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The latent structure of the functional dyspepsia symptom complex: a taxometric analysis
Author(s) -
Van Oudenhove L.,
Jasper F.,
Walentynowicz M.,
Witthöft M.,
Van den Bergh O.,
Tack J.
Publication year - 2016
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.12798
Subject(s) - medicine , psychology
Objectives Rome III introduced a subdivision of functional dyspepsia ( FD ) into postprandial distress syndrome and epigastric pain syndrome, characterized by early satiation/postprandial fullness, and epigastric pain/burning, respectively. However, evidence on their degree of overlap is mixed. We aimed to investigate the latent structure of FD to test whether distinguishable symptom‐based subgroups exist. Methods Consecutive tertiary care Rome II FD patients completed the dyspepsia symptom severity scale. Confirmatory factor analysis ( CFA ) was used to compare the fit of a single factor model, a correlated three‐factor model based on Rome III subgroups and a bifactor model consisting of a general FD factor and orthogonal subgroup factors. Taxometric analyses were subsequently used to investigate the latent structure of FD . Key Results Nine hundred and fifty‐seven FD patients (71.1% women, age 41 ± 14.8) participated. In CFA , the bifactor model yielded a significantly better fit than the two other models ( χ ² difference tests both p < 0.001). All symptoms had significant loadings on both the general and the subgroup‐specific factors (all p < 0.05). Somatization was associated with the general ( r = 0.72, p < 0.01), but not the subgroup‐specific factors (all r < 0.13, p > 0.05). Taxometric analyses supported a dimensional structure of FD (all CCFI <0.38). Conclusions and Inferences We found a dimensional rather than categorical latent structure of the FD symptom complex in tertiary care. A combination of a general dyspepsia symptom reporting factor, which was associated with somatization, and symptom‐specific factors reflecting the Rome III subdivision fitted the data best. This has implications for classification, pathophysiology, and treatment of FD .