4.3 Article

Clinical and psychological characteristics of patients with globus

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ELSEVIER MASSON, CORPORATION OFFICE
DOI: 10.1016/j.clinre.2019.01.006

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Globus; Hysteria; Hypochondriasis; MMPI-2

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Background/aims: Psychological factors are involved in many functional gastrointestinal disorders including globus. The aim of the present study was to assess the clinical and psychological correlates associated with globus. Patients and methods: 707 patients (69% female, 45.2 +/- 16.5 years, BMI 27.2 +/- 11.7 kg/m(2)) fitted an MMPI-2 questionnaire and a standard Rome III clinical questionnaire and were included in this cross sectional study. Data analysis was performed using a univariate analysis and a multivariate logistic regression with a backwards selection procedure on significant scales after a univariate analysis. Results: 140 patients (20%) reported suffering from gtobus. Globus appeared to be associated with older age (P=0.001; OR = 1.022; 95% CI = [1.009-1.035]), increased BMI (P=0.007; OR = 1.029; 95% CI = [1.008-1.051]), higher prevalence of regurgitations (P= 0.008; OR = 2.189; 95% CI = [1.228-3.902] ), heartburn (P=0.001 OR = 2.227; 95% CI = [1.406-3.530]), dysphagia (P < 0.001; OR =2.399; 95% CI = [1.500-3.837]), epigastric pain (P < 0.001; OR = 3.768; 95% CI = [1.880-7.552]) and nonspecific dyspepsia (P=0.018; OR= 1.786; 95% CI =[1.106-2.881]), and a higher score of hysteria (P=0.008 OR= 1.034; 95% CI = [1.009-1.059]). By comparison with patients who reported globus and scores of hysteria in the normal range (n = 73), patients complaining of globus associated with high scores of hysteria (n=67) have high scores of hypochondriasis (P < 0.001; OR = 1.235; 95% CI = [1.142-1.336]), high levels of Psychopathic deviate (P=0.005; OR = 1.091; 95% CI = [1.026-1.161]) and a higher, but not significant, prevalence of complaints of regurgitation (P=0.052; OR =4.022; 95% CI = [0.989-16.351]). Conclusion: Approximately 50% of the patients complaining of globus have a high score of hysteria associated with other personality disorders, and complain more frequently of regurgitation than other patients complaining of globus. These results tend to confirm that globus has a strong, although not systematic, connections with some specific personality disorders. (C) 2019 Elsevier Masson SAS. All rights reserved.

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