Lv ZT, Chen J, Fang SY. Impact of anxiety and depression on treatment adherence and nursing workload in hospitalized patients with gastrointestinal diseases. World J Psychiatry 2026; 16(8): 119250 [DOI: 10.5498/wjp.119250]
Corresponding Author of This Article
Zhi-Tiao Lv, MD, Doctor, Department of Gastroenterology, The First People’s Hospital of Yongkang City, No. 599 Jinshan West Road, Yongkang 321300, Zhejiang Province, China. lvzhitiao0331@163.com
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Lv ZT, Chen J, Fang SY. Impact of anxiety and depression on treatment adherence and nursing workload in hospitalized patients with gastrointestinal diseases. World J Psychiatry 2026; 16(8): 119250 [DOI: 10.5498/wjp.119250]
World J Psychiatry. Aug 19, 2026; 16(8): 119250 Published online Aug 19, 2026. doi: 10.5498/wjp.119250
Impact of anxiety and depression on treatment adherence and nursing workload in hospitalized patients with gastrointestinal diseases
Zhi-Tiao Lv, Juan Chen, Shao-Yu Fang
Zhi-Tiao Lv, Department of Gastroenterology, The First People’s Hospital of Yongkang City, Yongkang 321300, Zhejiang Province, China
Juan Chen, Department of Neurosurgery, The First People’s Hospital of Yongkang City, Yongkang 321300, Zhejiang Province, China
Shao-Yu Fang, Department of Psychiatric, The First People’s Hospital of Yongkang City, Yongkang 321300, Zhejiang Province, China
Author contributions: Lv ZT designed the study, supervised the entire research process, performed the statistical analysis, and drafted the manuscript; Chen J participated in data collection, patient screening, and data interpretation; Fang SY was responsible for psychiatric assessment, contributed to the acquisition and interpretation of psychological data, and critically revised the manuscript for important intellectual content; and all authors read and approved the final manuscript.
AI contribution statement: All the authors confirm that the manuscript and all related scientific content were independently written by the authors. No artificial intelligence assistance tools were used. We would like to clarify that we have not used AI tools to revise the manuscript nor have we used AI tools to respond to the reviewers. All the authors are fully responsible for the reliability, completeness and originality of the work.
Institutional review board statement: This study has been reviewed and approved by the Ethics Committee of the First People’s Hospital of Yongkang City, Approval No. 1-2026-02.
Informed consent statement: Given that retrospective design only involves anonymous analysis of historical medical record data, the ethics committee has granted an exemption for obtaining informed consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Zhi-Tiao Lv, MD, Doctor, Department of Gastroenterology, The First People’s Hospital of Yongkang City, No. 599 Jinshan West Road, Yongkang 321300, Zhejiang Province, China. lvzhitiao0331@163.com
Received: March 13, 2026 Revised: April 17, 2026 Accepted: May 11, 2026 Published online: August 19, 2026 Processing time: 127 Days and 5.3 Hours
Abstract
BACKGROUND
Anxiety and depression are associated with high comorbidity rates in patients with gastrointestinal diseases. Previous studies have confirmed a significant correlation between severe gastrointestinal symptoms and decreased quality of life. However, the specific impact of anxiety and depression on patients’ medical behaviors (such as treatment compliance) and healthcare staff workload (especially nursing workload) in an inpatient environment has not been fully described.
AIM
To explore the anxiety and depression effects on treatment compliance and nursing workload of hospitalized patients with gastrointestinal diseases.
METHODS
We retrospectively analyzed the data of 160 patients with gastrointestinal diseases admitted to the First People’s Hospital of Yongkang City between January 2021 and December 2025. According to the Hospital Anxiety and Depression Scale score, patients were divided into moderate/severe anxiety and depression and no/mild anxiety and depression groups. Baseline features, Medication Adherence Reporting Scale (MARS) scores, Mean Daily Activity Score, Length of Stay, total hospitalization costs, unplanned 30-day readmission rate, Gastrointestinal Symptom Rating Scale (GSRS) scores, and Gastrointestinal Quality of Life Index (GIQLI) scores were compared.
RESULTS
Compared with the no/mild group, patients in the moderate/severe anxiety and depression group were younger, had a higher proportion of functional gastrointestinal disorders, had higher disease severity, and had higher levels of C-reactive protein upon admission. The moderate/severe anxiety and depression groups had significantly lower MARS scores and higher average daily Nursing Activity Rating Scale scores. In addition, this group showed higher total GSRS scores and lower GIQLI total scores. Regarding the utilization of medical resources, the service level of the moderate/severe group was longer, the total hospitalization cost was higher, and the unplanned 30-day readmission rate was significantly higher. After adjusting for confounding factors, the multivariate linear regression analysis identified moderate/severe anxiety and depression as independent risk factors for decreased treatment compliance and increased nursing workload. Logistic regression analysis confirmed that this was an independent risk factor for unplanned readmission in the short term. A dose-response relationship was observed between the severity of anxiety/depression symptoms and primary outcome measures. In the subgroup analysis, the association between anxiety and depression status and nursing workload remained significant in both disease categories, with a stronger numerical impact on patients, which should be interpreted as exploratory.
CONCLUSION
Anxiety and depression were independently associated with decreased treatment compliance, increased nursing workload, prolonged hospital stay, and higher short-term readmission risk in hospitalized patients with gastrointestinal diseases. Routine screening and considering the psychological status of patients should be included in the management protocol. A tiered support strategy should be considered, providing basic psychological support for patients with mild symptoms and referring severe cases to specialists.
Core Tip: Anxiety and depression are common but often underestimated comorbidities in hospitalized patients with gastrointestinal diseases. This retrospective observational study showed that moderate-to-severe anxiety and depression were independently associated with poorer treatment adherence, greater nursing workload, longer hospital stay, higher hospitalization costs, and increased short-term readmission risk. A dose-response relationship was observed, with worsening psychological symptoms associated with lower adherence and higher nursing burden. These findings support the importance of routine psychological assessment and tiered psychosomatic management in the inpatient care of gastrointestinal diseases.
