Influence of Experimentally Induced Anxiety on Gastric Sensorimotor Function in Humans

doi:10.1053/j.gastro.2005.08.020

Gastroenterology

Volume 129, Issue 5, November 2005, Pages 1437-1444

https://doi.org/10.1053/j.gastro.2005.08.020 Get rights and content

Background & Aims: Unexplained dyspeptic symptoms are associated with changes in gastric sensorimotor function and several psychopathologic dimensions, including anxiety. It is unclear whether this reflects common predisposition or a causal relationship. The aim of this study was to investigate whether experimentally induced anxiety would alter gastric sensorimotor function in health. Methods: Fourteen subjects underwent a gastric barostat study to assess gastric sensitivity and accommodation. Eighteen subjects underwent a 10-minute satiety drinking test (30 mL/min) with registration of epigastric symptoms on a visual analogue scale (VAS) at 2-minute intervals. Emotional context was modulated for 10 minutes at the start of each experiment by combined projection of validated facial expressions and an audiotape recalling a neutral or an anxious autobiographical experience. Anxiety levels were assessed using a VAS and the Spielberger State-Trait Anxiety Inventory (STAI). Results: VAS and STAI scores confirmed efficacy of anxiety induction. During the anxiety condition, gastric compliance was significantly decreased (57 ± 5 vs 40 ± 5 mL/mm Hg; P < .01). Intraballoon pressures inducing discomfort during gastric distention were not altered, but the corresponding volume (630 ± 47 vs 489 ± 39 mL; P < .005) was significantly lower. Meal-induced relaxation was inhibited during the anxiety condition and this persisted for the 60-minute measurement (157 ± 29 vs 100 ± 24 mL; P < .05). During the satiety drinking test, the anxiety condition was associated with significantly higher scores for satiety, fullness, and bloating. Conclusions: Experimentally induced anxiety alters gastric sensorimotor function, suggesting that psychological factors may play a causal role in the pathogenesis of some dyspeptic symptoms and mechanisms.

Section snippets

Study Subjects

A total of 32 healthy volunteers (15 women; age range, 22–35 years) participated in the studies. None of the subjects had symptoms or a history of gastrointestinal disease or drug allergies, and no one was taking any medication. All participants were extensively screened for previous or current symptoms of psychiatric illness using a set of self-report questionnaires (the Patient Health Questionnaire, the Hospital Anxiety and Depression Scale, the NEO-Five Factors Inventory, the Toronto

Tolerability of the Study

All subjects completed the studies as planned. Both the barostat and the nutrient drink test protocols with emotional state induction were well tolerated. No adverse events occurred.

Anxiety-Induction Procedure

Both VAS anxiety scores and STAI-state anxiety scores confirmed the efficacy of the anxiety-induction procedure. VAS anxiety scores were significantly higher during the anxiety conditions compared with the neutral conditions (areas under the curve, 49 ± 20.6 vs 112.7 ± 29.1 mm · min; P < .01), and STAI-state anxiety

Discussion

In the present studies, we investigated the influence of experimentally induced anxiety on gastric sensorimotor function, as measured with the barostat, and on dyspeptic symptoms induced by a standardized meal in healthy volunteers. To induce a neutral or an anxious emotional state, we combined 2 frequently used methods of emotion induction/emotional context manipulation, namely, recall of emotional life events and viewing of affect-appropriate faces. The efficacy of the anxiety-induction

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Clinical–alimentary tractInfluence of Experimentally Induced Anxiety on Gastric Sensorimotor Function in Humans

Section snippets

Study Subjects

Tolerability of the Study

Anxiety-Induction Procedure

Discussion

Gastroenterology

Gastroenterology

Gastroenterology

Am J Gastroenterol

Gastroenterology

Gastroenterology

Gastroenterol Clin North Am

Gastroenterology

Baillieres Best Pract Res Clin Gastroenterol

Gastroenterology

Gastroenterology

Biol Psychiatry

Br J Anaesth

Br J Anaesth

Am J Gastroenterol

Am J Gastroenterol

Biol Psychiatry

Biol Psychol

J Psychosom Res

Prog Neurobiol

Functional gastroduodenal disorders

Gut

Visceral perception in health and functional dyspepsia. Crossover study of gastric distension with placebo and domperidone

Dig Dis Sci

Symptoms and visceral perception in severe functional and organic dyspepsia

Gut

Discriminant analysis of factors distinguishing patients with functional dyspepsia from patients with duodenal ulcer. Significance of somatization

Dig Dis Sci

Psychiatry, psychotherapy and gastroenterology, bringing it all together

Aliment Pharmacol Ther

Clinical–alimentary tract
Influence of Experimentally Induced Anxiety on Gastric Sensorimotor Function in Humans