The influence of subjective well-being on anxiety, depression and quality of life in patients with functional dyspepsia

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Anxiety and depression are now gradually believed to be the causes of functional dyspepsia (FD). The influence of SWB was ignored in FD patients. To explore the influence of SWB on anxiety, depression, symptom severity and quality of life (QoL) in FD patients. Methods A total of 374 patients with FD were selected according to Roman IV criteria. Satisfaction with life scale and affect balance scale, Generalized anxiety disorders-7, Patient healthy questionnaire-9, Dyspepsia symptoms severity(DSS）and Nepean dyspepsia index(NDI） were used to assess SWB,anxiety, depression, symptoms severity and QoL, respectively. One-way variance analysis, t-test, Pearson’s correlation and multiple linear regression were used to analyze the results. Results Life satisfaction and emotional balance of FD patients were negatively correlated with DSS, anxiety, depression, and NDI for QoL（r=-0.148,-0.330,-0.325,-0.195， all P <0.01), (r=-0.205,-0.545,-0.550, -0.357, all P <0.001), respectively. Multiple linear regression showed that life satisfaction and emotional balance were influencing factors of anxiety（β= -0. 143, P =0.001）, (β= -0. 318, P <0.001)， and depression（β=-0. 122, P =0.003）, (β= -0. 287, P <0.001), respectively. After removing anxiety and depression, life satisfaction and emotional balance were influencing factors of patients' DSS （β= -0.105, P =0.049）, (β= -0.180, P =0.001), and QoL（β= -0.117, P =0.023）, (β= -0.329, P <0.001) ,respectively. Conclusions FD patients’ SWB negatively affects their disease severity, anxiety and depression, and positively affects their QoL. These results suggested that further strengthening SWB may help reduce symptom severity and improve the QoL of patients, which needs to be confirmed by future follow-up studies. Functional dyspepsia Subjective well-being Anxiety Depression Quality of life Background Psychosocial factors believed as causes of functional dyspepsia (FD) FD is very common clinically in gastroenterology. According to Roman IV diagnostic criteria, its main symptoms are divided into three subtypes: epigastric pain syndrome (EPS) with epigastric burning or pain, postprandial distress syndrome (PDS) with early satiation or postprandial fullness, and an overlapping subtype with two features [1-3]. FD patients often have chronic gastritis when undergoing gastroscopy due to stomach discomfort. FD diagnosis is as easy as chronic gastritis, but FD pathogenesis such as visceral hypersensitivity and abnormal brain-gut interaction is different from gastritis [1]. Patients are often accompanied by anxiety and depression, which were previously thought to be concomitants of FD. With the important progress of brain-gut interaction, stress, anxiety and depression are now gradually believed to be the causes of FD [4-7]. Anxiety and depression have causal effects reducing the incidence of the symptoms in FD patients [8]. The treatments such as acid suppression and some antidepressants can alleviate symptoms of FD patients; however, there is a lack of specific pharmacological interventions to cure the disease, and patients with recurrent episodes may experience a chronic course lasting for decades, which significantly impacts various aspects of patients' daily life and work, thereby compromising their overall quality of life （QoL）[5].Thus, the influence of psychosocial factors on QoL should be paid more attention in FD patients. Subjective well-being (SWB) is a psychological index SWB is a psychological index for individuals to evaluate their own QoL as a whole based on self-determined standards, including life satisfaction and emotional balance, and it is also an important part of social psychological factors [9-11]. The evaluation of life satisfaction is a quantitative evaluation of most aspects of life such as: Whether individuals' life are satisfied with their current life, and want to change their life again [10]. Emotional balance includes negative emotions such as feeling upset and upset about criticism, as well as positive emotions such as: feeling happy when you have completed a task, whether things have gone according to your wishes, and feeling proud of others' praise for your work. The higher an individual's overall score was assessed, the higher the SWB [10-11]. The impact of SWB on FD patients was ignored On the other hand, with the development of the social economy and the increase in social competition pressure, if there is insufficient understanding of SWB, it may decrease[12]; SWB is related to diseases in a two-way relationship, and the SWB decreases in patients with chronic pulmonary diseases, arthritis, and coronary heart disease [9,13]. Lower life satisfaction had a strongly increased risk of moderate/severe depression [14,15]. Because the effect of drug treatment for FD is limited [5,16], patients often suspect that stomach problems are caused by serious diseases such as cancer, affecting their ability and interest in daily life or work. The disease may have a long-term impact on the QoL of patients, interacting with the disease [5,6]. The FD repeatedly and directly affects various aspects of patients' daily life and work, thereby compromising their QoL including the impact of stomach pain and discomfort on daily activities, eating/drinking, and emotional irritability, depression or tension [6]. Kaida et al. [17] showed that the higher the SWB, the higher the QoL. However， there are few studies on the impact of SWB on FD patients. The objective evidence of SWB in previous studies Previous studies have revealed that the SWB was defined as subjective happiness, and it was also objective [18-24]. The SWB was positive with the fractional amplitude of low-frequency fluctuations (fALFF) in the right thalamus, lingual gyrus, posterior mid-cingulate cortex, left postcentral gyrus, planum temporale, and bilateral posterior superior temporal gyrus, which was negative with the left inferior temporal gyrus, right orbitofrontal cortex, and bilateral superior frontal gyrus[18,19]. The SWB was negatively correlated with static functional connectivity between the salience network (SN) and the anterior default mode network (DMN), which was also negatively correlated with the fraction of time that participants spent in a brain state characterized by strong within the DMN and the frontal-parietal network dynamic functional network connectivity (dFNC) [20]. Furthermore, more evidence showed that the SWB was associated with the caudate nucleus [21], and a congenital corpus callosum disorder was associated with decreased SWB [22]. The rating scores of SWB can be predicted by the volume of the left caudate nucleus by promotion focus orientation [24]. Exploring the effect degree of SWB on FD patients’ QoL Currently, there is a lack of specific management to cure FD patients, of which recurrent episodes may significantly compromise their QoL [5,17]. SWB is also objective, which has a strongly increased risk of moderate/severe depression in long follow-up studies [14,15]. Depression may be the cause of FD.SWB influenced QoL in previous studies. However, few studies investigate the influence of SWB on QoL in FD patients, ignoring the influence of SWB. Therefore, we conducted a study aiming to examine the impact of SWB on anxiety, depression, symptoms severity, and QoL in individuals with FD, and establish a foundation for future studies enhancing SWB to improve the QoL in FD patients. Patients and Methods Patients This study recruited 374 patients diagnosed with FD from the gastroenterology outpatient department of the Affiliated Hospital of North Sichuan Medical College between June and December 2022 using a convenience sampling method. According to CONSORT guidelines, inclusion criteria were as follows: (1) adherence to the Rome IV diagnostic criteria for FD, characterized by symptoms such as epigastric distension, early satiety, epigastric pain, or burning sensation lasting more than six months, with consistent symptoms in the past three months; (2) age of 18 years or older; (3) normal language communication and cognitive abilities sufficient to comprehend the research content. Exclusion criteria included: (1) diagnosis of systemic or organic diseases based on biochemical tests, endoscopy, B-ultrasound, and other examinations; (2) presence of gastroesophageal reflux disease, or irritable bowel syndrome; (3) history of abdominal surgery; (4) lactation or pregnancy status; (5) use of non-steroidal anti-inflammatory drugs, glucocorticoids, or other medications. According to previous studies，300 FD patients achieved the minimum sample with a 95% confidence interval to equally split the (50/50) chance [25,26], with a final inclusion of 374 patients. Ethical approval was obtained from the Ethics Committee of the Affiliated Hospital of North Sichuan Medical College (Ethics number: 2021ER074-1), and informed consent was obtained from all participants. Instruments Satisfaction with Life Scale (SWLS) The SWLS created by Diener et al. [10] is a widely used five-item scale assessing overall life satisfaction: whether most aspects of an individual's life are close to the ideal, whether they are satisfied with their current life, whether they have what they want in life, and whether they want to change their life again. Higher scores indicate greater life satisfaction [27, 28]. Affect balance scale (ABS) The ABS developed by Bradburn et al. [27] measures both negative emotions (e.g., feeling upset due to criticism) and positive emotions (e.g., feeling happy after completing work). The scale consists of ten items, with higher negative emotion scores indicating poorer emotional balance and higher positive emotion scores indicating better emotional balance [28]. Generalized anxiety disorder-7 (GAD-7) The GAD-7 evaluates patients' anxiety levels over the past two weeks through seven items, each scored from 0 to 3. Anxiety levels are categorized as none (less than 5 points), mild (5-9 points), moderate (10-14 points), and severe (more than 14 points) [29]. Patient health questionnaire-9 (PHQ-9) The PHQ-9 assesses depressive mood and sleep status over the past two weeks. It includes nine items, each scored from 0 to 3. Results are classified as none (less than 5 points), mild (5-9 points), moderate (10-14 points), and severe (more than 14 points) [30]. D yspepsia symptoms severity (DSS) The DSS evaluates the severity of eight dyspepsia symptoms, including epigastric pain, burning sensation in the upper abdomen, fullness, abdominal distension, nausea, vomiting, and belching. Each symptom is scored from 0 to 3, with higher scores indicating more severe symptoms [31]. 10-item short form of Nepean dyspepsia index (SF-NDI) The SF-NDI assesses the impact of dyspepsia on patients' daily activities. In the past two weeks, patients were assessed on work, study, and ten other aspects, with each item rated on a scale of 1 to 5 points. Higher scores indicate a greater impact of the disease on QoL, reflecting a lower QoL for the patients [32]. Data collection and quality control methods We employed WeChat or telephone surveys for data collection. From September to December 2022, after receiving unified training, research team members conducted one-on-one investigations with patients who had provided informed consent. They patiently explained the purpose and content of the study to respondents, ensuring that no biased or suggestive language was used during questioning. The collected data includes general conditions such as gender, age, and education level of FD patients, SWLS, ABS, GAD-7, PHQ-9, DSS, and SF- NDI scores from FD patients. Statistical analysis Data were analyzed using SPSS 26.0 software. Qualitative data are presented as the number of cases (%), while normally distributed data are represented by mean ± standard deviation. T-tests were used for comparisons between two groups, and one-way ANOVA was applied for comparisons among more than three groups. Pearson correlation coefficients were calculated for correlation analysis. Backward linear regression was employed to analyze the effects of SWB, anxiety, and depression on DSS and QoL. P < 0.05 was considered statistically significant. Results General data analysis of patients' SWB A total of 374 individuals were surveyed; 22 were excluded due to incomplete data, resulting in 352 valid responses, with an effective response rate of 94.12%. A total of 352 FD patients were diagnosed, including 138 males with a mean age of (46.43±11.67) years and 214 females with a mean age of (47.29±8.35) years. Educational levels were distributed as follows: 5.1% (18/352) illiterate/below primary school, 23.6% (83/352) primary school, 40.3% (142/352) middle school, 14.5% (51/352) high school/technical school, and 16.5% (58/352) college or above. Anxiety levels were categorized as follows: no anxiety in 52.2% (184/352) cases, mild anxiety (≥4) in 40.9% (144/352) cases, and moderate/severe anxiety (≥10) in 6.8% (24/352) cases. In 352 cases, 45.5% (160/352) cases showed no depression, 44.3% (156/352) cases scoring 4 or above indicative of mild depression, and 10.2%（36/352）cases scoring 10 or above suggestive of moderate to severe depression. Among these, there were 57 cases with PDS, 122 cases with EPS, and 173 cases in the overlap group. No statistically significant differences were found in life satisfaction (PDS 22.14 ± 3.95, EPS 22.25 ± 4.40, overlap group 22.02 ± 4.36) or emotional balance (PDS 5.07 ± 1.50, EPS 5.44 ± 1.44, overlap group 5.01 ± 1.36) across the three subtypes (all P > 0.05). There were no significant differences in life satisfaction and emotional balance scores between genders and education levels (all P >0.05). The more severe the anxiety and depression symptoms, the lower the life satisfaction and emotional balance (all P <0.05), as shown in Table 1. Table 1 General data analysis illustrating the impact of sex, educational levels, anxiety, and depression on subjective well-being in functional dyspepsia patients Life satisfaction Emotional balance Information Mean SD t /F P Mean SD t /F P Sex 1.029 0.304 0.190 0.849 Male（n=138） 22.41 4.23 5.19 1.56 Female（n=214） 21.93 4.35 5.16 1.32 Educational levels 1.276 0.279 1.478 0.209 Below primary school（n=18） 20.83 4.90 4.56 1.25 Primary school（n=83） 21.71 4.39 5.14 1.19 Middle school（n=142） 22.13 4.11 5.23 1.42 High school（n=51） 22.14 4.58 5.00 1.56 College or above（n=58） 23.05 4.14 5.40 1.60 Anxiety 12.973 <0.001 42.193 <0.001 No（n=184） 23.16 3.86 5.80 1.30 Mild（n=144） 21.42 4.38 4.61 1.18 Moderate/severe（n=24） 18.64 4.16 3.91 0.81 Depression 11.226 <0.001 36.108 <0.001 No（n=160） 23.08 3.61 5.81 1.14 Mild（n=156） 21.92 4.18 4.87 1.29 Moderate/severe（n=36） 18.61 5.48 3.73 1.44 SWB, subjective well-being; FD, functional dyspepsia; SD, standard deviation Correlation analysis of SWB with anxiety , depression , DSS, and QoL The correlation analysis revealed that life satisfaction and emotional balance were significantly negatively correlated with anxiety, depression, symptom severity, and the NDI for QoL (all P <0.05). Notably, the correlation coefficient for emotional balance was higher than that for life satisfaction (Table 2). Additionally, patient age exhibited a positive correlation with life satisfaction (r=0.176, P =0.001). Table 2 Correlation analysis illustrating the relationship between SWB, anxiety, depression, DSS, and QoL in FD patients Variable Anxiety Depression DSS QoL SWLS (n=352) r -0.330 -0.325 -0.148 -0.195 P <0.001 <0.001 0.005 <0.001 ABS (n=352) r -0.545 -0.550 -0.205 -0.357 P <0.001 <0.001 <0.001 <0.001 SWB, subjective well-being; SWLS, satisfaction with life scale; ABS, affect balance scale; DSS, dyspepsia symptoms severity; QoL, quality of life; FD, functional dyspepsia; A multi-factor analysis of the influence of SWB on anxiety Multiple linear regression analysis was conducted to examine the effects of age, education level, life satisfaction, emotional balance, symptom severity, depression, and quality of life on anxiety. The results indicated that life satisfaction, emotional balance, depression, and quality of life were significant influential factors for anxiety (all P <0.05) (Table 3). Table 3 Linear regression analysis illustrating the relationship between SWLS, ABS, depression, QoL, and anxiety in FD patients Variables Unstandardized coefficients Standardized coefficients t P value Adjusted R 2 Constant 7.129 6.679 <0.001 0.422 SWLS -0.096 -0.143 -3.315 0.001 ABS -0.650 -0.318 -6.498 <0.001 Depression 0.232 0.249 4.494 <0.001 QoL 0.106 0.160 3.308 0.001 SWB, subjective well-being; SWLS, satisfaction with life scale; ABS, affect balance scale; QoL, quality of life; FD, functional dyspepsia;R 2 ,the fit degree of the model A multi-factor analysis of the influence of SWB on depression The effects of age, gender, education level, life satisfaction, emotional balance, DSS, anxiety, and QoL on depression. The results indicated that life satisfaction, emotional balance, anxiety and QoL were influential factors for depression (all P <0.05) (Table 4). Table 4 Linear regression analysis illustrating the relationship between SWB, anxiety, QoL, and depression in FD patients Variable Unstandardized coefficients Standardized coefficients t P Adjusted R 2 Constant 5.366 4.846 0.001 0.485 SWLS -0.088 -0.122 -3.001 0.003 ABS -0.628 -0.287 -6.187 <0.001 Anxiety 0.237 0.221 4.494 <0.001 QoL 0.224 0.317 7.340 <0.001 SWB, subjective well-being; SWLS, satisfaction with life scale; ABS, affect balance scale; QoL, quality of life; FD, functional dyspepsia; R 2 , the fit degree of the model A multi-factor analysis of the influence of SWB on DSS Multivariate linear regression analysis revealed that life satisfaction and emotional balance were significant predictors of symptom severity (all P < 0.05), with emotional balance exerting a more substantial influence. However, when anxiety and depression were incorporated into the model, neither life satisfaction nor emotional balance remained significant predictors of DSS (all P > 0.05) (Table 5). Table 5 Linear regression analysis illustrating the relationship between SWLS, ABS, anxiety, depression, and DSS in FD patients Variable Unstandardized coefficients Standardized coefficients t P Adjusted R 2 Constant 8.755 11.381 <0.001 0.047 SWLS -0.062 -0.105 -1.967 0.049 ABS -0.323 -0.180 -3.359 0.001 SWB, subjective well-being; DSS, dyspepsia symptoms severity; FD, functional dyspepsia; SWLS, satisfaction with life scale; ABS, affect balance scale; R 2 , the fit degree of the model A multi-factor analysis of the influence of SWB on QoL Similarly, life satisfaction and emotional balance were identified as significant determinants of quality of life (all P < 0.05), again with emotional balance having a more pronounced effect. Nevertheless, after accounting for anxiety and depression, neither life satisfaction nor emotional balance retained their significance as determinants of QoL (all P > 0.05) (Table 6). Table 6 Linear regression analysis illustrating the relationship between SWB (SWLS and ABS), anxiety, depression, and QoL in FD patients Variables Unstandardized coefficients Standardized coefficients t P Adjusted R 2 Constant 24.949 19.719 <0.001 0.135 SWLS -0.120 -0.117 -2.291 0.023 ABS -1.018 -0.329 -6.439 <0.001 SWB, subjective well-being; QoL, quality of life; FD, functional dyspepsia; SWLS, satisfaction with life scale; ABS, affect balance scale; R 2 , the fit degree of the model The factors influencing life satisfaction by multivariate analysis Table 7 showed that a multiple linear regression approach was conducted to examine the effects of age, gender, educational levels, anxiety, depression, DSS and QoL on life satisfaction. The results indicated that age, educational levels, anxiety and depression were significant influential factors for emotional balance (all P < 0.05). Table 7 Linear regression analysis illustrating the relationship between age, educational levels, anxiety, depression, and life satisfaction in FD patients Variable Unstandardized coefficients Standardized coefficients t P Adjusted R 2 Constant 18.771 11.916 <0.001 0.169 Age 0.085 0.194 3.679 <0.001 Educational levels 0.638 0.164 3.134 0.002 Anxiety -0.299 -0.202 -3.447 0.001 Depression -0.252 -0.182 -3.094 0.002 FD, functional dyspepsia; R 2 , the fit degree of the model Multivariate analysis of factors influencing emotional balance A multiple linear regression approach was conducted to examine the effects of age, gender, education levels, DSS, anxiety, depression, and QoL on emotional balance in FD patients. The results indicated that anxiety and depression were significant influential factors for emotional balance (all P < 0.05), as shown in Table 8. Table 8 Linear regression analysis illustrating the relationship between DSS, anxiety, depression, and emotional balance in FD patients Variable Unstandardized coefficients Standardized coefficients t P -value Adjusted R 2 Constant 6.654 28.512 <0.001 0.388 DSS -0.044 -0.101 -1.919 0.056 Anxiety -0.171 -0.351 -6.961 <0.001 Depression -0.137 -0.300 -5.123 <0.001 FD, functional dyspepsia; DSS, dyspepsia symptoms severity; R 2 , the fit degree of the model Discussion To our knowledge, to investigate whether SWB is associated with anxiety, depression, and symptom severity in FD patients, few relevant studies have been conducted. This study represents the first exploration of the effects of SWB on anxiety, depression, symptom severity, and QoL in FD patients. Our findings indicate that SWB is negatively correlated with anxiety, depression, and symptom severity, which is positively associated with QoL, patients with more severe anxiety and depression symptoms tend to have lower life satisfaction and emotional balance, and dissatisfaction with current life is common among patients with anxiety and depression, leading to reduced life satisfaction, which was following the results in other diseases [ 33 , 34 ]. This study also revealed no significant differences in SWB among the three subtypes of FD, and anxiety had a more significant impact on SWB compared to depression. Therefore, these results suggested that mitigating anxiety and depression may alleviate symptom severity and enhance QoL. Multivariate analysis showed that SWB had a less significant impact on symptom severity and QoL compared to anxiety and depression, of which the fit degree of the model R 2 was low in this cross-sectional study, which suggested that the influence of SWB was easily ignored in FD patients. Medical staff often focused on the influence of anxiety and depression while neglecting the role of SWB in FD patients. However, considering the brain-gut interaction, anxiety and depression are increasingly recognized as contributing factors to the etiology of FD [ 4 , 5 ]. There is an inverse relationship between SWB and resilience in depression [ 34 ]. Lower life satisfaction was associated with a significantly increased risk (OR = 10.4) of moderate/severe depression over a 15-year follow-up of healthy adults [ 15 ]. Given that most FD cases are chronic, SWB can serve as a crucial potential indicator for studying the development and management of FD in future long-term follow-up studies. The determinants of SWB were classified into seven major domains: health and functioning, social support, socioeconomic status, demographic characteristics, personality traits, religious and cultural factors, and infrastructure and geography [ 35 , 36 ]. Socioeconomic status was identified as a significant factor influencing SWB [ 37 , 38 ]. With societal economic development, the prevalence of FD has also increased [ 2 ]. Our findings revealed a positive correlation between patient age and life satisfaction with older individuals reporting higher levels of satisfaction, and higher educational level with higher levels of satisfaction. Additionally, social support emerged as a crucial determinant of SWB [ 39 ]. However, medical interventions aimed at improving socioeconomic status and social support are limited in their effectiveness; therefore, this study primarily focused on assessing the health and functioning of SWB, including mental health aspects such as anxiety and depression. To enhance SWB, psychotherapeutic interventions have demonstrated moderate effects in reducing negative affect and enhancing positive affect among depressed adults [ 40 ]. Educational programs and cognitive interventions have been shown to effectively improve SWB and promote resilience in elderly populations, thereby alleviating depressive symptoms [ 41 ]. A positive optimistic personality trait can also contribute to higher SWB [ 16 , 38 ]. Leisure time physical activity (LTPA) interventions have been found to promote SWB by improving health and functioning [ 42 , 43 ]. Furthermore, Ludwigs et al. [ 11 ] demonstrated that both professional psychological training groups and control groups that repeatedly filled out scales of SWB could effectively enhance SWB without any statistically significant differences between them, and simply reinforcing the concept of SWB can lead to improvements. Therefore, strengthening content awareness of SWB is a simple and feasible approach to improving it. This study had the following limitations: Firstly, the data were derived from a single center of FD patients in one hospital, which may limit the generalizability of the findings. Secondly, this was a cross-sectional study that showed that SWB was negatively correlated with symptom severity, anxiety, and depression and positively correlated with QoL. However, as a cross-sectional study, it is limited in its ability to infer causality; therefore, a longitudinal cohort study is necessary to confirm whether enhancing SWB can reduce the incidence or severity of FD symptoms in future research. Thirdly, although SWB showed a negative correlation with anxiety, depression, and disease impact on QoL, the correlation coefficient in this study was below 0.7, indicating a weaker association. Fourthly, multiple linear regression analysis revealed that when including anxiety and depression, SWB did not significantly influence symptom severity and QoL, suggesting that SWB played a less significant role compared to anxiety and depression. Gastroenterology medical staff tended to focus more on the effects of anxiety and depression on FD while overlooking the impact of SWB. However, SWB associated with anxiety and depression, which are potentially the etiology of FD, and lower life satisfaction was associated with a significantly increased risk of moderate/severe depression over a long follow-up study [ 15 ]. These results suggested that reinforcing the impact of FD patients' SWB may help reduce symptoms, which requires further confirmation in future long-term studies. Conclusions The study indicated that FD patients' SWB was negatively correlated with symptom severity, anxiety, and depression, and positively correlated with QoL. These results suggested that SWB could be considered as a potential indicator for studying the development and management of FD in future research, Furthermore, enhancing the SWB of FD patients through targeted interventions by medical staff may contribute to reducing symptom severity, anxiety, and depression levels while improving their QoL. These potential benefits warrant confirmation through long-term follow-up studies. Abbreviations FD Functional dyspepsia SWB Subjective well-being QoL Quality of life fALFF fractional amplitude of low frequency fluctuations SNS Salience network DMN Default mode network dFNC dynamic functional network connectivity SWLS Satisfaction with life scale ABS Affect balance scale GAD-7 Generalized anxiety disorders-7 PHQ-9 Patient healthy questionnaire-9 DSS Dyspepsia symptoms severity NDI Nepean dyspepsia index SD Standard deviation Declarations Acknowledgements None. Authors’ contributions YGZ conceptualized and designed the study, coordinated data collection, performed data analysis, and wrote the initial draft of the manuscript; WX assisted in data collection, contributed to the interpretation of results, and provided critical feedback on the manuscript draft; XY assisted in data collection, conducted the literature review, contributed to the writing of the background section and revised the manuscript for intellectual content.; HGB prepared figures 1-8, provided technical support for data analysis, and contributed to the discussion of the results. The final manuscript was approved by all authors. Funding Special project on science and technology strategic cooperation between Nanchong city and schools（20SXQT0080） Data Availability The research data are available in the Supplementary Material. Additional datasets can be obtained from the corresponding author upon reasonable request. Declarations Competing interests The authors declare that there are no competing interests. Ethics approval and consent to participate Ethical approval for this study was obtained from the Ethics Committee of the Affiliated Hospital of North Sichuan Medical College (Nanchong, China), and informed consent was obtained from all participants. In this study, all protocols were conducted according to the Declaration of Helsinki. Participants have the right to withdraw from the study at any time. Consent for publication Not applicable. Author Details 1 Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College, No. 1 South Maoyuan Road, Shunqing, Nanchong 637000, Sichuan, China 2 School of Nursing, North Sichuan Medical College, No. 234 Fujiang Road, Shunqing, Nanchong 637000, Sichuan, China References Drossman D A, Hasler W L. Rome IV --functional GI disorders: disorders of gut- brain interaction. Gastroenterology.2016;150(6):1257-61. 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How does the subjective well-being of Australian adults with a congenital corpus callosum disorder compare with that of the general Australian population? Qual Life Res. 2024. Mas-Cuesta L, Baltruschat S, Cándido A, Verdejo-Lucas C, Catena-Verdejo E, Catena A. Brain changes following mindfulness: reduced caudate volume is associated with decreased positive urgency. Behav Brain Res. 2024;461. Matsunaga M, Ohtsubo Y, Ishii K, Tsuboi H, Suzuki K, Takagishi H. Subjective well-being can be predicted by caudate volume and promotion focus. Brain Struct Funct. 2024. Creswell JM. Educational research: planning, conducting, and evaluating quantitative and qualitative research. 4th ed. Upper Saddle River, NJ: Pearson Education Inc. 2012;147:609 – 11. Yuan C, Yong G, Wang X, Xie T, Wang C, Yuan Y, et al. Developing the Patient Health Questionnaire-8 for a greater impact on the quality of life of patients with functional dyspepsia compared to Somatic Symptom Scale-8. 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Pearson KA, Watkins ER, Kuyken W, Mullan EG. The psychosocial context of depressive rumination: ruminative brooding predicts diminished relationship satisfaction in individuals with a history of past major depression. Br J Clin Psychol. 2010 ;49(Pt 2):275-80. Zafari M, Sadeghipour Roudsari M, Yarmohammadi S, Jahangirimehr A, Marashi T. Investigating the relationship between spiritual well-being, resilience, and depression: a cross-sectional study of the elderly. Psychogeriatrics. 2023;23(3):442-9. Das KV, Jones-Harrell C, Fan Y, Ramaswami A, Orlove B, Botchwey N. Understanding subjective well-being: perspectives from psychology and public health. Public Health Rev. 2020;41(1):25. Anglim J, Horwood S, Smillie LD, Marrero RJ, Wood JK. Predicting psychological and subjective well-being from personality: A meta-analysis. Psychol Bull. 2020;146(4):279-323. Ngamaba KH. Determinants of subjective well-being in representative samples of nations. Eur J Public Health. 2017 ;27(2):377-82. Diener E, Diener C, Choi H, Oishi S. Revisiting "most people are happy"-And discovering when they are not. Perspect Psychol Sci. 2018;13(2):166-70. Ngamaba KH, Panagioti M, Armitage CJ. How strongly related are health status and subjective well-being? Systematic review and meta-analysis. Eur J Public Health. 2017;27(5):879-85. Boumparis N, Karyotaki E, Kleiboer A, Hofmann SG, Cuijpers P. The effect of psychotherapeutic interventions on positive and negative affect in depression: A systematic review and meta-analysis. J Affect Disord. 2016 ;202:153-62. Okorie CO, Ogba FN, Aal. Zoom-based GROW coaching intervention for improving subjective well-being in a sample of school administrators: A randomized control trial. Internet Interv. 2022 ;29:10054 Todd KR, Lawrason SVC, Shaw RB, Wirtz D, Martin Ginis KA. Physical activity interventions, chronic pain, and subjective well-being among persons with spinal cord injury: a systematic scoping review. Spinal Cord. 2021;59(2):93-104. Herbert C. Enhancing mental health, well-being and active lifestyles of university students by means of physical activity and exercise research programs. Front Public Health. 2022;25(10):849093. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6109334","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":448285792,"identity":"d3da69b5-2f1b-4da3-820d-6e84db21164c","order_by":0,"name":"Guizhen Yong","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9ElEQVRIiWNgGAWjYPACCQYDBgbGB1CeAdFamGFKidICVsYmQZQWg+O9h19+bbOwN2fvPVZd8GebPAN78zYJhpo7uLWcOZdmLdsmwWzZcy7t9sy224YNPMfKJBiOPcOt5UaOmbFkmwQbiHGbt+F2AoNEjpkEY8Nhglp4DO6/MSvm+QPUIv+GoBbjhx/bJCQMbvCYMfOwgWzhwa9F8swZM2aGcxIGBmdyjKV5gX5p40krtkg4hlsL3/Ee448/yursDY6fMfwMdJg8P/vhjTc+1ODWonCAgU2aB1mEDUQk4NTAwCDfwMD88QceBaNgFIyCUTAKGACUQVH/zjj31QAAAABJRU5ErkJggg==","orcid":"","institution":"Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College","correspondingAuthor":true,"prefix":"","firstName":"Guizhen","middleName":"","lastName":"Yong","suffix":""},{"id":448285794,"identity":"3758de48-1506-46d3-bc9c-1803b8d51fcf","order_by":1,"name":"Xi Wang","email":"","orcid":"","institution":"Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College","correspondingAuthor":false,"prefix":"","firstName":"Xi","middleName":"","lastName":"Wang","suffix":""},{"id":448285795,"identity":"fe31695a-81e6-4f6f-ab9b-7554f3bd66ef","order_by":2,"name":"Yan Xu","email":"","orcid":"","institution":"School of Nursing, North Sichuan Medical College","correspondingAuthor":false,"prefix":"","firstName":"Yan","middleName":"","lastName":"Xu","suffix":""},{"id":448285797,"identity":"9cfdd58c-1b8a-410c-afba-e476aee3f293","order_by":3,"name":"Guobin He","email":"","orcid":"","institution":"Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College","correspondingAuthor":false,"prefix":"","firstName":"Guobin","middleName":"","lastName":"He","suffix":""}],"badges":[],"createdAt":"2025-02-26 03:23:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6109334/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6109334/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12876-025-04075-8","type":"published","date":"2025-07-01T15:58:09+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":86179119,"identity":"20cb10be-4e32-4d2d-b781-bfdab2d9e7fe","added_by":"auto","created_at":"2025-07-07 16:15:57","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1152230,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6109334/v1/eb165408-b2f1-4813-9550-b1c5c2deca5a.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The influence of subjective well-being on anxiety, depression and quality of life in patients with functional dyspepsia","fulltext":[{"header":"Background","content":"\u003cp\u003e\u003cstrong\u003ePsychosocial factors believed as causes of functional dyspepsia (FD)\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFD is very common clinically in gastroenterology. According to Roman IV diagnostic criteria, its main symptoms are divided into three subtypes: epigastric pain syndrome (EPS) with epigastric burning or pain, postprandial distress syndrome (PDS) with early satiation or postprandial fullness, and an overlapping subtype with two features [1-3]. FD patients often have chronic gastritis when undergoing gastroscopy due to stomach discomfort. FD diagnosis is as easy as chronic gastritis, but FD pathogenesis such as visceral hypersensitivity and abnormal brain-gut interaction is different from gastritis [1]. Patients are often accompanied by anxiety and depression, which were previously thought to be concomitants of FD. With the important progress of brain-gut interaction, stress, anxiety and depression are now gradually believed to be the causes of FD [4-7]. Anxiety and depression have causal effects reducing the incidence of the symptoms in FD patients [8]. The treatments such as acid suppression and some antidepressants can alleviate symptoms of FD patients; however, there is a lack of specific pharmacological interventions to cure the disease, and patients with recurrent episodes may experience a chronic course lasting for decades, which significantly impacts various aspects of patients\u0026apos; daily life and work, thereby compromising their overall quality of life\u0026nbsp;（QoL）[5].Thus, the influence of psychosocial factors on QoL should be paid more attention in FD patients.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSubjective well-being (SWB) is a psychological index\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSWB is a psychological index for individuals to evaluate their own QoL as a whole based on self-determined standards, including life satisfaction and emotional balance, and it is also an important part of social psychological factors [9-11]. The evaluation of life satisfaction is a quantitative evaluation of most aspects of life such as: Whether individuals\u0026apos; life are satisfied with their current life, and want to change their life again [10]. Emotional balance includes negative emotions such as feeling upset and upset about criticism, as well as positive emotions such as: feeling happy when you have completed a task, whether things have gone according to your wishes, and feeling proud of others\u0026apos; praise for your work. The higher an individual\u0026apos;s overall score was assessed, the higher the SWB [10-11].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe impact of SWB on FD patients\u003c/strong\u003e \u003cstrong\u003ewas ignored\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOn the other hand, with the development of the social economy and the increase in social competition pressure, if there is insufficient understanding of SWB, it may decrease[12]; SWB is related to diseases in a two-way relationship, and the SWB decreases in patients with chronic pulmonary diseases, arthritis, and coronary heart disease [9,13]. Lower life satisfaction had a strongly increased risk of moderate/severe depression [14,15]. Because the effect of drug treatment for FD is limited [5,16], patients often suspect that stomach problems are caused by serious diseases such as cancer, affecting their ability and interest in daily life or work. The disease may have a long-term impact on the QoL of patients, interacting with the disease [5,6]. The FD repeatedly and directly affects various aspects of patients\u0026apos; daily life and work, thereby compromising their QoL including the impact of stomach pain and discomfort on daily activities, eating/drinking, and emotional irritability, depression or tension [6]. Kaida et al. [17] showed that the higher the SWB, the higher the QoL. However，\u0026nbsp;there are few studies on the impact of SWB on FD patients.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe objective evidence of SWB in previous studies\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePrevious studies have revealed\u0026nbsp;that the SWB was defined as subjective happiness, and it was also objective\u0026nbsp;[18-24]. The SWB was positive with the fractional amplitude of low-frequency fluctuations (fALFF) in the right thalamus, lingual gyrus, posterior mid-cingulate cortex, left postcentral gyrus, planum temporale, and bilateral posterior superior temporal gyrus, which was negative with the left inferior temporal gyrus, right orbitofrontal cortex, and bilateral superior frontal gyrus[18,19]. The SWB was negatively correlated with static functional connectivity between the salience network (SN) and the anterior default mode network (DMN), which was also negatively correlated with the fraction of time that participants spent in a brain state characterized by strong within the DMN and the frontal-parietal network dynamic functional network connectivity (dFNC) [20]. Furthermore, more evidence showed that the SWB was associated with the caudate nucleus [21], and a congenital corpus callosum disorder was associated with decreased SWB [22]. The rating scores of SWB can be predicted by the volume of the left caudate nucleus by promotion focus orientation [24].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eExploring the effect degree of SWB on FD patients\u0026rsquo; QoL\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCurrently, there is a lack of specific management to cure FD patients, of which recurrent episodes may significantly compromise their QoL [5,17]. SWB is also objective, which has a strongly increased risk of moderate/severe depression in long follow-up studies [14,15].\u0026nbsp;Depression may be the cause of FD.SWB influenced QoL in previous studies. However, few studies investigate the influence of SWB on QoL in FD patients, ignoring the influence of SWB. Therefore, we conducted a study aiming to examine the impact of SWB on anxiety, depression, symptoms\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eseverity, and QoL in individuals with FD, and establish a foundation for future studies enhancing SWB to improve the QoL in FD patients.\u003c/p\u003e"},{"header":"Patients and Methods","content":"\u003cp\u003e\u003cstrong\u003ePatients\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study recruited 374 patients diagnosed with FD from the gastroenterology outpatient department of the Affiliated Hospital of North Sichuan Medical College between June and December 2022 using a convenience sampling method. According to CONSORT guidelines, inclusion criteria were as follows: (1) adherence to the Rome IV diagnostic criteria for FD, characterized by symptoms such as epigastric distension, early satiety, epigastric pain, or burning sensation lasting more than six months, with consistent symptoms in the past three months; (2) age of 18 years or older; (3) normal language communication and cognitive abilities sufficient to comprehend the research content. Exclusion criteria included: (1) diagnosis of systemic or organic diseases based on biochemical tests, endoscopy, B-ultrasound, and other examinations; (2) presence of gastroesophageal reflux disease, or irritable bowel syndrome; (3) history of abdominal surgery; (4) lactation or pregnancy status; (5) use of non-steroidal anti-inflammatory drugs, glucocorticoids, or other medications. According to previous studies，300 FD patients achieved the minimum sample with a 95% confidence interval to equally split the (50/50) chance [25,26], with a final inclusion of 374 patients. Ethical approval was obtained from the Ethics Committee of the Affiliated Hospital of North Sichuan Medical College (Ethics number: 2021ER074-1), and informed consent was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstruments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSatisfaction with Life Scale (SWLS)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe SWLS created by Diener et al. [10] is a widely used five-item scale assessing overall life satisfaction: whether most aspects of an individual\u0026apos;s life are close to the ideal, whether they are satisfied with their current life, whether they have what they want in life, and whether they want to change their life again. Higher scores indicate greater life satisfaction [27, 28].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAffect balance scale (ABS)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe ABS developed by Bradburn et al. [27] measures both negative emotions (e.g., feeling upset due to criticism) and positive emotions (e.g., feeling happy after completing work). The scale consists of ten items, with higher negative emotion scores indicating poorer emotional balance and higher positive emotion scores indicating better emotional balance [28].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGeneralized anxiety disorder-7 (GAD-7)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe GAD-7 evaluates patients\u0026apos; anxiety levels over the past two weeks through seven items, each scored from 0 to 3. Anxiety levels are categorized as none (less than 5 points), mild (5-9 points), moderate (10-14 points), and severe (more than 14 points) [29].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePatient health questionnaire-9 (PHQ-9)\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe PHQ-9\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eassesses depressive mood and sleep status over the past two weeks. It includes nine items, each scored from 0 to 3. Results are classified as none (less than 5 points), mild (5-9 points), moderate (10-14 points), and severe (more than 14 points) [30].\u003c/p\u003e\n\u003cp\u003eD\u003cstrong\u003eyspepsia symptoms severity (DSS)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe DSS evaluates the severity of eight dyspepsia symptoms, including epigastric pain, burning sensation in the upper abdomen, fullness, abdominal distension, nausea, vomiting, and belching. Each symptom is scored from 0 to 3, with higher scores indicating more severe symptoms [31].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e10-item short form of Nepean dyspepsia index (SF-NDI)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe SF-NDI assesses the impact of dyspepsia on patients\u0026apos; daily activities. In the past two weeks, patients were assessed on work, study, and ten other aspects, with each item rated on a scale of 1 to 5 points. Higher scores indicate a greater impact of the disease on QoL, reflecting a lower QoL for the patients [32].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection and quality control methods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe employed WeChat or telephone surveys for data collection. From September to December 2022, after receiving unified training, research team members conducted one-on-one investigations with patients who had provided informed consent. They patiently explained the purpose and content of the study to respondents, ensuring that no biased or suggestive language was used during questioning. The collected data includes general conditions such as gender, age, and education level of FD patients, SWLS, ABS, GAD-7, PHQ-9, DSS, and SF- NDI scores from FD patients.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eanalysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were analyzed using SPSS 26.0 software. Qualitative data are presented as the number of cases (%), while normally distributed data are represented by mean \u0026plusmn; standard deviation. T-tests were used for comparisons between two groups, and one-way ANOVA was applied for comparisons among more than three groups. Pearson correlation coefficients were calculated for correlation analysis. Backward linear regression was employed to analyze the effects of SWB, anxiety, and depression on DSS and\u0026nbsp;QoL. \u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u0026lt; 0.05 was considered statistically significant.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eGeneral data analysis of patients\u0026apos;\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;SWB\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 374 individuals were surveyed; 22 were excluded due to incomplete data, resulting in 352 valid responses, with an effective response rate of 94.12%. A total of 352 FD patients were diagnosed, including 138 males with a mean age of (46.43\u0026plusmn;11.67) years and 214 females with a mean age of (47.29\u0026plusmn;8.35) years. Educational levels were distributed as follows: 5.1% (18/352) illiterate/below primary school, 23.6% (83/352) primary school, 40.3% (142/352) middle school, 14.5% (51/352) high school/technical school, and 16.5% (58/352) college or above. Anxiety levels were categorized as follows: no anxiety in 52.2% (184/352) cases, mild anxiety (\u0026ge;4) in 40.9% (144/352) cases, and moderate/severe anxiety (\u0026ge;10) in 6.8% (24/352) cases. In 352 cases, 45.5% (160/352) cases showed no depression, 44.3% (156/352) cases scoring 4 or above indicative of mild depression, and 10.2%（36/352）cases scoring 10 or above suggestive of moderate to severe depression. Among these, there were 57 cases with PDS, 122 cases with EPS, and 173 cases in the overlap group. No statistically significant differences were found in life satisfaction (PDS 22.14 \u0026plusmn; 3.95, EPS 22.25 \u0026plusmn; 4.40, overlap group 22.02 \u0026plusmn; 4.36) or emotional balance (PDS 5.07 \u0026plusmn; 1.50, EPS 5.44 \u0026plusmn; 1.44, overlap group 5.01 \u0026plusmn; 1.36) across the three subtypes (all\u0026nbsp;\u003cem\u003eP\u003c/em\u003e \u0026gt; 0.05). There were no significant differences in life satisfaction and emotional balance scores between genders and education levels (all\u0026nbsp;\u003cem\u003eP\u003c/em\u003e \u0026gt;0.05). The more severe the anxiety and depression symptoms, the lower the life satisfaction and emotional balance (all\u0026nbsp;\u003cem\u003eP\u003c/em\u003e \u0026lt;0.05), as shown in Table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e General data analysis illustrating the impact of sex, educational levels, anxiety, and depression on subjective well-being in functional dyspepsia patients\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" style=\"width: 34px;\"\u003e\n \u003cp\u003eLife satisfaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" style=\"width: 34px;\"\u003e\n \u003cp\u003eEmotional balance\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eInformation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1.029\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.304\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.849\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eMale（n=138）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e22.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e4.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eFemale（n=214）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e21.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e4.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eEducational levels\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1.276\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.279\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1.478\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.209\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eBelow primary school（n=18）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e20.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e4.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e4.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003ePrimary school（n=83）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e21.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e4.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eMiddle school（n=142）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e22.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e4.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eHigh school（n=51）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e22.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e4.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eCollege or above（n=58）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e23.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e4.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e1.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eAnxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e12.973\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e42.193\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eNo（n=184）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e23.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e3.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eMild（n=144）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e21.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e4.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e4.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eModerate/severe（n=24）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e18.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e4.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e3.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eDepression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e11.226\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e36.108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eNo（n=160）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e23.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e3.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eMild（n=156）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e21.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e4.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e4.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26px;\"\u003e\n \u003cp\u003eModerate/severe（n=36）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e18.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e5.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e3.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eSWB, subjective well-being; FD, functional dyspepsia; SD, standard deviation\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorrelation analysis of SWB with anxiety\u003c/strong\u003e, \u003cstrong\u003edepression\u003c/strong\u003e, \u003cstrong\u003eDSS, and\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eQoL\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe correlation analysis revealed that life satisfaction and emotional balance were significantly negatively correlated with anxiety, depression, symptom severity, and the NDI for QoL (all \u003cem\u003eP\u003c/em\u003e \u0026lt;0.05). Notably, the correlation coefficient for emotional balance was higher than that for life satisfaction (Table 2). Additionally, patient age exhibited a positive correlation with life satisfaction (r=0.176, \u003cem\u003eP\u003c/em\u003e =0.001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u003c/strong\u003e Correlation analysis illustrating the relationship between SWB, anxiety, depression, DSS, and QoL in FD patients\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"574\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eAnxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eDepression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eDSS\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eQoL\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003eSWLS (n=352)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e-0.330\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e-0.325\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-0.148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-0.195\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003eABS (n=352)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e-0.545\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e-0.550\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-0.205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-0.357\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eSWB, subjective well-being; SWLS,\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003esatisfaction with life scale;\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eABS,\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eaffect balance scale; DSS, dyspepsia symptoms severity; QoL, quality of life; FD, functional dyspepsia;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eA multi-factor analysis of the influence of SWB on anxiety\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMultiple linear regression analysis was conducted to examine the effects of age, education level,\u003c/p\u003e\n\u003cp\u003elife satisfaction, emotional balance, symptom severity, depression, and quality of life on anxiety. The results indicated that life satisfaction, emotional balance, depression, and quality of life were significant influential factors for anxiety (all \u003cem\u003eP\u003c/em\u003e \u0026lt;0.05)\u0026nbsp;(Table 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u003c/strong\u003e \u0026nbsp;Linear regression analysis illustrating the relationship between SWLS, ABS, depression, QoL, and anxiety in FD patients\u0026nbsp;\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003eUnstandardized\u003c/p\u003e\n \u003cp\u003ecoefficients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003eStandardized\u003c/p\u003e\n \u003cp\u003ecoefficients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cem\u003eP value\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003eAdjusted R\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003eConstant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e7.129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e6.679\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.422\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003eSWLS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e-0.096\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp\u003e-0.143\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e-3.315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003eABS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e-0.650\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp\u003e-0.318\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e-6.498\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003eDepression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e0.232\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp\u003e0.249\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e4.494\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003eQoL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e0.106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16px;\"\u003e\n \u003cp\u003e0.160\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e3.308\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eSWB, subjective well-being;\u0026nbsp;SWLS,\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003esatisfaction with life scale;\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eABS,\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eaffect balance scale;\u0026nbsp;QoL, quality of life; FD, functional dyspepsia;R\u003csup\u003e2\u003c/sup\u003e,the fit degree of the model\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eA multi-factor analysis of the influence of\u003c/strong\u003e \u003cstrong\u003eSWB on\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;depression\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe effects of age, gender, education level, life satisfaction, emotional balance, DSS, anxiety, and QoL on depression. The results indicated that life satisfaction, emotional balance, anxiety and QoL were influential factors for depression (all\u0026nbsp;\u003cem\u003eP\u003c/em\u003e \u0026lt;0.05) (Table 4).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4\u0026nbsp;\u003c/strong\u003eLinear regression analysis illustrating the relationship between SWB, anxiety, QoL, and depression in FD patients\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003eUnstandardized\u003c/p\u003e\n \u003cp\u003ecoefficients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003eStandardized\u003c/p\u003e\n \u003cp\u003ecoefficients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003eAdjusted R\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003eConstant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e5.366\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e4.846\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e0.485\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003eSWLS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e-0.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e-0.122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e-3.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003eABS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e-0.628\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e-0.287\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e-6.187\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003eAnxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e0.237\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e0.221\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e4.494\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003eQoL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e0.224\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e0.317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e7.340\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eSWB, subjective well-being; SWLS, satisfaction with life scale; ABS, affect balance scale; QoL, quality of life;\u0026nbsp;FD, functional dyspepsia;\u0026nbsp;R\u003csup\u003e2\u003c/sup\u003e, the fit degree of the model\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eA multi-factor analysis of the influence of SWB on\u003c/strong\u003e \u003cstrong\u003eDSS\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMultivariate linear regression analysis revealed that life satisfaction and emotional balance were significant predictors of symptom severity (all\u0026nbsp;\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05), with emotional balance exerting a more substantial influence. However, when anxiety and depression were incorporated into the model, neither life satisfaction nor emotional balance remained significant predictors of DSS (all\u0026nbsp;\u003cem\u003eP\u003c/em\u003e \u0026gt; 0.05) (Table 5).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5\u0026nbsp;\u003c/strong\u003eLinear regression analysis illustrating the relationship between SWLS, ABS, anxiety, depression, and DSS in FD patients\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003eUnstandardized\u003c/p\u003e\n \u003cp\u003ecoefficients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003eStandardized\u003c/p\u003e\n \u003cp\u003ecoefficients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003eAdjusted R\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003eConstant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e8.755\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e11.381\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e0.047\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003eSWLS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e-0.062\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e-0.105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e-1.967\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.049\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003eABS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e-0.323\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e-0.180\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e-3.359\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eSWB, subjective well-being; DSS, dyspepsia symptoms severity;\u0026nbsp;FD, functional dyspepsia;\u0026nbsp;SWLS,\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003esatisfaction with life scale;\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eABS,\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eaffect balance scale; R\u003csup\u003e2\u003c/sup\u003e,\u003csub\u003e\u0026nbsp;\u003c/sub\u003ethe fit degree of the model\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eA multi-factor analysis of the influence of SWB on\u003c/strong\u003e \u003cstrong\u003eQoL\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSimilarly, life satisfaction and emotional balance were identified as significant determinants of quality of life (all\u0026nbsp;\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05), again with emotional balance having a more pronounced effect. Nevertheless, after accounting for anxiety and depression, neither life satisfaction nor emotional balance retained their significance as determinants of QoL (all\u0026nbsp;\u003cem\u003eP\u003c/em\u003e \u0026gt; 0.05) (Table 6).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6\u0026nbsp;\u003c/strong\u003eLinear regression analysis illustrating the relationship between SWB (SWLS and ABS), anxiety, depression, and QoL in FD patients\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003eUnstandardized\u003c/p\u003e\n \u003cp\u003ecoefficients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003eStandardized\u003c/p\u003e\n \u003cp\u003ecoefficients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003eAdjusted R\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003eConstant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e24.949\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e19.719\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e0.135\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003eSWLS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e-0.120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e-0.117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e-2.291\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003eABS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e-1.018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e-0.329\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e-6.439\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eSWB, subjective well-being; QoL, quality of life; FD, functional dyspepsia;\u0026nbsp;SWLS,\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003esatisfaction with life scale;\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eABS,\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eaffect balance scale; R\u003csup\u003e2\u003c/sup\u003e,\u003csub\u003e\u0026nbsp;\u003c/sub\u003ethe fit degree of the model\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe factors influencing life satisfaction by multivariate analysis\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 7 showed that a multiple linear regression approach was conducted to examine the effects of age, gender, educational levels, anxiety, depression, DSS and QoL on life satisfaction. The results indicated that age, educational levels, anxiety and depression were significant influential factors for emotional balance (all \u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 7\u003c/strong\u003e\u0026nbsp; Linear regression analysis illustrating the relationship between age, educational levels, anxiety, depression, and life satisfaction in FD patients\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003eUnstandardized\u003c/p\u003e\n \u003cp\u003ecoefficients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003eStandardized\u003c/p\u003e\n \u003cp\u003ecoefficients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003eAdjusted R\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003eConstant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e18.771\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e11.916\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e0.169\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e0.085\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e0.194\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e3.679\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003eEducational levels\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e0.638\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e0.164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e3.134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003eAnxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e-0.299\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e-0.202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e-3.447\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003eDepression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e-0.252\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e-0.182\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003e-3.094\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eFD, functional dyspepsia;\u0026nbsp;R\u003csup\u003e2\u003c/sup\u003e,\u003csub\u003e\u0026nbsp;\u003c/sub\u003ethe fit degree of the model\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMultivariate analysis of factors influencing emotional balance\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA multiple linear regression approach was conducted to examine the effects of age, gender, education levels, DSS, anxiety, depression, and\u0026nbsp;QoL on emotional balance in FD patients. The results indicated that anxiety and depression were significant influential factors for emotional balance (all \u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05), as shown in Table 8.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 8\u0026nbsp;\u003c/strong\u003eLinear regression analysis illustrating the relationship between DSS, anxiety, depression, and emotional balance in FD patients\u0026nbsp;\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18px;\"\u003e\n \u003cp\u003eUnstandardized\u003c/p\u003e\n \u003cp\u003ecoefficients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003eStandardized\u003c/p\u003e\n \u003cp\u003ecoefficients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003eAdjusted R\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003eConstant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e6.654\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e28.512\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.388\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003eDSS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e-0.044\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e-0.101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e-1.919\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.056\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003eAnxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e-0.171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e-0.351\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e-6.961\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22px;\"\u003e\n \u003cp\u003eDepression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003e-0.137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e-0.300\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e-5.123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eFD, functional dyspepsia;\u0026nbsp;DSS, dyspepsia symptoms severity; R\u003csup\u003e2\u003c/sup\u003e,\u003csub\u003e\u0026nbsp;\u003c/sub\u003ethe fit degree of the model\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eTo our knowledge, to investigate whether SWB is associated with anxiety, depression, and symptom severity in FD patients, few relevant studies have been conducted. This study represents the first exploration of the effects of SWB on anxiety, depression, symptom severity, and QoL in FD patients.\u003c/p\u003e \u003cp\u003eOur findings indicate that SWB is negatively correlated with anxiety, depression, and symptom severity, which is positively associated with QoL, patients with more severe anxiety and depression symptoms tend to have lower life satisfaction and emotional balance, and dissatisfaction with current life is common among patients with anxiety and depression, leading to reduced life satisfaction, which was following the results in other diseases [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. This study also revealed no significant differences in SWB among the three subtypes of FD, and anxiety had a more significant impact on SWB compared to depression. Therefore, these results suggested that mitigating anxiety and depression may alleviate symptom severity and enhance QoL.\u003c/p\u003e \u003cp\u003eMultivariate analysis showed that SWB had a less significant impact on symptom severity and QoL compared to anxiety and depression, of which the fit degree of the model R\u003csup\u003e2\u003c/sup\u003e was low in this cross-sectional study, which suggested that the influence of SWB was easily ignored in FD patients. Medical staff often focused on the influence of anxiety and depression while neglecting the role of SWB in FD patients. However, considering the brain-gut interaction, anxiety and depression are increasingly recognized as contributing factors to the etiology of FD [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. There is an inverse relationship between SWB and resilience in depression [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Lower life satisfaction was associated with a significantly increased risk (OR\u0026thinsp;=\u0026thinsp;10.4) of moderate/severe depression over a 15-year follow-up of healthy adults [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Given that most FD cases are chronic, SWB can serve as a crucial potential indicator for studying the development and management of FD in future long-term follow-up studies.\u003c/p\u003e \u003cp\u003eThe determinants of SWB were classified into seven major domains: health and functioning, social support, socioeconomic status, demographic characteristics, personality traits, religious and cultural factors, and infrastructure and geography [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Socioeconomic status was identified as a significant factor influencing SWB [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. With societal economic development, the prevalence of FD has also increased [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Our findings revealed a positive correlation between patient age and life satisfaction with older individuals reporting higher levels of satisfaction, and higher educational level with higher levels of satisfaction. Additionally, social support emerged as a crucial determinant of SWB [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. However, medical interventions aimed at improving socioeconomic status and social support are limited in their effectiveness; therefore, this study primarily focused on assessing the health and functioning of SWB, including mental health aspects such as anxiety and depression.\u003c/p\u003e \u003cp\u003eTo enhance SWB, psychotherapeutic interventions have demonstrated moderate effects in reducing negative affect and enhancing positive affect among depressed adults [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. Educational programs and cognitive interventions have been shown to effectively improve SWB and promote resilience in elderly populations, thereby alleviating depressive symptoms [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. A positive optimistic personality trait can also contribute to higher SWB [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. Leisure time physical activity (LTPA) interventions have been found to promote SWB by improving health and functioning [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. Furthermore, Ludwigs et al. [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] demonstrated that both professional psychological training groups and control groups that repeatedly filled out scales of SWB could effectively enhance SWB without any statistically significant differences between them, and simply reinforcing the concept of SWB can lead to improvements. Therefore, strengthening content awareness of SWB is a simple and feasible approach to improving it.\u003c/p\u003e \u003cp\u003eThis study had the following limitations: Firstly, the data were derived from a single center of FD patients in one hospital, which may limit the generalizability of the findings. Secondly, this was a cross-sectional study that showed that SWB was negatively correlated with symptom severity, anxiety, and depression and positively correlated with QoL. However, as a cross-sectional study, it is limited in its ability to infer causality; therefore, a longitudinal cohort study is necessary to confirm whether enhancing SWB can reduce the incidence or severity of FD symptoms in future research. Thirdly, although SWB showed a negative correlation with anxiety, depression, and disease impact on QoL, the correlation coefficient in this study was below 0.7, indicating a weaker association. Fourthly, multiple linear regression analysis revealed that when including anxiety and depression, SWB did not significantly influence symptom severity and QoL, suggesting that SWB played a less significant role compared to anxiety and depression. Gastroenterology medical staff tended to focus more on the effects of anxiety and depression on FD while overlooking the impact of SWB. However, SWB associated with anxiety and depression, which are potentially the etiology of FD, and lower life satisfaction was associated with a significantly increased risk of moderate/severe depression over a long follow-up study [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. These results suggested that reinforcing the impact of FD patients' SWB may help reduce symptoms, which requires further confirmation in future long-term studies.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe study indicated that FD patients' SWB was negatively correlated with symptom severity, anxiety, and depression, and positively correlated with QoL. These results suggested that SWB could be considered as a potential indicator for studying the development and management of FD in future research, Furthermore, enhancing the SWB of FD patients through targeted interventions by medical staff may contribute to reducing symptom severity, anxiety, and depression levels while improving their QoL. These potential benefits warrant confirmation through long-term follow-up studies.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eFD Functional dyspepsia \u003c/p\u003e\n\u003cp\u003eSWB Subjective well-being \u003c/p\u003e\n\u003cp\u003eQoL Quality of life \u003c/p\u003e\n\u003cp\u003efALFF fractional amplitude of low frequency fluctuations \u003c/p\u003e\n\u003cp\u003eSNS Salience network \u003c/p\u003e\n\u003cp\u003eDMN Default mode network \u003c/p\u003e\n\u003cp\u003edFNC dynamic functional network connectivity \u003c/p\u003e\n\u003cp\u003eSWLS Satisfaction with life scale\u003c/p\u003e\n\u003cp\u003eABS Affect balance scale \u003c/p\u003e\n\u003cp\u003eGAD-7 Generalized anxiety disorders-7\u003c/p\u003e\n\u003cp\u003ePHQ-9 Patient healthy questionnaire-9\u003c/p\u003e\n\u003cp\u003eDSS Dyspepsia symptoms severity\u003c/p\u003e\n\u003cp\u003eNDI Nepean dyspepsia index\u003c/p\u003e\n\u003cp\u003eSD Standard deviation\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eYGZ conceptualized and designed the study, coordinated data collection, performed data analysis, and wrote the initial draft of the manuscript; WX assisted in data collection, contributed to the interpretation of results, and provided critical feedback on the manuscript draft; \u0026nbsp;XY assisted in data collection, conducted the literature review, contributed to the writing of the background section and revised the manuscript for intellectual content.; HGB prepared figures 1-8, provided technical support for data analysis, and contributed to the discussion of the results. The final manuscript was approved by all authors.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSpecial project on science and technology strategic cooperation between Nanchong city and schools（20SXQT0080）\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research data are available in the Supplementary Material. Additional datasets can be obtained from the corresponding author upon reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclarations\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that there are no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for this study was obtained from the Ethics Committee of the Affiliated Hospital of North Sichuan Medical College (Nanchong, China), and informed consent was obtained from all participants. In this study, all protocols were conducted according to the Declaration of Helsinki. Participants have the right to withdraw from the study at any time.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1 Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College, No. 1 South Maoyuan Road, Shunqing, Nanchong 637000, Sichuan, China \u0026nbsp; 2 School of Nursing, North Sichuan Medical College, No. 234 Fujiang Road, Shunqing, Nanchong 637000, Sichuan, China\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eDrossman D A, Hasler W L. Rome IV --functional GI disorders: disorders of gut- brain interaction. Gastroenterology.2016;150(6):1257-61.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eKim SE, Kim N, Lee JY, Park KS, Shin JE, Nam K, et al. 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Qual Life Res. 2024.\u003c/li\u003e\n \u003cli\u003eMas-Cuesta L, Baltruschat S, C\u0026aacute;ndido A, Verdejo-Lucas C, Catena-Verdejo E, Catena A. Brain changes following mindfulness: reduced caudate volume is associated with decreased positive urgency. Behav Brain Res. 2024;461.\u003c/li\u003e\n \u003cli\u003eMatsunaga M, Ohtsubo Y, Ishii K, Tsuboi H, Suzuki K, Takagishi H. Subjective well-being can be predicted by caudate volume and promotion focus. Brain Struct Funct. 2024.\u003c/li\u003e\n \u003cli\u003eCreswell JM. Educational research: planning, conducting, and evaluating quantitative and qualitative research. 4th ed. Upper Saddle River, NJ: Pearson Education Inc. 2012;147:609 \u0026ndash; 11.\u003c/li\u003e\n \u003cli\u003eYuan C, Yong G, Wang X, Xie T, Wang C, Yuan Y, et al. Developing the Patient Health Questionnaire-8 for a greater impact on the quality of life of patients with functional dyspepsia compared to Somatic Symptom Scale-8. BMC Gastroenterol. 2020 ;20(1):359.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eBradburn NM. The structure of psychological well-being. Chicago: Aldine. 1969.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eKrueger AB, Schkade DA. The reliability of subjective well-being Measures. J Public Econ. 2008 ;92(8-9):1833-45.\u003c/li\u003e\n \u003cli\u003eSpitzer RL,\u0026nbsp;Kroenke K,\u0026nbsp;Williams JB, L\u0026ouml;we B．\u0026nbsp;A brief measure for assessing generalized anxiety disorder: the GAD-7．Arch Intern Med. 2006;166( 10) : 1092-7．\u003c/li\u003e\n \u003cli\u003eKroenke K,\u0026nbsp;Spitzer RL,\u0026nbsp;Williams JB. The PHQ-9: Validity of a brief depression severity measure . 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Investigating the relationship between spiritual well-being, resilience, and depression: a cross-sectional study of the elderly. Psychogeriatrics. 2023;23(3):442-9.\u003c/li\u003e\n \u003cli\u003eDas KV, Jones-Harrell C, Fan Y, Ramaswami A, Orlove B, Botchwey N. Understanding subjective well-being: perspectives from psychology and public health. Public Health Rev. 2020;41(1):25.\u003c/li\u003e\n \u003cli\u003eAnglim J, Horwood S, Smillie LD, Marrero RJ, Wood JK. Predicting psychological and subjective well-being from personality: A meta-analysis. Psychol Bull. 2020;146(4):279-323.\u003c/li\u003e\n \u003cli\u003eNgamaba KH. Determinants of subjective well-being in representative samples of nations. Eur J Public Health. 2017 ;27(2):377-82.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eDiener E, Diener C, Choi H, Oishi S. Revisiting \u0026quot;most people are happy\u0026quot;-And discovering when they are not. Perspect Psychol Sci. 2018;13(2):166-70.\u003c/li\u003e\n \u003cli\u003eNgamaba KH, Panagioti M, Armitage CJ. How strongly related are health status and subjective well-being? Systematic review and meta-analysis. Eur J Public Health. 2017;27(5):879-85.\u003c/li\u003e\n \u003cli\u003eBoumparis N, Karyotaki E, Kleiboer A, Hofmann SG, Cuijpers P. The effect of psychotherapeutic interventions on positive and negative affect in depression: A systematic review and meta-analysis. J Affect Disord. 2016 ;202:153-62.\u003c/li\u003e\n \u003cli\u003eOkorie CO, Ogba FN, Aal. Zoom-based GROW coaching intervention for improving subjective well-being in a sample of school administrators: A randomized control trial. Internet Interv. 2022 ;29:10054\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eTodd KR, Lawrason SVC, Shaw RB, Wirtz D, Martin Ginis KA. Physical activity interventions, chronic pain, and subjective well-being among persons with spinal cord injury: a systematic scoping review. Spinal Cord. 2021;59(2):93-104.\u003c/li\u003e\n \u003cli\u003eHerbert C. Enhancing mental health, well-being and active lifestyles of university students by means of physical activity and exercise research programs. Front Public Health. 2022;25(10):849093.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-gastroenterology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmge","sideBox":"Learn more about [BMC Gastroenterology](http://bmcgastroenterol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmge/default.aspx","title":"BMC Gastroenterology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Functional dyspepsia, Subjective well-being, Anxiety, Depression, Quality of life","lastPublishedDoi":"10.21203/rs.3.rs-6109334/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6109334/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground \u003c/strong\u003eSubjective well-being (SWB) was subjective happiness, and it was also objective. Anxiety and depression are now gradually believed to be the causes of functional dyspepsia (FD). The influence of SWB was ignored in FD patients. To explore the influence of SWB on anxiety, depression, symptom severity and quality of life (QoL) in FD patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods \u003c/strong\u003eA total of 374 patients with FD were selected according to Roman IV criteria. Satisfaction with life scale and affect balance scale, Generalized anxiety disorders-7, Patient healthy questionnaire-9, Dyspepsia symptoms severity(DSS）and Nepean dyspepsia index(NDI） were used to assess SWB,anxiety, depression, symptoms severity and QoL, respectively. One-way variance analysis, t-test, Pearson’s correlation and multiple linear regression were used to analyze the results.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults \u003c/strong\u003eLife satisfaction and emotional balance of FD patients were negatively correlated with DSS, anxiety, depression, and NDI for QoL（r=-0.148,-0.330,-0.325,-0.195，\u003cem\u003e \u003c/em\u003eall \u003cem\u003eP\u003c/em\u003e\u0026lt;0.01), (r=-0.205,-0.545,-0.550, -0.357, all \u003cem\u003eP\u003c/em\u003e\u0026lt;0.001), respectively. Multiple linear regression showed that life satisfaction and emotional balance were influencing factors of anxiety（β= -0. 143, \u003cem\u003eP\u003c/em\u003e=0.001）, (β= -0. 318, \u003cem\u003eP\u003c/em\u003e\u0026lt;0.001)， and depression（β=-0. 122, \u003cem\u003eP\u003c/em\u003e=0.003）, (β= -0. 287, \u003cem\u003eP\u003c/em\u003e\u0026lt;0.001), respectively. After removing anxiety and depression, life satisfaction and emotional balance were influencing factors of patients' DSS （β= -0.105, \u003cem\u003eP\u003c/em\u003e=0.049）, (β= -0.180, \u003cem\u003eP\u003c/em\u003e=0.001), and QoL（β= -0.117, \u003cem\u003eP\u003c/em\u003e=0.023）, (β= -0.329,\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001) ,respectively.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions \u003c/strong\u003eFD patients’ SWB negatively affects their disease severity, anxiety and depression, and positively affects their QoL. These results suggested that further strengthening SWB may help reduce symptom severity and improve the QoL of patients, which needs to be confirmed by future follow-up studies.\u003c/p\u003e","manuscriptTitle":"The influence of subjective well-being on anxiety, depression and quality of life in patients with functional dyspepsia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-28 11:31:07","doi":"10.21203/rs.3.rs-6109334/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-05-09T05:21:37+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-08T23:47:47+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-06T17:00:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"16629302501744513619718033520361539329","date":"2025-04-28T20:04:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"199753555798519240374137233703749846996","date":"2025-04-26T06:38:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"233326403586561159402073893867711236142","date":"2025-04-25T13:48:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"68203241171590597391006430423100665047","date":"2025-04-25T08:45:54+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-25T08:00:51+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-17T06:40:07+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Gastroenterology","date":"2025-04-10T13:41:23+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-gastroenterology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmge","sideBox":"Learn more about [BMC Gastroenterology](http://bmcgastroenterol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmge/default.aspx","title":"BMC Gastroenterology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4cde4b4e-311e-4b7c-b575-4bca7c648a67","owner":[],"postedDate":"April 28th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-07-07T16:05:38+00:00","versionOfRecord":{"articleIdentity":"rs-6109334","link":"https://doi.org/10.1186/s12876-025-04075-8","journal":{"identity":"bmc-gastroenterology","isVorOnly":false,"title":"BMC Gastroenterology"},"publishedOn":"2025-07-01 15:58:09","publishedOnDateReadable":"July 1st, 2025"},"versionCreatedAt":"2025-04-28 11:31:07","video":"","vorDoi":"10.1186/s12876-025-04075-8","vorDoiUrl":"https://doi.org/10.1186/s12876-025-04075-8","workflowStages":[]},"version":"v1","identity":"rs-6109334","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6109334","identity":"rs-6109334","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}