New Study by Leighann Litcher-Kelly, PhD Links Psychological Distress to New-Onset Upper GI Symptoms in World Trade Center Responders

Leighann Litcher-Kelly, PhD

December 10, 2014 – In a paper published in Psychosomatic Medicine, Leighann Litcher-Kelly, PhD and colleagues from the Departments of Psychiatry and Medicine demonstrated a link between symptoms of psychological distress and new onset upper gastrointestinal (GI) symptoms in responders to the 9/11 attack on the World Trade Center (WTC). An understanding of the associations between psychological symptoms and upper GI symptoms may help with the identification of people at risk for developing GI disease and provide important clues in the development of more effective therapies.

Dr. Litcher-Kelly and colleagues analyzed data from 10,953 responders being monitored by the WTC Health Program. Approximately half of them were professionally trained police responders and half untrained nontraditional responders. Patients were first evaluated by the program for psychological distress symptoms and medical conditions approximately 4 years after 9/11 (first visit), and again approximately 6-7 years after 9/11 (second visit). Individuals who reported upper GI symptoms at the time of their first visit were excluded from these analyses, in order to examine the prospective relationship of psychological distress reported at the first visit on new-onset GI symptoms reported at the second visit. Of the patients who did not report GI symptoms at the first visit, 15.6% reported new-onset upper GI symptoms at the second.

Patients who reported symptoms of psychological distress at either their first or second visit were significantly more likely to report new-onset GI symptoms at their second visit, and the researchers found significant associations between the number of psychological distress symptoms reported and the risk of developing new GI symptoms.

The most important finding from the study was the discovery of an association between reports of psychological distress symptoms at the first visit and new-onset upper GI symptoms at the second visit, suggesting that psychological distress symptoms can indicate a heightened risk of developing upper GI symptoms years later. The surveys used to assess psychological distress (items from the Patient Health Questionnaire and the PTSD Checklist) included questions about depression, anxiety, panic and PTSD. The associations between psychological distress reported at the first visit and new-onset GI upper symptoms reported at the second were significant for all four dimensions among the nontraditional responders and three out of four among the police responders (the exception being the measure of anxiety).

Dr. Litcher-Kelly is a voluntary Research Assistant Professor in the Department of Psychiatry. The results of the study were published in the November/December 2014 issue of Psychosomatic Medicine under the title “Longitudinal Study of the Impact of Psychological Distress Symptoms on New-Onset Upper Gastrointestinal Symptoms in World Trade Center Responders.” Department of Psychiatry faculty members, Roman Kotov, PhD and Evelyn Bromet, PhD participated in the study. The senior author was Benjamin Luft, MD , Edmund D. Pellegrino Professor of Medicine and Medical Director of the Long Island World Trade Center Health Program.