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

Table 1 Sociodemographic profile of study participants

	Number of cases (n = 296)	Constituent ratio (%)
Gender
Male	147	49.7
Female	149	50.3
Age	47.48 ± 7.57
Body mass index	23.61 ± 3.14
Ethnicity
Han	242	81.8
Ethnic minorities	54	18.2
Educational attainment
≤ Junior high school	90	30.4
College, technical secondary school, or senior high school	105	35.5
≥ University	101	34.1
Occupation
Employed	107	36.1
Retired	94	31.8
Unemployed	95	32.1
Marital status
Unmarried	21	7.1
Married	246	83.1
Divorced or widowed	29	9.8
Place of residence
Urban	153	51.7
Rural	143	48.3
Annual income (in 10000 Chinese yuan)
≤ 1	91	30.7
1-6	112	37.8
> 6	93	31.5
Medical insurance type
Employee or resident medical insurance	124	41.9
New rural cooperative medical scheme	78	26.4
Commercial insurance	56	18.9
No medical insurance	38	12.8
Family history
Positive	113	38.2
Negative	183	61.8
Endoscopic ultrasonography
Yes	145	49.0
No	151	51.0

Table 2 Sleep quality metrics: Study cohort vs Chinese norms

	Digestive tract SEL patients (n = 296)	Chinese norms (n = 112)	t	P value
Subjective sleep quality	0.94 ± 0.60	0.67 ± 0.88	3.538	0.0004
Sleep onset latency	1.18 ± 0.72	0.70 ± 0.98	5.412	< 0.0001
Sleep duration	0.93 ± 0.81	0.46 ± 0.68	5.455	< 0.0001
Sleep efficiency	0.99 ± 0.74	0.02 ± 0.73	11.859	< 0.0001
Sleep disturbances	1.00 ± 0.71	0.83 ± 0.61	2.240	0.026
Hypnotic medication use	0.19 ± 0.39	0.18 ± 0.63	0.193	0.402
Daytime dysfunction	1.02 ± 0.65	0.79 ± 0.94	2.799	0.005
Total PSQI score	6.25 ± 1.85	3.23 ± 3.12	11.99	< 0.0001

SEL: Subepithelial lesion; PSQI: Pittsburgh Sleep Quality Index.

Table 3 Prevalence of anxiety and depression in the study cohort

	Total score (n = 296)		Score
SAS score	46.56 ± 9.13	Anxiety (n = 106)	41.13 ± 6.14
		Non-anxiety (n = 190)	56.29 ± 4.17
SDS score	48.64 ± 8.30	Depression (n = 98)	44.15 ± 5.99
		Non-depression (n = 198)	57.71 ± 3.53

SAS: Self-Rating Anxiety Scale; SDS: Self-Rating Depression Scale.

Table 4 Relationships between anxiety, depression, and sleep quality indicators

	SAS		SDS
	r	P value	r	P value
Subjective sleep quality	0.161	0.006	0.253	< 0.0001
Sleep onset latency	0.124	0.033	0.149	0.010
Sleep duration	0.108	0.064	0.209	0.0003
Sleep efficiency	0.157	0.007	0.114	0.051
Sleep disturbances	0.048	0.406	0.094	0.107
Hypnotic medication use	0.010	0.864	0.030	0.602
Daytime dysfunction	0.212	0.0002	0.057	0.325
Total PSQI score	0.304	< 0.0001	0.338	<0.0001

SAS: Self-Rating Anxiety Scale; SDS: Self-Rating Depression Scale; PSQI: Pittsburgh Sleep Quality Index.

Table 5 Univariate analysis of anxiety-related factors

	Anxiety (n = 106)	Non-anxiety (n = 190)	χ2/t	P value
Gender			0.780	0.377
Male	49	98
Female	57	92
Age	49.43 ± 7.42	46.38 ± 7.45	3.381	0.0008
Body mass index	23.27 ± 2.90	23.80 ± 3.2	1.397	0.163
Ethnicity			0.539	0.463
Han	89	153
Ethnic minorities	17	37
Educational attainment			6.038	0.049
≤ Junior high school	41	49
College, technical secondary school, or senior high school	36	69
≥ University	29	72
Occupation			3.012	0.222
Employed	42	65
Retired	27	67
Unemployed	37	58
Marital status			0.497	0.780
Unmarried	9	12
Married	87	159
Divorced or widowed	10	19
Place of residence			0.458	0.498
Urban	52	101
Rural	54	89
Annual income (in 10000 Chinese yuan)			11.462	0.003
≤ 1	46	48
1-6	36	73
> 6	24	69
Medical insurance type			0.596	0.897
Employee or resident medical insurance	48	79
New rural cooperative medical scheme	28	50
Commercial insurance	19	37
No medical insurance	11	24
Family history			1.280	0.258
Positive	45	68
Negative	61	122
Endoscopic ultrasonography			14.921	0.0001
Yes	36	109
No	70	81
Sleep disorders			31.861	<0.0001
Yes	48	29
No	58	161
Disease cognition level			14.171	0.0002
Without cognition	66	75
With cognition	40	115

Table 6 Multivariate logistic regression analysis of anxiety-related factors

Variable	β	SE	Wald	P value	OR	95%CI
Constant	-3.145	0.940	11.186	0.001	0.043
Age (continuous variable)	0.057	0.019	8.934	0.003	1.059	1.020-1.099
Educational attainment (0, ≤ junior high school)			3.070	0.215
1, college, technical secondary school, or senior high school	-0.319	0.332	0.923	0.337	0.727	0.379-1.393
2, ≥ university	-0.596	0.34	3.059	0.080	0.551	0.282-1.075
Annual income (in 10000 Chinese yuan; 0, > 6)			4.539	0.103
1, 1-6	0.563	0.344	2.684	0.101	1.756	0.89-3.443
2, < 1	0.723	0.355	4.157	0.041	2.061	1.028-4.131
Sleep disorders (0 = no, 1 = yes)	1.148	0.317	13.417	0.000	3.153	1.695-5.865
Endoscopic ultrasonography (0 = no, 1 = yes)	-0.807	0.21	8.227	0.004	0.446	0.257-0.775
Disease cognition level (0 = without cognition; 1 = with cognition)	-0.569	0.285	3.91	0.046	0.561	0.324-0.989

OR: Odds ratio; CI: Confidence interval.

Table 7 Univariate analysis of depression-related variables, mean ± SD

	Depression (n = 98)	Non-depression (n = 198)	χ2/t	P value
Gender			1.145	0.285
Male	53	94
Female	45	104
Age	48.93 ± 7.06	46.76 ± 7.73	2.339	0.020
Body mass index	23.58 ± 3.34	23.62 ± 3.05	0.090	0.928
Ethnicity			2.683	0.101
Han	75	167
Ethnic minorities	23	31
Educational attainment			0.168	0.920
≤ Junior high school	31	59
College, technical secondary school, or senior high school	35	70
≥ University	32	69
Occupation			2.475	0.290
Employed	33	74
Retired	37	57
Unemployed	28	67
Marital status			12.022	0.003
Unmarried	12	9
Married	71	175
Divorced or widowed	15	14
Place of residence			0.068	0.794
Urban	57	112
Rural	41	86
Annual income (in 10000 Chinese yuan)			73.682	< 0.0001
≤ 1	63	31
1-6	14	95
> 6	21	72
Medical insurance type			2.617	0.455
Employee or resident medical insurance	36	88
New rural cooperative medical scheme	28	50
Commercial insurance	18	38
No medical insurance	16	22
Family history			0.753	0.867
Positive	34	79
Negative	64	119
Endoscopic ultrasonography			17.661	< 0.0001
Yes	31	114
No	67	84
Sleep disorders			83.7511	< 0.0001
Yes	58	19
No	40	179
Disease cognition level			33.251	< 0.0001
Without cognition	70	71
With cognition	28	127

Table 8 Multivariate logistic regression analysis of depression determinants

Variable	β	SE	Wald	P value	OR	95%CI
Constant	-0.632	1.283	0.243	0.622	0.532
Age (continuous variable)	0.027	0.023	1.395	0.238	1.027	0.983-1.074
Marital status (0 = unmarried)			10.609	0.005
1 = married	-1.794	0.660	7.384	0.007	0.166	0.046-0.606
2 = divorced or widowed	-0.627	0.809	0.601	0.438	0.534	0.109-2.607
Annual income (in 10000 Chinese yuan; 0, > 6)			45.297	0.000
1, 1-6	-0.629	0.456	1.904	0.168	0.533	0.218-1.303
2, < 1	2.332	0.445	27.454	0.000	10.302	4.305-24.649
Sleep disorders (0 = no, 1 = yes)	2.037	0.399	26.092	0.000	7.667	3.509-16.751
Endoscopic ultrasonography (0 = no, 1 = yes)	-0.930	0.363	6.551	0.010	0.394	0.193-0.804
Disease cognition level (0 = without cognition; 1 = with cognition)	-1.474	0.371	15.809	0.000	0.229	0.111-0.474

OR: Odds ratio; CI: Confidence interval.