INTRODUCTION Esophageal achalasia (EA) is a chronic esophageal dysmotility disease, of which psychological distress was poorly understood. This study aims to assess the status of psychosocial characteristics in EA and to determine the relationship between psychological distress and EA. METHODS Seventy pairs of age and gender-matched patients with EA and healthy control individuals were prospectively enrolled from December 2019 to April 2020 at our hospital. Demographic, psychosocial, and clinical data were obtained. Psychosocial assessments contained psychological distress (Symptom Checklist-90 Revised), perceived stress (Perceived Stress Scale-14), and stressful life events (Life Events Scale). Comparison for psychological parameters was made between patients with EA and controls as well as for EA before/after per oral endoscopic myotomy (POEM). Spearman rank correlation coefficients were used to testify the association between psychological distress and achalasia symptoms. RESULTS The mean course and Eckardt score of patients with EA were 4.26 ± 5.11 years and 6.63 ± 2.21, respectively. There was a significant difference between patients with EA and healthy individuals in Global Severity Index ( P = 0.039) and Positive Symptoms Total ( P = 0.041) for Symptom Checklist-90 Revised as well as positive intensity ( P = 0.011) for the Life Events Scale. Somatization ( P < 0.001), anxiety ( P = 0.021), anger-hostility ( P = 0.009), and others (appetite and sleep, P = 0.010) accounted for the most difference. Somatization was positively associated with chest pain ( P = 0.045). Two patients with EA developed recurrence and showed no relationship with psychological status. Psychological status was significantly improved after POEM. DISCUSSION Psychological distress, especially somatization, was more prevalent in patients with EA than healthy controls. POEM seemed able to improve psychological distress.

中文翻译：

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食管贲门失弛缓症患者的心理概况。

简介 食管贲门失弛缓症 (EA) 是一种慢性食管运动障碍性疾病，人们对其心理困扰知之甚少。本研究旨在评估 EA 的心理社会特征状况，并确定心理困扰与 EA 之间的关系。方法 2019年12月至2020年4月前瞻性入组我院70对年龄和性别匹配的EA患者和健康对照者。获得了人口统计、社会心理和临床数据。心理社会评估包括心理困扰（症状检查表-90修订版）、感知压力（感知压力量表-14）和压力生活事件（生活事件量表）。对 EA 患者和对照组以及口腔内镜肌切开术 (POEM) 前后的心理参数进行比较。斯皮尔曼等级相关系数用于证明心理困扰与失弛缓症症状之间的关联。结果 EA 患者的平均病程和 Eckardt 评分分别为 4.26 ± 5.11 年和 6.63 ± 2.21。EA 患者与健康个体之间在症状检查表 90 修订版的总体严重性指数 (P = 0.039) 和阳性症状总数 (P = 0.041) 以及生活事件的阳性强度 (P = 0.011) 方面存在显着差异规模。躯体化（P < 0.001）、焦虑（P = 0.021）、愤怒-敌意（P = 0.009）和其他（食欲和睡眠，P = 0.010）占最大差异。躯体化与胸痛呈正相关（P = 0.045）。两名 EA 患者出现复发，且与心理状态无关。POEM后心理状态明显改善。讨论 心理困扰，尤其是躯体化，在 EA 患者中比健康对照者更为普遍。POEM 似乎能够改善心理困扰。