Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Studies of dyspepsia show a 1% to 2% prevalence in adults, and 25% to 40% of these patients do not have a physical reason for their symptoms. These findings prompted us to do a retrospective follow-up study of 390 patients having motility studies for chest pain and gastrointestinal (GI) symptoms; 278 (71%) responded. Patients were asked to complete a self-rating symptom questionnaire regarding current GI symptoms and current symptoms of anxiety, panic, and depression; they were also asked to complete the Brief Symptom Inventory. Two groups were compared--those with known heart disease and those without heart disease. Substantial numbers of patients in both groups satisfied criteria for generalized anxiety disorders (> 70%), panic disorder (> 30%), and major depression (> 35%). GI symptoms compatible with nonulcer dyspepsia were strongly associated with a psychiatric diagnosis. Our data suggest that anxiety and depressive states are strongly associated with dyspepsia and other GI symptoms not caused by ulcer disease.
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PMID:Nonulcer dyspepsia associated with psychiatric disorder. 850 84

An association between panic disorder and functional gastrointestinal disease has emerged since the introduction of reliable diagnostic criteria, first for psychiatric disorders and more recently for functional gastrointestinal disorders. At the same time, a more rigorous review of methodology of older reports linking structural gastrointestinal diseases such as peptic ulcer and inflammatory bowel disease to psychiatric illness has cast doubt on the validity of their association. In this review original articles reporting an association between panic disorder and globus, functional chest pain of presumed esophageal origin, functional dyspepsia, and irritable bowel syndrome are critically reviewed and it is concluded that panic disorder is overrepresented in noncardiac chest pain and irritable bowel syndrome. Original reports of the prevalence of panic disorder in structural gastrointestinal disease are reviewed and it is concluded that they do not support an association with panic. Hypotheses explaining the statistical link of panic disorder and functional gastrointestinal disease are discussed.
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PMID:Panic disorder associated with gastrointestinal disease: review and hypotheses. 948 67

Panic disorder, a psychiatric disorder characterised by frequent panic attacks, is the most common anxiety disorder, affecting 2 to 6% of the general population. No one line of treatment has been found to be superior, making a risk-benefit assessment of the treatments available useful for treating patients. Choice of treatment depends on a number of issues, including the adverse effect profile, efficacy and the presence of concomitant syndromes. Tricyclic antidepressants (TCAs) are beneficial in the treatment of panic disorder. They have a proven efficacy, are affordable and are conveniently administered. Adverse effects, including jitteriness syndrome, bodyweight gain, anticholinergic effects and orthostatic hypotension are commonly associated with TCAs, but can be managed successfully. Selective serotonin (5-hydroxytryptamine; 5HT) reuptake inhibitors are also potential first line agents and are well tolerated and effective, with a favourable adverse effects profile. There is little risk in overdose or of anticholinergic effects. Adverse effects include sedation, dyspepsia and headache early in treatment, and sexual dysfunction and increased anxiety, but these can be effectively managed with proper dosage escalation and management. Benzodiazepines are an effective treatment, providing short-term relief of panic-related symptoms. Patients respond to treatment quickly, providing rapid relief of symptoms. Adverse effects include ataxia and drowsiness, and cognitive and psycho-motor impairment. There are reservations over their first-line use because of concerns regarding abuse and dependence. Monoamine oxidase inhibitors, because of their adverse effects profile, potential drug interactions, dietary restrictions, gradual onset of effect and overdose risk, are not considered to be first-line agents. They are effective however, and should be considered for patients with refractory disease. Valproic acid (valproate sodium), while not intensively studied, shows potential for use in panic disorder. More studies are needed in this area before the available data can be confirmed. As a supplement to drug therapy, cognitive behavioural therapy is effective. It is well tolerated, and may be beneficial in certain clinical situations. Its main drawback is the time commitment and effort needed to be made by the patient.
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PMID:A risk-benefit assessment of pharmacological treatments for panic disorder. 963 87

This cross-sectional psychiatric and cardiological study compared patients with and without coronary artery disease (CAD) with respect to psychiatric morbidity, psychological factors, pain characteristics, medical morbidity and the prevalence of coronary risk factors. The 199 participants had been referred to cardiological outpatient clinics for the investigation of chest pain and had no history of heart disease. Current panic disorder occurred significantly more often in non-CAD patients (41% vs. 22%). No significant differences were found for other psychiatric disorders and psychological variables. Non-CAD patients reported significantly longer histories of pain and a higher prevalence of atypical chest pain. In other respects, there were surprisingly few differences between the groups. High morbidity of both psychiatric disease (pain disorder, 19%; any current psychiatric disorder, 72%) and somatic conditions (musculoskeletal disease, 33%; dyspepsia, 23%) was found with no significant differences between the groups. In these patients, multifactorial complaints may explain chest pain in both patient groups. The physicians should attend to psychiatric disorders in non-CAD as well as in CAD patients.
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PMID:Psychological factors, pain attribution and medical morbidity in chest-pain patients with and without coronary artery disease. 1556 12