Inconsistent association of esophageal symptoms, psychometric abnormalities and dysmotility

OBJECTIVES: The aim of this study was to characterize the psychometric prof iles of symptomatic patients with abnormal esophageal motility and symptoma tic patients with normal manometric findings compared to asymptomatic contr ols. METHODS: A total of 113 patients with abnormal esophageal motility (7 achal asia, 8 diffuse esophageal spasm, 27 nutcracker esophagus, 37 hypertensive lower esophageal sphincter, 21 hypotensive peristalsis, 13 failed peristals is), 23 symptomatic controls with similar esophageal symptoms but normal ma nometry, and 27 asymptomatic controls were enrolled. Validated questionnair es assessing depression (Beck Depression Inventory), anxiety (Spielberger S tate Anxiety Inventory or Trait Anxiety Inventory), and somatization (Psych osomatic Symptom Checklist) were administered to all subjects. RESULTS: Patients with both esophageal symptoms and either hypertensive low er esophageal sphincter, nutcracker esophagus, or hypotensive contractions exhibited increased somatization. acute anxiety, or depression compared to asymptomatic controls but not compared to symptomatic controls. On the othe r hand, the psychometric profiles of patients with achalasia and diffuse es ophageal spasm were strikingly normal. Among esophageal symptoms, chest pai n was closely correlated with psychometric abnormalities. CONCLUSIONS: The esophageal symptoms of patients with abnormal esophageal m otility may relate to the underlying psychological abnormalities, independe nt of manometric abnormalities. (C) 2001 by Am. Coll. of Gastroenterology.