Psychiatric Comorbidity and Functional Dyspepsia: Do They Go Together?

Functional dyspepsia (FD) is a chronic, heterogeneous, multifactorial functional gastrointestinal disorder that has a significant impact on quality of life and imposes a substantial economic burden on society. The Rome III Consensus has proposed the subdivision of FD into two subgroups: epigastric pain syndrome (EPS), characterized by epigastric pain and burning, and postprandial distress syndrome (PDS), characterized by postprandial fullness and early satiety. Epidemiological studies have shown that anxiety, neuroticism, somatization, and depression are more common in patients with FD than in healthy controls. Patients with functional dyspepsia have also been demonstrated to have higher anxiety and depressive scores than do non-dyspeptic individuals. There is bidirectional comorbidity between FD and psychiatric disorders, especially mood and anxiety disorders. A novel study using functional brain imaging reported impairments in the integration of gut-brain signals. In FD patients with hypersensitivity, abnormal activity in the brain appeared bilaterally in the precentral gyrus, inferior frontal gyrus, medial frontal gyrus, superior temporal gyrus, and cerebellar hemisphere and unilaterally in the left inferior temporal gyrus. In treatment, the addition of antidepressants appears to contribute to a favorable outcome.