Relationship Between Severity of Gastrointestinal Symptoms and Anxiety Symptoms in Patients with Chronic Gastrointestinal Disease: The Mediating Role of Illness Perception

Abstract

Zixuan Wang,1 Yuanchen Lu,1 Li Li,2 Xiaoting Wu,2 Junliang Liu,2 Jie Tang,3 Wei Wang,3 Lili Lu2 1First Medical College, Xuzhou Medical University, Xuzhou, People’s Republic of China; 2Department of Gastroenterology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People’s Republic of China; 3School of Public Health, Xuzhou Medical University, Xuzhou, People’s Republic of ChinaCorrespondence: Wei Wang, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China, Tel [phone], Email [email protected] Lili Lu, Department of Gastroenterology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221004, People’s Republic of China, Tel [phone], Email [email protected]: Anxiety, as an important public health issue, may frequently trouble the chronic GI patients with severe symptoms. In this study, we aimed to investigate the relationship between the severity of GI symptoms and anxiety symptoms and further examine whether this relationship was mediated through illness perception.Patients and Methods: A total of 295 patients with chronic GI disease from the affiliated hospital of Xuzhou Medical University were enrolled in this cross-sectional study. They were interviewed with self-reported questionnaires containing demographic variables, clinical variables, and several self-rating scales. Multivariable linear regression models were established to explore the relationship between the severity of GI symptoms and anxiety symptoms. Finally, we performed the mediation analysis to test the mediating effect of illness perception.Results: After adjustments for key demographic and clinical covariates, the severity of GI symptoms was positively associated with anxiety symptoms (β=0.214, 95% CI: 0.009– 0.028, P < 0.001). Additionally, the results of the mediation analysis suggested that illness perception partially mediated the association between the severity of GI symptoms and anxiety symptoms with a mediating ratio of 25.3%.Conclusion: Our findings indicated that chronic GI patients with more severe GI symptoms were more likely to have anxiety symptoms and this effect is partially mediated by illness perception. Therefore, illness perception is recommended to be integrated into the routine assessment of chronic GI patients, and perception-based interventions may be beneficial in relieving anxiety symptoms among patients with severe chronic GI diseases.Keywords: illness perception, anxiety symptoms, severity of GI symptoms, chronic GI diseases, mediating effect

Keywords

• illness perception
• anxiety symptoms
• severity of gi symptoms
• chronic gi diseases
• mediating effect