Original article Psychological modulation in patients surgically intervened for gastroesophageal reflux disease F. J. Pérez Lara, 1 G. Carranque, 2 H. Oehling, 1 J. M. Hernández, 1 H. Oliva 1 1 Digestive Surgery Department, Antequera Hospital, and 2 Virgen de la Victoria Hospital, Málaga, Spain SUMMARY. Gastroesophageal reflux disease (GERD) has been related with certain psychological dimensions. The influence of mood, emotional intelligence, and perceived quality of life on clinical symptoms and outcome of antireflux surgery was evaluated in GERD patients with and without hiatal hernia. The study included 61 patients who were diagnosed with GERD between 2003 and 2008: 16 of them without hiatal hernia (group A) and 45 of them with hiatal hernia (group B). All of these patients had undergone laparoscopic antireflux surgery. Patients were clinically examined and evaluated with the following instruments: Short Form (SF)-36 Health Survey, Gastrointes- tinal Quality of Life Index, Hospital Anxiety and Depression (HAD) Scale, and Trait Meta-Mood Scale (TMMS)-24. Proportions were compared by using the chi-squared test; averages were compared by using the Student’s t-test (with Bonferroni’s correction). In general, our patients intervened for GERD showed results lower than normal or close to the lower limit of normal in the administered tests. Patients in the group without hernia were younger (P < 0.001) and with lower American Society of Anaesthesiologists risk. They showed higher scores in the SF-36 dimensions: Physical Functioning, Physical Role and Emotional Role, and lower scores in the Social Role (P < 0.001). They showed lower scores in the Emotional dimension of Gastrointestinal Quality of Life Index (P = 0.0068) and worse results in the Hospital Anxiety and Depression subscales of Anxiety (P < 0.001) and Depression (not significant). Men in the group without hernia showed higher scores than men in the group with hernia in the TMMS subscales corresponding to Emotional Clarity and Emotional Repair (P < 0.001). Women in the group with hernia showed higher scores than women in the group without hernia regarding Emotional Clarity (P = 0.0012). GERD patients showed poor results in all the tests, and patients without hiatal hernia compared with patients with hernia showed higher levels of anxiety, which interfered with their social life. Moreover, they showed lower tolerance to stress and higher frustration, fear, and worry. On the basis of such unfavorable phy- choemotional results observed with GERD patients (especially those without hernia) in the different tests, we propose that improving our knowledge of the psychological profile of GERD patients – particularly those without hiatal hernia – could help in designing individualized medical and psychological therapies and increase success rates. KEY WORDS: anxiety, depression, emotional intelligence, gastroesophageal reflux disease (GERD), quality of life. INTRODUCTION Gastroesophageal reflux disease (GERD)-associated symptoms such as pyrosis and regurgitation are rather common and affect about 20% of subjects in the general population. 1,2 Manifestations of this disease vary from occasional pyrosis or regurgitation to more severe conditions such as stenosis or Barrett’s esophagus. Patients’ self-perception of their health status is a rather important part of current applied medical lit- erature. Morbidity and mortality data are being supplemented with data on dimensions such as disability, discomfort, and dissatisfaction by using recently validated tools. Psychological factors may influence esophageal exposure to gastric acid in GERD patients 3 and consequently, their response to therapy. 4 A case-control study evidenced that patients with psychiatric disorders had 2.7 times assessing such dimensions, involved psychological factors can be detected, which can be measured by higher pro- bability to report pyrosis than healthy controls. 5 Address correspondence to: Dr Francisco Javier Pérez Lara, MD, Antequera Hospital, Urb Jardines del Golf Fase 4 n°33, Añoreta, Rincón de la Victoria, Málaga., Código Postal 29730, Spain. Email: javinewyork@hotmail.com Diseases of the Esophagus (2014) 27, 538–546 DOI: 10.1111/j.1442-2050.2012.01443.x © 2012 Copyright the Authors Journal compilation © 2012, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus 538 Downloaded from https://academic.oup.com/dote/article/27/6/538/2329029 by guest on 16 July 2022