Gastrointestinal Symptom Burden in Comorbid Anxiety and Depression Compared With Anxiety Alone and Depression Alone: A Cross-Sectional Study from a Tertiary Care Centre in North-West India.

Dr Yogesh kumar Satija; Dr Niharika Bawankar; Aisha Zubair; Dr. Vipul Sharma; Dr Ashish Kumar Shukla

doi:10.51168/9fdw0316

Authors

Dr. Yogesh Kumar Satija Senior Professor, Department of Psychiatry, and Medical Superintendent, Psychiatric Centre, SMS Medical College, Jaipur, Rajasthan, India.
Dr. Niharika Bawankar Junior Resident (Year 3), Department of Psychiatry, SMS Medical College, Jaipur, Rajasthan, India.
Aisha Zubair Postgraduate Student (MA Psychology, Year 2), University of Rajasthan, Jaipur 302004, Rajasthan, India.
Dr. Vipul Sharma Junior Resident (Year 1), Department of Anatomy, RUHS College of Medical Sciences, Jaipur, Rajasthan, India.
Dr. Ashish Kumar Shukla Junior Resident (Year 2), Department of Anatomy, RUHS College of Medical Sciences, Jaipur, Rajasthan, India.

DOI:

https://doi.org/10.51168/9fdw0316

Keywords:

Anxiety Disorders, Depressive Disorder, Irritable Bowel Syndrome, Gastrointestinal Diseases, Comorbidity

Abstract

Background: Anxiety and depressive disorders frequently co-occur, and both are individually associated with gastrointestinal (GI) symptoms. Whether their co-occurrence carries a greater GI symptom burden than either alone has rarely been examined directly within a psychiatric outpatient population.

Objectives: To compare GI symptom burden, assessed by the IBS-SSS and GSRS, among patients with comorbid anxiety and depression, anxiety alone, and depression alone, and to examine whether any difference tracked psychiatric symptom severity.

Methods: A cross-sectional study was conducted in the psychiatry department of SMS Hospital, Jaipur, between March and June 2026. Adults aged 18–60 years with a DSM-5 diagnosis of anxiety only, depression only, or comorbid anxiety and depression were enrolled. Severity was graded with the HAM-A and PHQ-9. Groups were compared using Kruskal-Wallis and Fisher exact tests, with effect estimates from Firth penalised logistic regression.

Results: Thirty-two patients were analysed (comorbid, n=11; depression only, n=16; anxiety only, n=5). Clinically relevant IBS symptomatology (IBS-SSS ≥75) was present in 8/11 (72.7%, 95% CI 43.5–91.7) of the comorbid group, 1/16 (6.2%, 0.7–25.7) with depression alone, and 0/5 (0.0%, 0.0–37.9) with anxiety alone (p<0.001). Severe GSRS scores (≥40) occurred only in the comorbid group (6/11, 54.5%; p=0.003). Comorbidity remained associated with IBS symptomatology after adjustment for age and sex (OR 27.36, 95% CI 3.09–241.93; p=0.003). HAM-A and PHQ-9 distributions did not differ across groups (p=0.906; p=0.577).

Conclusion: In this small single-centre sample, comorbid anxiety and depression was associated with greater GI symptom burden than either alone, unexplained by psychiatric symptom severity.

Recommendation: Brief GI symptom screening should be considered for psychiatric outpatients with comorbid anxiety and depression, and the association should be confirmed in larger, multicentre, longitudinal studies.

Author Biographies

Dr. Yogesh Kumar Satija, Senior Professor, Department of Psychiatry, and Medical Superintendent, Psychiatric Centre, SMS Medical College, Jaipur, Rajasthan, India.

is a Senior Professor in the Department of Psychiatry at SMS Medical College, Jaipur, and serves as Medical Superintendent of the Psychiatric Centre, Jaipur. He has long-standing experience in clinical psychiatry, postgraduate teaching, and the administration of public mental health services in Rajasthan, and supervised the present study.
Dr. Niharika Bawankar, Junior Resident (Year 3), Department of Psychiatry, SMS Medical College, Jaipur, Rajasthan, India.

is a third-year Junior Resident (postgraduate trainee) in the Department of Psychiatry, SMS Medical College, Jaipur. Her clinical and research interests include common mental disorders, psychiatric comorbidity, and the somatic manifestations of anxiety and depression, including gut-brain interactions.
Aisha Zubair, Postgraduate Student (MA Psychology, Year 2), University of Rajasthan, Jaipur 302004, Rajasthan, India.

is a second-year postgraduate student pursuing a Master's degree in Psychology at the University of Rajasthan, Jaipur. Her interests include psychological assessment, psychometric instruments, and the psychological correlates of physical symptoms.
Dr. Vipul Sharma, Junior Resident (Year 1), Department of Anatomy, RUHS College of Medical Sciences, Jaipur, Rajasthan, India.

is a first-year Junior Resident in the Department of Anatomy, RUHS College of Medical Sciences, Jaipur. His academic interests include medical research methodology, biostatistics, and interdisciplinary clinical research.

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