INTESTINAL TRANSIT IN ANXIETY AND DEPRESSION

Background-Patients with anxiety and depression often have bowel sympt oms. Until now, studies investigating a link between altered bowel hab it and psychological illness have focused on patients with disturbed d efecation presenting to gastroenterologists. Aims-To determine whether patients with anxiety and depression have objective evidence of abnor mal intestinal transit irrespective of any bowel symptoms. Methods-21 psychiatric outpatients fulfilling research criteria for generalised a nxiety disorder and/or major depression, and 21 healthy volunteers wer e studied. Orocaecal transit time (OCTT) was measured by lactulose hyd rogen breath test. Whole gut transit time (WGTT) was measured by abdom inal radiography after ingestion of radio-opaque markers. Results-Medi an (range) WGTT was shorter in patients with anxiety (14 (6-29) hours) than in patients with depression (49 (35-71) hours) (p<0.001), and co ntrols (42 (10-68) hours) (p<0.001). In patients with anxiety, orocaec al transit time was shorter (60 (10-70) minutes) than in patients with depression (110 (60-180) minutes) (p<0.01), and shorter than in contr ols (75 (50-140)) minutes (p<0.05). The prolongation of transit times in depression compared with controls was not significant, However, WGT T correlated with both the Deck Depression Inventory score (r=0.59, p< 0.01) and the depression score of the Hospital Anxiety and Depression scale (r=0.66, p<0.001). Conclusions-These objective measurements of i ntestinal transit in affective disorders are consistent with clinical impressions that anxiety is associated with increased bowel frequency, and depressed patients tend to be constipated; mood has an effect on intestinal motor function.