Effects Of Changing Cognitive Factors On Dyspepsia Symptoms And Quality Of Life In Patients With Functional Dyspepsia

Objective: To explore the effects of changing illness perceptions on dyspepsia symptoms and quality of life in functional dyspepsia(FD) patients.Methods: All FD outpatients completed the Brief Illness Perception Questionnaire and got cognitive interventions. Dyspepsia symptoms score(DSS), quality of life(Qo L), psychosocial factors, and “somatization” were assessed using self-report questionnaires. At 1 year follow-up, patients indicated their appreciation of symptomatic evolution,such as worsened, unchanged, improved, or disappeared, and provided information about their currently treatments. To analyze the changes of FD patients’ disease perceptions and the influence on dyspepsia symptoms and quality of life, the t test and chi-square test, Spearman correlation and linear regression statistical analysis were used.Results: Reported disappeared, improved, unchanged, and worsened symptoms in illness perceptions changed patients were 39(21.1%), 115(62.2%), 23(12.4%), and 8(4.3%) respectively; disappeared, improved, unchanged, and worsened symptoms were reported by23(15.3%), 61(40.7%), 45(30%), and 21(14%) of the illness perceptions unchanged patients, respectively. The difference of patients appreciation of symptomatic evolution between illness beliefs changed and unchanged group was significant(χ2 = 30.321, P< 0.01), and the choice of treatment was also different(χ2 = 22.393, P< 0.01); The DSS(t =3.713, P<0.001) and NDI(t =4.862, P<0.001) scores of illness perceptions changed patients were significantly lower than illness perceptions unchanged patients, the difference was statistically significant. The cross-sectional linear regression analysis showed that consequences, identity, concern and emotional response were independently associated with DSS(β = 0.363, 0.397, 0.214, 0.246; all P< 0.05) and NDI(β = 0.329, 0.183, 0.191, 0.236; all P< 0.05) score at initial visit. The longitudinal linear regression analysis showed that consequences, identity, personal control, concern, and emotional response were significantly associated with DSS(β= 0.392, 0.291,- 0.136, 0.325, 0.403; all P< 0.05); consequences, identity, personal control, concern, emotional response and comprehensibility were significantly associated with NDI(β= 0.248, 0.212, 0.248, 0.212, 0.263, 0.146; all P< 0.05) at follow-upConclusion: Illness perceptions such as consequence, identity, concern, and emotional response might be associated with long-term clinical course in FD. Recognizing and modifying FD patients these irrational illness beliefs may be helpful to improve their quality of life.