Anxiety in Patients Undergoing Endoscopic Procedures: Identifying People at Risk

Background: Endoscopic examination, like colonoscopy and Esophagogastroduodenoscopy (EGDS), can have adverse psychological effects like anxiety. It is known that any examination can cause anxiety and worry, sometimes so much as to avoid the exam itself, and it is known that anxiety for one's own health can lead to continual recourse to the doctor and diagnostic examinations. Goals: To assess the impact of endoscopic examination on anxiety levels of patients, and look for associations between levels of state and trait anxiety and different variables, in order to identify people most at risk of developing complications. Study: We recruited 400 patients waiting to undergo endoscopic examination. Anxiety levels were obtained after administration of the test State- Trait Anxiety Inventory (STAI S and T form) for the evaluation of trait and state anxiety. Results: Patients who undergo an invasive examination have higher anxiety levels than the general population, especially women and those who perform EGDS. The highest levels of anxiety can be seen in patients who undergo the examination in the presence of a specific symptom, rather than as a screening. Conclusion: Endoscopic examinations cause a significant increase of anxiety. Moreover, the analysis of the different variables considered, suggests a typology of patients most at risk in the performance of the procedures. This will allow greater selectivity of preventive interventions for patients with an anxiety disorder. Also, the doctor should do a careful assessment of the patient before requiring an endoscopic examination, to determine if they belong to those subgroups most at risk for anxiety disorders and complications.