The Association of Mood Disorders, Psychoactive Drugs and Gastroesophageal Reflux Disease (GERD): A National Population-based Study

情感性精神疾病、精神作用藥物使用與罹患胃食道逆流之關聯性分析

10.29478/TJP.201109.0007

潘英傑(Ying-Chang Pan)；楊斯年(Szu-Nian Yang)；諶立中(Lih-Jong Shen)；翁郡珮(Chun-Pei Weng)；張家豪(Chia-Hao Chang)；陶屏(Ping Tao)；錢慶文(Ching-Wen Chien)

gastroesophageal reflux disease GERD ； mood disorders ； antipsychotic drugs ； antidepressant drugs

台灣精神醫學

25卷3期（2011 / 09 / 01）

180 - 190

英文

Objective: This study was to examine the association of mood disorders and psychoactive drugs with GERD. Method: In this study, we retrospectively analyzed 2003-2006 Taiwan National Health Insurance Research Database (NHIRD). The case cohort included patients who were first diagnosed with a mood disorder in 2004 but did not have a previous diagnosis of GERD, and the control cohort included patients who did not have mental disorders. Both cohorts were followed over a period of two years. Mood disorders were classified as major depressive disorder or bipolar disorder, and psychoactive drugs were classified as antidepressant drugs or antipsychotic drugs. We also calculated the average daily frequency (ADF) of psychoactive drugs use before the occurrence of GERD in patients. Logistic regression was used in this study to investigate the association of mood disorders and ADF of psychoactive drugs use with GERD. Results: The incidence of GERD was 4.14% in the case cohort and 1.60% in the control cohort. The risk of GERD in patients with bipolar disorder and major depressive disorder compared with control were 1.94 and 2.48 (p＜0.001). The risk of GERD in the patients who took antipsychotic drugs or antidepressant drugs with an ADF of one or more times compared with an ADF of less than one were 1.77 and 2.55 (p＜0.001). Conclusion: Mood disorders and use of psychoactive drugs were highly associated with GERD. In addition, a patient's ADF of antidepressant use should be carefully observed, regardless of whether the patient has a mental disorder. When ADF of a patient is one or more, then the patient should be followed up for any esophageal irritability.

1. Avidan, B,Sonnenberg, A,Giblovich, H,Sontag, SJ(2001).Reflux symptoms are associated with psychiatric disease.Aliment Pharmacol Ther,15,1907-1912.
2. Baker, RW,Chengappa, KN(1997).Gastroesophageal reflux as a possible result of clozapine treatment.J Clin Psychiatry,58,364-365.
3. Chen, M,Xiong, L,Chen, H(2005).Prevalence, risk factors and impact of gastroesophageal reflux disease symptoms: a population-based study in South China.Scand J Gastroenterol,40,759-767.
4. Chow, WH,Finkle, WD,McLaughlin, JK,Frankl, H,Ziel, HK,Fraumeni, JF Jr(1995).The relation of gastroesophageal refl ux disease and its treatment to adenocarcinomas of the esophagus and gastric cardia.JAMA,274,474-477.
5. Dean, BB,Crawley, JA,Schmitt, CM,Wong, J,Ofman, JJ(2003).The burden of illness of gastro-oesophageal reflux disease: impact on work productivity.Aliment Pharmacol Ther,17,1309-1317.
6. Dent, J,El-Serag, HB,Wallander, MA,Johansson, S(2005).Epidemiology of gastro-oesophageal refl ux disease: A systematic review.Gut,54,710-717.
7. Fass, R,Quan, SF,O''Connor, GT,Ervin, A,Iber, C(2005).Predictors of heartburn during sleep in a large prospective cohort study.Chest,127,1658-1666.
8. Fennerty, MB(2005).Review article: alternative approaches to the long-term management of GERD.Aliment Pharmacol Ther,22,39-44.
9. Henke, CJ,Levin, TR,Henning, JM,Potter, LP(2000).Work loss costs due to peptic ulcer disease and gastroesophageal refl ux disease in a health maintenance organization.Am J Gastroenterol,95,788-792.
10. Ho, KY(1999).Gastroesophageal reflux disease is uncommon in Asia: evidence and possible explanations.World J Gastroenterol,5,4-6.
11. Hu, WH,Wong, WM,Lam, CL(2002).Anxiety but not depression determines health care-seeking behaviour in Chinese patients with dyspepsia and irritable bowel syndrome: a population-based study.Aliment Pharmacol Ther,16,2081-2088.
12. Jansson, C,Nordenstedt, H,Wallander, MA(2007).Severe gastro-oesophageal refl ux symptoms in relation to anxiety, depression and coping in a population-based study.Aliment Pharmacol Ther,26,683-691.
13. Johnston, BT(2005).Stress and heartburn.J Psychosom Res,59,425-426.
14. Kamolz, T,Velanovich, V(2002).Psychological and emotional aspects of gastroesophageal reflux disease.Dis Esophagus,15,199-203.
15. Lagergren, J,Bergström, R,Lindgren, A,Nyrén, O(1999).Symptomatic gastroesophageal refl ux as a risk factor for esophageal adenocarcinoma.N Engl J Med,340,825-831.
16. Laker, MK,Cookson, JC(1997).Reflux oesophagitis and clozapine.Int Clin Psychopharmacol,12,37-39.
17. Lee, YC,Wang, HP,Chiu, HM(2006).Comparative analysis between psychological and endoscopic profiles in patients with gastroesophageal reflux disease: a prospective study based on screening endoscopy.J Gastroenterol Hepatol,21,798-804.
18. Lin, SR,Xu, GM,Hu, PJ(2007).Chinese consensus on gastroesophageal refl ux disease (GERD): October 2006, Sanya, Hainan Province, China.J Dig Dis,8,162-169.
19. Martín-Merino, E,Ruigómez, A,García Rodríguez, LA,Wallander, MA,Johansson, S(2010).Depression and treatment with antidepressants are associated with the development of gastro-oesophageal reflux disease.Aliment Pharmacol Ther,31,1132-1140.
20. Mizyed, I,Fass, SS,Fass, R(2009).Review article: gastro-oesophageal reflux disease and psychological comorbidity.Aliment Pharmacol Ther,29,351-358.
21. Revicki, DA,Wood, M,Maton, PN,Sorensen, S(1998).The impact of gastroesophageal refl ux disease on healthrelated quality of life.Am J Med,104,252-258.
22. Rey, E,García-Alonso, M,Moreno-Ortega, M,Almansa, C,Alvarez-Sanchez, A,Díaz-Rubio, M(2009).Influence of psychological distress on characteristics of symptoms in patients with GERD: the role of IBS comorbidity.Dig Dis Sci,54,321-327.
23. Ronkainen, J,Aro, P,Storskrubb, T(2006).Gastro-oesophageal refl ux symptoms and health-related quality of life in the adult general population-the Kalixanda study.Aliment Pharmacol Ther,23,1725-1733.
24. Sandler, RS,Everhart, JE,Donowitz, M(2002).The burden of selected digestive diseases in the United States.Gastroenterology,122,1500-1511.
25. van Soest, EM,Dieleman, JP,Siersema, PD,Schoof, L,Sturkenboom, MC,Kuipers, EJ(2007).Tricyclic antidepressants and the risk of refl ux esophagitis.Am J Gastroenterol,102,1870-1877.
26. Wong, WM,Lai, KC,Lam, KF(2003).Prevalence, clinical spectrum and health care utilization of gastro-oesophageal reflux disease in a Chinese population: a population-based study.Aliment Pharmacol Ther,18,595-604.