Background and aims Chronic gastroduodenal symptoms may be associated with psychological factors; however, recent evidence suggests these associations vary by previously undetermined disease factors. Body surface gastric mapping (BSGM) is a non-invasive diagnostic method integrating high-resolution myoelectrical measurement and validated symptom profiling. This cross-sectional study investigated associations between psychological factors and BSGM phenotypes.

Methods Patients from the general community meeting the Rome IV Criteria for functional dyspepsia or chronic nausea and vomiting syndrome underwent BSGM using Gastric Alimetry®. The test protocol included a 30-min fasting baseline, 482 kCal meal, and 4-hr postprandial recording. Measures of depression, anxiety, stress, and quality of life were assessed at baseline, and symptoms were logged throughout the test. BSGM phenotypes were classified using established rule-based criteria.

Results Among 278 patients (mean age 39.5, 15-88; 77% female), clinical diagnoses of depression (45%) and anxiety (46%) were common. Depression, anxiety, and stress measures were positively associated with symptom severity; however, these associations varied substantially by BSGM phenotype. Abnormal rhythm stability predicted higher depression (B=0.35, p=.044) and stress (B=1.48, p=.026). Among patients with normal spectral metrics, continuous symptoms predicted higher levels of depression (B=0.42, p=.003), anxiety (B=0.30, p=.045), and stress (B=1.43, p=.008), and worse quality of life (B=-0.57, p< .001); while sensorimotor symptoms predicted higher anxiety (B=0.46, p=.029) and worse quality of life (B=-0.49, p=.033).

Conclusion This study confirms significant connections between gastroduodenal symptoms and mental health, but refines these associations to specific BSGM phenotypes. Individuals exhibiting normal spectral metrics alongside continuous or sensorimotor symptoms may particularly benefit from integrated psychological interventions.

Disclosures: GOG and AG hold intellectual property and grants in gastric electrophysiology and are Directors of the University of Auckland spin-out company Alimetry Ltd. ML, GS, BW, CD, DF, CNA, and SC are members of Alimetry Ltd. The remaining authors have no relevant conflicts to declare.

This study is funded by a New Zealand Health Research Council Programme Grant 3715588.

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Ethical approvals were granted by the Auckland Health Research Ethics Committee (AHREC; AH1130 & AH27068), the University of Calgary Conjoint Health Research Ethics Board (REB19-1925), and the Human Research Ethics Committee at Western Sydney (H15157). All participants provided written informed consent.

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