The prevalence of nausea in the community: psychological, social and somatic factors

Nausea is a commonly reported symptom with a point prevalence of about 12% in the community. Nausea is a prominent symptom in functional gastrointestinal disorders and patients with anxiety and depression frequently present gastrointestinal symptoms such as nausea and abdominal discomfort as their main problem when they consult a doctor. Functional gastrointestinal disorders are strongly related to anxiety and depressive disorders with a lifetime prevalence of 80--90% in samples from clinics of gastroenterology. This study examines the relationship between anxiety disorders, depressions and nausea in a large community sample. A questionnaire on physical and mental health and demographic and life-style factors was sent to all adults 20 years and above in Nord Tr?ndelag county in Norway. A total of 94,197 questionnaires were sent, with 62,651 persons returning the questionnaire, a response rate of 66.5%. The presence of nausea, heartburn, diarrhea and constipation during the last year was recorded. Anxiety disorders and depressions were based on self-rating of the Hospital Anxiety and Depression Scale (HADS). Forty-eight per cent reported one or several gastrointestinal complaints during the last year. 12.5% complained of nausea. 15.3% had an anxiety disorder and 10.4% a depression based on HADS ratings. Presence of anxiety disorders carried the highest risk for nausea (OR 3.42). Presence of depression also increased the risk, but less than anxiety disorders (OR 1.47). Demographic factors, life-style factors and extra-gastrointestinal conditions did not reduce the OR of anxiety disorders and depressions to any significant extent. We found that the presence of anxiety disorders was the strongest risk factor for nausea. Depression also carried a certain risk while demographic factors, life-style factors and other somatic conditions did not carry any substantial risk for nausea. Differential diagnoses of nausea should therefore include both anxiety and depressive conditions.