Table 3.
General recommendations: |
Identify prevalence of psychological conditions based upon standardized and validated assessment tools (e.g., SCID[37], MINI[38]) |
Use standardized assessment of gastroparesis (e.g., gastric emptying scintigraphy, PAGI-SYM[39]) |
Use validated psychological scales to assess, anxiety, depression, stress (e.g., BDI[40], BAI[41], STAI[42], DASS[43]) and QoL measures relevant to individuals with upper gastrointestinal disorders (e.g., PAGI-QoL[44]) |
Use and provide clear scoring information |
Report assessment results in a manner that allows comparison across studies (e.g., standardized cut-off scores) |
Psychological interventions: |
Randomized control trial design |
Prior to intervention, power analyses conducted |
Clear details of intervention content made fully available to allow other researchers to review and undertake accurate replication |
Gastroparesis-focused interventions |
Include measures that assess a cost/benefit analysis, engagement of medical services |
Where possible, patients, assessors, and statistician blinded |
Independent evaluation of intervention session recordings to ensure protocol/treatment consistency |
Psychological interventions need to be clearly identified and undertaken by trained and appropriately qualified individuals (i.e., psychologists, psychiatrists) |
Identify clear inclusion and exclusion criteria |
Identifying if (and where possible control for) participants have/have not received or are currently receiving psychotherapy (including type, duration etc.), using psychotropic medication, are on specialized diets for their gastroparesis |
Utilize valid measures which can be accurately compared to other intervention studies |
Evaluate participant engagement in therapy (e.g., % attendance to sessions, completion of homework) |
Evaluate differences between completers versus non-completers |
Include long-term post-therapy efficacy review time points (i.e., 1 and 2 yr post-intervention) |
Future research questions: |
What is the prevalence of psychopathology in gastroparesis compared to other gastroenterological cohorts? |
What psychological processes act as moderating/mediating factors between gastroparesis symptom activity and outcome variables such as QoL, anxiety, and depression (e.g., personality, coping style, self-efficacy)? |
How may gender impact upon the presentation and course of gastroparesis and associated psychological distress? |
How may historical and current stressors and/or traumas impact upon the presentation and course of gastroparesis? |
To what extent does duration of symptoms/disease influence the relationship between gastroparesis and psychological distress? |
QoL: Quality of life.