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J Dig Dis. 2016 Apr;17(4):236-43. doi: 10.1111/1751-2980.12330.

Psychological factors influence the overlap syndrome in functional gastrointestinal disorders and their effect on quality of life among firefighters in South Korea.

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Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Korea.
Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Wonkwang University, Iksan, Korea.



The aim of this study was to investigate the predictor variables that could influence overlap syndrome in functional gastrointestinal disorders (FGID) among firefighters in Korea.


Data collected from 1217 firefighters in Korea were reviewed. FGID were diagnosed according to the Rome III diagnostic criteria. Psychological factors were measured by self-reported questionnaires. The scores for depression, anxiety, quality of life (QOL) and occupational job stress were analyzed. The correlation between psychological factors and QOL was analyzed and a stepwise multiple regression analysis was performed.


FGID were observed in 461 (37.9%) participants. In those with FGID, functional heartburn (FH) was most common (32.2%), followed by functional dyspepsia (12.2%). Patients with overlap syndrome had the highest depression, anxiety and occupational stress score than those having non-overlap syndrome and healthy controls, respectively (depression: F = 142.29, η(2)  = 0.190; anxiety: F = 88.33, η(2)  = 0.127; occupational stress: F = 43.68, η(2)  = 0.067; all P < 0.001). Healthy controls had the highest QOL score (F = 73.39, P < 0.001, η(2)  = 0.108). Pychological factors were significantly correlated with QOL in the overlap syndrome of FGID. After the stepwise selection, the final model explained 45.6% of predictable variance and contained four significant variables: depression, self-esteem, occupational stress and anxiety.


Psychological factors are associated with the overlap syndrome of FGID. Acknowledging this common comorbidity may facilitate the recognition and treatment of patients with FGID.


anxiety; depression; functional gastrointestinal disorders; occupational job stress; overlap syndrome; quality of life

[Indexed for MEDLINE]

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