Relationship between psychological distress and physical symptoms of functional dyspepsia with the mediating role of pain related mental imagery, visceral sensitivity, pain catastrophizing and pain self-efficacy

Introduction: Functional dyspepsia is a group of gastrointestinal disorders in which the psychological symptoms play a significant role in their incidence. Aim: The aim of this study is determination of the relationship between psychological distress and physical symptoms of functional dyspepsia with the mediating role of pain-related mental imagery, visceral sensitivity, pain catastrophizing and pain self-efficacy. Method: The present study is conducted using the descriptive cross-sectional method. The statistical population includes all patients with functional dyspepsia referred to gastrointestinal clinics of Isfahan in 2021-2022. The statistical population consists of 363 people who are selected by the convenience sampling. Instruments include Depression Anxiety Stress Scale, Nepin Dyspepsia Index, Chronic Pain Mental Image Questionnaire, Visceral Sensitivity Index, Pain Catastrophizing Scale and Chronic Pain Self-Efficacy Questionnaire. Software such as smart-PLS, SPSS-23 and descriptive indices and structural equations are used for data analysis. Results: Results showed that the direct path of psychological distress (0.329), pain-related mental imagery (0.396) and pain catastrophizing (0.234) to physical symptoms were significant. Also, the indirect paths from psychological distress to physical symptoms through the mediating pain-related mental imagery, pain catastrophizing, and self-efficacy on pain-related mental imagery and visceral sensitivity on pain-related mental imagery with values of 0.052, 0.231, 0.058 and 0.246 respectively had significant relations. Conclusion: The results show that the pain-related mental imagery, visceral sensitivity, pain catastrophizing and pain self-efficacy play a mediating role between the psychological distress and physical symptoms of functional dyspepsia. It is suggested that these factors are included in patients treatment plans to reduce recurrence, exacerbation of symptoms and burden of the disease.