Factors influencing anxiety and depression among patients with digestive tract subepithelial lesions

Abstract

BACKGROUND

Digestive tract subepithelial lesions (SELs) are relatively common, and early diagnosis and treatment are critical for improving patient quality of life and prognosis. However, diagnostic uncertainty often leads to negative psychological effects, including anxiety and depression.

AIM

To investigate the prevalence of anxiety and depressive symptoms and identify associated factors among patients with digestive tract SELs.

METHODS

This retrospective study included 296 consecutive patients diagnosed with digestive tract SELs at the Affiliated Hospital of North Sichuan Medical College Endoscopy Center between October 2024 and April 2025. Demographic and clinical data were collected through standardized questionnaires. Anxiety and depression were assessed using the Self-Rating Anxiety Scale and the Self-Rating Depression Scale, respectively, while sleep quality was evaluated using the Pittsburgh Sleep Quality Index. Participants were classified into anxiety vs non-anxiety and depression vs non-depression groups based on established cutoff scores, and potential determinants were examined.

RESULTS

Anxiety symptoms were observed in 35.8% of cases (mean Self-Rating Anxiety Scale score: 46.56 ± 9.13) and depressive symptoms in 33.1% (mean Self-Rating Depression scale score: 48.64 ± 8.30). Pittsburgh Sleep Quality Index scores were positively correlated with both anxiety and depression (P < 0.05). Univariate analysis identified age, annual income, sleep disorders, and endoscopic ultrasonography (EUS) evaluation status as significant factors (P < 0.05). Multivariable analysis revealed that low annual income (< 10000 Chinese yuan) and sleep disorders were independent risk factors, whereas undergoing EUS examination and having disease awareness were protective factors against anxiety and depression (P < 0.05).

CONCLUSION

Patients with digestive tract SELs are at increased risk for anxiety and depression, with poor sleep strongly linked to worsening psychological symptoms. Early diagnostic assessment with EUS appears to serve a protective role against the onset of these psychological disorders.

Keywords: Subepithelial lesions; Anxiety; Depressive symptoms; Sleep disorders; Endoscopic ultrasonography

Core Tip: With advancements in endoscopic technology and increasing public awareness of digestive tract endoscopy, the detection rate of digestive tract subepithelial lesions has risen. However, limited medical knowledge among patients often leads to anxiety, worry, depression, and other psychological concerns. This study aims to investigate the prevalence of anxiety and depression among patients with digestive tract subepithelial lesions, identify influencing factors, and propose targeted interventions to promote physical and mental health and improve quality of life.