The interplay between stress and fullness in patients with functional dyspepsia and healthy controls: an exploratory experience sampling method study

Tim Klaassen*, Lisa Vork, Fabienne G M Smeets, Freddy J Troost, Joanna W Kruimel, Carsten Leue, Ad A M Masclee, Daniel Keszthelyi

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Objective Fullness is a cardinal symptom in functional dyspepsia (FD). The use of real-time symptom assessment might provide more insight into factors, such as daily stress, that can influence fullness. Therefore, this study aimed to use the experience sampling method (a real-time, repeated-measurement method making use of repeated questionnaires available at random moments for a limited amount of time) to assess the association between stress and fullness in patients with FD and healthy controls (HCs). Methods Thirty-five patients with FD (25 female, mean age = 44.7 years) and 34 HCs (24 female, mean age = 44.1 years) completed the experience sampling method (a maximum of 10 random moments per day) for 7 consecutive days. Stress and fullness were rated on an 11-point Numeric Rating Scale. Data between patients with FD and HCs were statistically compared using a Student samples t test and linear mixed-effects models with repeated measures (level 1) nested within participants (level 2). Results Average fullness scores were 2.23 (standard error = 0.37) points higher in patients with FD compared with HCs (p < .001). Average stress scores were 1.37 (standard error = 0.30) points higher in patients with FD compared with HCs (p = .002). In FD, fullness scores increased with 0.14 for every 1-point increase in concurrent stress scores (p = .010). Fullness scores at t = 0 increased with 0.12 for every 1-point increase in stress scores at t = -1 (p = .019). T = 0 stress scores were not associated with change in t = -1 fullness scores. No associations between concurrent symptom scores were found for HCs. Conclusions Concurrent and preceding stress scores are positively associated with fullness scores in patients with FD, but not in HCs. These findings indicate that increased levels of stress may precede feelings of fullness in patients with FD.

Original languageEnglish
Pages (from-to)306-312
Number of pages7
JournalPsychosomatic Medicine
Issue number3
Early online date14 Sept 2021
Publication statusPublished - Apr 2022


  • ESM
  • functional dyspepsia
  • fullness
  • satiation
  • PROM
  • AIC = Akaike Information Criterion
  • EPS = epigastric pain syndrome
  • ESM = experience sampling method
  • FD = functional dyspepsia
  • GAD-7=Generalized Anxiety Disorder
  • GI = gastrointestinal
  • HADS = Hospital Anxiety and Depression Scale
  • HCs = healthy controls
  • IBS = irritable bowel syndrome
  • MUMC plus = Maastricht University Medical Centre plus
  • OS = overlap syndrome
  • PDS = postprandial distress syndrome
  • PROM = patient-reported outcome measure

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