The Importance of Hypochondriasis in Dyspeptic Patients

Psychological factors are involved in functional dyspepsia and irritable bowel syndrome. The aim of the study was to characterize the psychological factors associated with functional dyspepsia (FD) with or without overlap with irritable bowel syndrome (IBS). We included 693 outpatients (69% female) consulting in a tertiary center for functional gastrointestinal disorders (FGIDs) in this cross sectional study. Patients have filled a MMPI-2 questionnaire and a standard Rome III clinical questionnaire. Data analysis was performed using univariate analysis and multivariate logistic regression. Dyspeptic disorders without IBS were found in 139 patients (20%) (21 had epigastric pain syndrome, 46 postprandial distress syndrome, 72 nonspecific dyspepsia), 214 patients (31%) had overlap between FD and IBS, 68 patients (10%) have only IBS, and 272 (39%) had other FGIDs. These groups show no difference for age, stool form, but patients with overlap between FD and IBS have more frequently female gender (P<0.05) and all dyspeptic patients had lower BMI than patients with other FGIDs. As compared to the group "other FGIDs" patients, the multivariate analysis shows that patients with isolated FD are associated with lower BMI (P=0.002; OR=0.921; 95% CI=[0.874-0.970]), and higher hypochondriasis scale (P<0.001; OR=1.096; 95% CI=[1.061-1.133]), patients with overlap of IBS and FD are associated with lower BMI (P=0.001; OR=0.929; 95% CI=[0.888-0.972]), higher Infrequency scale (P=0.013; OR=1.035; 95% CI=[1.007-1.063]), higher hypochondriasis scale (P<0.001; OR=1.095; 95% CI=[1.064-1.127]) and lower schizophrenia scale (P=0.036; OR=0.959; 95% CI=[0.921-0.997]). To conclude high hypochondriasis scales are found in FD patients and in patients with overlap between IBS and dyspepsia.