A Validated Tool for Psychiatric Comorbidity in the Patients With Functional Dyspepsia: Author's Reply.

TO THE EDITOR: tudies on psychometric properties of screening questionnaires in chronic medical conditions are often criticized for their limited generalizability.1 The reason is obvious, as most studies are conducted in referral centres where referral bias is unavoidable.2 This might contribute to the high prevalence of psychiatric illness in our sample.3 This suggestion could be also observed by similar results in other studies.4-6 On the other hand, it is often difficult to make confirmed diagnosis of functional dyspepsia in primary care setting where endoscopic examination is not widely available. In addition, gold standard Structured Clinical Interview is difficult to be implemented in large scale, because as trained clinicians are needed to conduct this lengthy assessment in this process. In order to tackle this dilemma, one of the solutions is to conduct a population-based study, using 12-item General Health Questionnaire by general practitioners and family physicians before they refer their patients with functional dyspepsia for thorough psychiatric assessment. We hope to audit the appropriateness of this 12-item General Health Questionnaire as a screening tool in primary care setting.