar Disorder	1.44	[1.43, 1.45]	< 0.001
	Schizophrenia	1.40	[1.38, 1.42]	< 0.001
Esophagitis	MDD	2.06	[2.05, 2.08]	< 0.001
	GAD	1.80	[1.79, 1.82]	< 0.001
	Bipolar Disorder	1.11	[1.09, 1.12]	< 0.001
	Schizophrenia	0.94	[0.92, 0.97]	< 0.001
Barrett's Esophagus	MDD	1.68	[1.66, 1.70]	< 0.001
	GAD	1.44	[1.41, 1.47]	< 0.001
	Bipolar Disorder	1.09	[1.06, 1.12]	< 0.001
	Schizophrenia	0.67	[0.64, 0.71]	< 0.001

Table: Table 1: Associations between various psychiatric disorders and GERD and its complications. CI, confidence interval. GAD, generalized anxiety disorder. GERD, gastroesophageal reflux disease. MDD, major depressive disorder.

Disclosures:

Josue Davila indicated no relevant financial relationships.

Nabil El Hage Chehade indicated no relevant financial relationships.

Sherif Saleh indicated no relevant financial relationships.

Fahmi Shibli indicated no relevant financial relationships.

Sophie Trujillo indicated no relevant financial relationships.

Yuhan Fu indicated no relevant financial relationships.

Ronnie Fass indicated no relevant financial relationships.

Josue Davila, MD¹, Nabil El Hage Chehade, MD¹, Sherif Saleh, MD¹, Fahmi Shibli, MD¹, Sophie Trujillo, DO¹, Yuhan Fu, DO¹, Ronnie Fass, MD². P1340 - Major Depressive Disorder and Generalized Anxiety Disorder Are Associated With Gastroesophageal Reflux Disease and Its Complications: A Nationwide Study, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.