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Title: Heterogeneity of symptom pattern, psychosocial factors, and pathophysiological mechanisms in severe functional dyspepsia
Authors: Fischler, Benjamin
Tack, Jan
De Gucht, Véronique
Persoons, Philippe
Broekaert, Dorine
Issue Date: 2003
Publisher: ELSEVIER
Source: GASTROENTEROLOGY, 124(4). p. 903-910
Abstract: Background & Aims: Categorization of functional dyspepsia into subgroups is based on expert opinion according to (dominant) symptoms or on underlying pathophysiological mechanisms. We used an evidence-based approach to the determination of subtypes of functional dyspepsia. Methods: Consecutive functional dyspepsia patients were recruited from a tertiary referral center. The following were performed: (1) exploratory (EFA) and confirmatory factor analysis (CFA) of symptom patterns in a large group of patients with functional dyspepsia; (2) external validation of these factors by the determination of their association pattern with physio- and psychopathological mechanisms, and with health-related quality of life and sickness behavior; and (3) cluster analysis of their distribution in this population. Results: Both EFA and CFA do not support the existence of functional dyspepsia as a homogeneous (unidimensional) condition. A 4-factor model is found to be valid, with differential distribution within the patient population according to cluster analysis. Factor 1 is characterized by nausea, vomiting, early satiety, and weight loss and factor 2 by postprandial fullness and bloating. Both factor 1 and 2 are associated with delayed emptying, but only factor 1 is associated with younger age, female sex, and sickness behavior. Factor 3 is characterized by pain symptoms and associated with gastric hypersensitivity and several psychosocial dimensions including medically unexplained symptoms and health-related quality of life dimensions. Factor 4, characterized by belching, is also associated with hypersensitivity, but is unrelated to psychosocial dimensions. Conclusions: In a tertiary care population, functional dyspepsia is a heterogeneous condition characterized by 4 major dimensions differentially associated with psychopathological and physiopathological mechanisms.
Notes: Univ Hosp Gasthuisberg, Div Gastroenterol, Dept Internal Med, B-3000 Louvain, Belgium. Univ Hosp Gasthuisberg, Dept Psychiat, B-3000 Louvain, Belgium. Katholieke Univ Leuven, Dept Neurosci & Psychiat, Louvain, Belgium. Limburgs Univ Ctr, Ctr Stat, Diepenbeek, Belgium.Tack, J, Univ Hosp Gasthuisberg, Div Gastroenterol, Dept Internal Med, Herestr 49, B-3000 Louvain, Belgium.
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ISSN: 0016-5085
e-ISSN: 1528-0012
DOI: 10.1053/gast.2003.50155
ISI #: 000182002700010
Rights: © 2003 by the American Gastroenterological Associatio
Category: A1
Type: Journal Contribution
Validations: ecoom 2004
Appears in Collections:Research publications

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