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SEVERITY OF INFECTIOUS GASTROENTERITIS IS NOT PREDICTED BY PATIENT ANXIETY OR DEPRESSION
MR Borgaonkar
1, JK Marshall1, E Churchill1, D Marsillo2, E Mathews2, D King2, C Bannon2, A Haley2, C Buffett2, E Richardson2, SM Collins1Search
CDDW Abstracts
SEVERITY OF INFECTIOUS GASTROENTERITIS IS NOT PREDICTED BY PATIENT ANXIETY OR
DEPRESSION MR Borgaonkar
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1
McMaster University, Division of Gastroenterology; 2Hamilton-Wentworth Regional Department of Public Health, Hamilton, Ontario, CanadaRationale: There is evidence to support a relationship between psychological factors and the development of post-infectious irritable bowel syndrome (PI-IBS). The relationship between the symptoms of acute infectious gastroenteritis (GE) and psychological factors has not been studied.
Purpose: To examine the relationship between reported symptoms of bacterial GE and psychological distress.
Methods: A patient cohort with documented bacterial GE within the preceding month was prospectively recruited. Questionnaires regarding demographics, details of the GE, gastrointestinal symptoms, and the Hospital Anxiety and Depression Scale (HADS) were completed. Linear regression analysis was performed to assess the relationship between HADS score and symptom severity.
Results: From April 6 to October 28, 1999, 226 cases of bacterial GE occurred in the region of Hamilton-Wentworth. The majority of cases were caused by Campylobacter (34.1%), Giardia (25.7%), and Salmonella (24.8%) species. 52 patients (23%) were eligible and agreed to participate. 27 had Campylobacter (51.9%), 13 Giardia (25%), and 8 Salmonella (15.4%). The mean age was 43.8 years with 30 (57.7%) females. 98% of patients had diarrhea, 72.5% abdominal pain, 43.1% fever, and 30.8% vomiting. The mean number of days with diarrhea, pain, fever, and vomiting was 11.8, 8.1, 3.5, and 2.6, respectively. 72.4% of patients missed at least some of their usual activities. The mean time to return to all regular activities was 16.2 days. The mean HADS anxiety and depression scores were 6.4 (SD 4.0, range 12) and 3.3 (SD 2.9, range 10) respectively. There was no relationship between the presence or duration of any symptoms and the HADS anxiety or depression score. Symptoms did not differ among the specific bacterial pathogens.
Conclusions: These data suggest that psychological factors have no impact on the reported severity of acute GE, which is in contrast to the association of psychological distress and development of PI-IBS. This ongoing study will explore chronic symptoms after acute GE and the incidence of PI-IBS.