The role of psychosocial factors and psychiatric disorders in functional dyspepsia
L Van Oudenhove, Q Aziz - Nature Reviews Gastroenterology & …, 2013 - nature.com
Nature Reviews Gastroenterology & Hepatology, 2013•nature.com
In this Review, after a brief historical introduction, we first provide an overview of
epidemiological studies that demonstrate an association between functional dyspepsia and
psychological traits, states or psychiatric disorders. These studies suggest an important
intrinsic role for psychosocial factors and psychiatric disorders, especially anxiety and
depression, in the aetiopathogenesis of functional dyspepsia, in addition to their putative
influence on health-care-seeking behaviour. Second, we describe pathophysiological …
epidemiological studies that demonstrate an association between functional dyspepsia and
psychological traits, states or psychiatric disorders. These studies suggest an important
intrinsic role for psychosocial factors and psychiatric disorders, especially anxiety and
depression, in the aetiopathogenesis of functional dyspepsia, in addition to their putative
influence on health-care-seeking behaviour. Second, we describe pathophysiological …
Abstract
In this Review, after a brief historical introduction, we first provide an overview of epidemiological studies that demonstrate an association between functional dyspepsia and psychological traits, states or psychiatric disorders. These studies suggest an important intrinsic role for psychosocial factors and psychiatric disorders, especially anxiety and depression, in the aetiopathogenesis of functional dyspepsia, in addition to their putative influence on health-care-seeking behaviour. Second, we describe pathophysiological evidence on how psychosocial factors and psychiatric disorders might exert their role in functional dyspepsia. Novel insights from functional brain imaging studies regarding the integration of gut–brain signals, processed in homeostatic–interoceptive brain regions, with input from the exteroceptive system, the reward system and affective and cognitive circuits, help to clarify the important role of psychological processes and psychiatric morbidity. We therefore propose an integrated model of functional dyspepsia as a disorder of gut–brain signalling, supporting a biopsychosocial approach to the diagnosis and management of this disorder.
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