Exploring Anxiety Triggers in Non-sedated Upper Gastrointestinal Endoscopy: A Prospective Analysis

Abstract

Introduction: This study aims to identify the demographic, medical, and psychological factors associated with anxiety in patients undergoing non-sedated upper gastrointestinal endoscopy (EGD). By determining high-risk groups and key anxiety triggers, the research seeks to provide insights for improving pre-procedural communication and patient preparation. Methods: A total of 1242 patients aged between 18 and 90 years were included in the study. In this cross-sectional and observational study, the anxiety levels of the patients were measured using data collected through face-to-face interviews and the Spielberger State-Trait Anxiety Inventory (STAI). Participants' demographic information, medical history and previous endoscopy experiences were recorded. Results: Among the participants, 52.7% (n = 654) reported anxiety related to the procedure. Women (n = 645) exhibited higher anxiety levels than men (STAI-I score: 43.28 ± 13.06 vs. 41.52 ± 12.93, p = 0.017). Chronic conditions, such as COPD (mean STAI-I score: 52.53 ± 9.39, p < 0.001), cardiac disorders (49.68 ± 11.58, p = 0.014), and chronic kidney disease (55.50 ± 10.42, p = 0.004), were associated with significantly elevated anxiety levels. Additionally, patients with depression (50.86 ± 9.19, p < 0.001) and panic disorder (51.12 ± 5.99, p < 0.001) exhibited higher anxiety. Prior experience with endoscopy did not significantly reduce anxiety, with 40% (n = 497) having undergone the procedure before. Notably, 46.7% (n = 580) of participants reported prior knowledge of the procedure, but this did not correspond with significantly lower anxiety levels. Conclusion: Anxiety before endoscopic procedures was observed to be common among patients and may directly affect the quality of the procedure. High rates of anxiety in women and individuals with chronic diseases are consistent with the literature. Accurate and comprehensive information of patients prior to the procedure appears to be critical in reducing anxiety levels.