Relationship between Psychological Factors and Quality of Life in Subtypes of Gastroesophageal Reflux Disease

Background/Aims: Quality of life (QoL) is consistently decreased in gastroesophageal reflux disease (GERD), but the relationship between QoL and psychological factors in GERD has not yet been clearly defined. The present study investigated the relationship between the psychological factors of two sub-types of GERD and QoL. Methods. A cohort of 769 participants underwent upper endoscopic evaluation in the health-promotion center of St. Paul's Hospital. The severity of GERD symptoms, psychological factors, and QoL were analyzed using the Visual Analogue Scale, the Hospital Anxiety and Depression Scale, and the abbreviated version of the World Health Organization Quality of Life instrument, respectively. Results: Among the total of 769 participants, 153 participants were included in the exclusion criteria. Erosive reflux disease (ERD) and nonerosive reflux disease (NERD) were present in 106 (14%) and 61 (8%) of the participants, respectively, and 449 (58%) acted as controls. In each GERD group, the QoL had no correlatioion with the symptom severity. The scores for anxiety and depression were highest in the NERD group, and QoL scores were lower in both the ERD and NERD groups than in the control group. Anxiety and depression resulted in QoL scores being lower in both the ERD and NERD groups than in the nonanxiety and nondepressed groups, respectively. Conclusions: This study provides evidence that the QoL associated with the ERD and NERD subtypes may be more related to psychological factors than to symptom severity. (Gut and Liver 2009;3:259-265)