Gastroesophageal reflux disease (GERD) is more prevalent among patients with major depressive disorder (MDD) than in general population, and vice versa. Bidirectional association of GERD and MDD is well documented. Although protective effect for gastric symptoms has been indicated for several antidepressants like trazodone, citalopram, fluoxetine, mirtazapine or fluvoxamine, these findings are sometimes contradictory. Similar may be claimed for antidepressive effect of some proton pump inhibitors. We decided to examine the association of GERD with the long-term efficacy of MDD treatment.

To examine the association of GERD and efficacy of MDD treatment.

This nested cross-sectional study was done during 2016 at Psychiatric hospital Sveti Ivan, Zagreb, Croatia on the sample of 1008 psychiatric patients. Key outcome was the number of psychiatric rehospitalizations since the first diagnosis of MDD. Predictor was patient-self-declared diagnosis of GERD. Covariates controlled by multivariate analysis of covariance were sex, age, duration of MDD in years, education, marital status, number of household members, work status, clinical global impression scale–severity of MDD at diagnosis, treatment with tricyclic antidepressants (TCA), selective serotonin reuptake inhbitors (SSRI), serotonin-norephinephrine reuptake inhibitors (SNRI), noradrenergic and specific serotonergic (NaSSA) and antipsychotics.

MDD patients with GERD had significantly larger number of psychiatric rehospitalizations (mean = 5.4 (SD 6.82)) than MDD patients with no GERD (mean = 3.1 (SD 4.45)). After adjustment for all covariates, GERD significantly moderated the efficacy of treatment of MDD (P = 0.048; η2 = 0.05) (Figure 1).

To treat MDD effectively we should treat GERD as well.

The authors have not supplied their declaration of competing interest.