Interactive Effects of Early-Life Stress, Diet, and Metabolism on Gastrointestinal Dysfunction With Neuropsychiatric Symptoms

NCT07852819 | Not Yet Recruiting

• 1 other identifier: KYLL-2026-03(YJ)-063
• Study Type: observational
• Target: 200
• Locations: 0 countries
• Sites: N/A

Brief Summary

The goal of this observational case-control study is to learn how stressful experiences, dietary habits, and blood nutrient levels are associated with gastrointestinal symptoms and symptoms of depression and anxiety in adults aged 18 to 65 years. The study will also examine whether positive psychological resources, such as hope, optimism, resilience, and self-confidence, are related to these associations. The main questions this study aims to answer are:

• Are stressful experiences in childhood and recent stressful life events associated with gastrointestinal symptoms and symptoms of depression and anxiety?
• Are dietary habits and blood levels of selected nutrients associated with gastrointestinal and psychological symptoms?
• Do psychological resources, such as hope, optimism, resilience, and self-confidence, influence the relationships among stress, nutrition, gastrointestinal symptoms, and psychological well-being? Researchers will compare 100 participants with gastrointestinal disorders and psychological symptoms or a history of stress with 100 control participants who do not have chronic gastrointestinal symptoms and have low levels of depression and anxiety symptoms. Participants will:
• Complete questionnaires about stressful experiences, dietary habits, gastrointestinal symptoms, depression and anxiety symptoms, psychological resources, and quality of life.
• Have gastrointestinal sounds recorded.
• Allow blood remaining from routine clinical testing performed before endoscopy to be used to measure cholesterol, vitamin B6, and vitamin C levels. No additional blood draw will be required for this study. All study assessments will be completed once at enrollment. There will be no follow-up visits, and participants will not receive or be assigned to any treatment as part of this study.

Conditions

Irritable Bowel Syndrome (IBS); Functional Dyspepsia; Inflammatory Bowel Disease (IBD); Gastroparesis; Depressive Symptoms; Anxiety Symptoms

Outcome Measures

Primary Outcomes (5)

• Gastrointestinal Symptom Severity Assessed by the Gastroparesis Cardinal Symptom Index (GCSI)

  Gastrointestinal symptom severity will be assessed using the Gastroparesis Cardinal Symptom Index (GCSI). The GCSI assesses three symptom domains: nausea/vomiting, postprandial fullness/early satiety, and bloating. The total GCSI score ranges from 0 to 5, with higher scores indicating greater gastrointestinal symptom severity.

  At enrollment (single assessment)

• Depressive Symptoms Assessed by the Patient Health Questionnaire-9 (PHQ-9)

  Depressive symptoms will be assessed using the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 consists of 9 items, with a total score ranging from 0 to 27. Higher scores indicate greater severity of depressive symptoms.

  At enrollment (single assessment)

• Depressive Symptoms Assessed by the 17-Item Hamilton Depression Rating Scale (HAMD-17)

  Depressive symptoms will be assessed using the 17-item Hamilton Depression Rating Scale (HAMD-17). The total score ranges from 0 to 52, with higher scores indicating greater severity of depressive symptoms.

  At enrollment (single assessment)

• Anxiety Symptoms Assessed by the Zung Self-Rating Anxiety Scale (SAS)

  Anxiety symptoms will be assessed using the Zung Self-Rating Anxiety Scale (SAS). The SAS consists of 20 items, with a total raw score ranging from 20 to 80. Higher scores indicate greater severity of anxiety symptoms.

  At enrollment (single assessment)

• Anxiety Symptoms Assessed by the Hamilton Anxiety Rating Scale (HAM-A)

  Anxiety symptoms will be assessed using the Hamilton Anxiety Rating Scale (HAM-A). The scale consists of 14 items, with a total score ranging from 0 to 56. Higher scores indicate greater severity of anxiety symptoms.

  At enrollment (single assessment)

Secondary Outcomes (2)

• Irritable Bowel Syndrome Symptom Severity Assessed by the Irritable Bowel Syndrome Severity Scoring System (IBS-SSS)

  At enrollment (single assessment)

• Quality of Life Assessed by the Irritable Bowel Syndrome Quality of Life (IBS-QOL) Questionnaire

  At enrollment (single assessment)

Study Arms (2)

Case Group

Participants must meet at least one psychological or stress-related criterion: Patient Health Questionnaire-9 (PHQ-9) score ≥5, 17-item Hamilton Depression Rating Scale (HAMD-17) score ≥8, Zung Self-Rating Anxiety Scale (SAS) score ≥50, Hamilton Anxiety Rating Scale (HAM-A) score ≥7, Childhood Trauma Questionnaire (CTQ) total score ≥40, or Adolescent Self-Rating Life Events Checklist (ASLEC) total score ≥30.

Control Group

Adults aged 18-65 years with no history of functional dyspepsia, gastroparesis, or irritable bowel syndrome and no chronic gastrointestinal symptoms. Participants must have PHQ-9 \<5, HAMD-17 \<8, SAS \<50, and HAM-A \<7, with no significant abnormalities on endoscopic examinations. Age and sex will be matched to the case group where feasible. All participants must provide written informed consent. Planned enrollment: 100 participants.

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population comprises adults aged 18-65 years of any sex. A total of 200 participants are planned: 100 cases with functional dyspepsia, gastroparesis, or irritable bowel syndrome, gastrointestinal symptoms lasting at least 3 months, and psychological symptoms or stress-related questionnaire scores meeting the protocol-defined thresholds; and 100 controls undergoing routine health examinations, without a history of these gastrointestinal disorders or chronic gastrointestinal symptoms, with depression and anxiety scores below the specified thresholds and no significant endoscopic abnormalities. Age and sex will be matched between groups where feasible. All participants must meet the eligibility criteria and provide written informed consent.

You may qualify if:

• Case Group:
• Adults aged 18-65 years, of any sex.
• Functional dyspepsia, gastroparesis, or irritable bowel syndrome, with gastrointestinal symptoms lasting at least 3 months. Relevant symptoms include nausea, vomiting, postprandial fullness, early satiety, and bloating.
• At least one of the following psychological or stress-related criteria: Patient Health Questionnaire-9 (PHQ-9) score ≥5; 17-item Hamilton Depression Rating Scale (HAMD-17) score ≥8; Self-Rating Anxiety Scale (SAS) score ≥50; Hamilton Anxiety Rating Scale (HAMA) score ≥7; Childhood Trauma Questionnaire (CTQ) total score ≥40; or Adolescent Self-Rating Life Events Checklist (ASLEC) total score ≥30.
• Upper gastrointestinal endoscopy and colonoscopy excluding organic gastrointestinal lesions, such as peptic ulcers, gastrointestinal tumors, or esophageal strictures.
• Voluntary participation and provision of written informed consent.
• Control Group:
• Adults aged 18-65 years, of any sex, with age and sex matched to the case group where feasible.
• No history of functional dyspepsia, gastroparesis, or irritable bowel syndrome, and no chronic gastrointestinal symptoms, such as recurrent abdominal pain, bloating, nausea, or vomiting.
• All of the following: PHQ-9 score \<5, HAMD-17 score \<8, SAS score \<50, and HAMA score \<7.
• Undergoing routine health examinations, with no significant abnormalities on upper gastrointestinal endoscopy and colonoscopy.
• Voluntary participation and provision of written informed consent.

You may not qualify if:

• Severe underlying disease, including severe hepatic or renal dysfunction (ALT/AST \>3 times the upper limit of normal or serum creatinine \>133 μmol/L), malignancy, severe coronary artery disease, or heart failure.
• Diagnosed organic gastrointestinal disease, including peptic ulcers, gastrointestinal tumors, inflammatory bowel disease, or intestinal obstruction.
• Previous gastrointestinal resection, except appendectomy.
• Use within the past month of medications affecting gastrointestinal motility, such as opioids, anticholinergics, or prokinetic agents, or medications substantially affecting metabolism, such as statins or systemic corticosteroids.
• Diagnosed severe psychiatric disorders, such as schizophrenia or bipolar disorder, or a suicide attempt or suicidal behavior within the past 6 months.
• Pregnancy or breastfeeding.
• Inability to understand the questionnaires or cooperate with completion of the assessments.

Sponsors & Collaborators

• Shandong University: lead

MeSH Terms

Conditions

Irritable Bowel Syndrome; Inflammatory Bowel Diseases; Gastroparesis; Depression; Anxiety Disorders

Condition Hierarchy (Ancestors)

Colonic Diseases, Functional; Colonic Diseases; Intestinal Diseases; Gastrointestinal Diseases; Digestive System Diseases; Gastroenteritis; Stomach Diseases; Paralysis; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Behavioral Symptoms; Behavior; Mental Disorders

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: September 23, 2026
• First Posted: October 1, 2026
• Study Start: September 1, 2026
• Primary Completion (Estimated): March 1, 2027
• Study Completion (Estimated): March 1, 2027
• Last Updated: October 1, 2026

Record last verified: 2026-09