Association of anxiety, depression, and psychological distress in people with and without functional dyspepsia

Global prevalence of functional dyspepsia according to Rome criteria, 1990-2020: a systematic review and meta-analysis

Although functional dyspepsia (FD) is a common functional gastroduodenal disorder with a high socioeconomic burden, little is known about its global prevalence. Thus, we performed a comprehensive study to estimate long-term trends in the prevalence of FD. We searched PubMed/MEDLINE, Embase, and Google Scholar from 1990 to 2022 for population-based studies that reported the prevalence of FD in adults (≥ 18 years old) according to Rome I, II, III, or IV criteria. The prevalence of FD was extracted from included studies to obtain pooled prevalence with 95% confidence intervals (CI) and 95% prediction intervals. Subgroup analysis was performed according to certain characteristics, including geographic region. A total of 44 studies met the eligibility criteria, including 256,915 participants from 40 countries across six continents. The overall global pooled prevalence of FD was 8.4% (95% CI 7.4-.9.5). The prevalence was the highest in Rome I (11.9%; 95% CI 5.1-25.4) and lowest in Rome IV (6.8%; 95% CI 5.8-7.9). Developing countries showed a higher prevalence than developed countries (9.1% versus 8.0%), and prevalence was higher in women, irrespective of the definition used (9.0% versus 7.0%). The pooled prevalence gradually decreased from 1990 to 2020 (12.4% [8.2-18.3] in 1990-2002 versus 7.3% [6.1-8.7] in 2013-2020). The prevalence of FD differs by country, economic status, geographical region, and sex, and the global prevalence has been gradually declining. Despite the heterogeneity of sample population, our study estimates the current global burden of FD and provides information to heath care policy decisions.

Meranzin Hydrate Improves Depression-Like Behaviors and Hypomotility via Ghrelin and Neurocircuitry

OBJECTIVE

To investigate whether meranzin hydrate (MH) can alleviate depression-like behavior and hypomotility similar to Chaihu Shugan Powder (CSP), and further explore the potential common mechanisms.

METHODS

Totally 120 Spraque-Dawley rats were randomly divided into 5-8 groups including sham, vehicle, fluoxetine (20 mg/kg), mosapride (10 mg/kg), CSP (30 g/kg), MH (9.18 mg/kg), [D-Lys3]-GHRP-6 (Dlys, 0.5 mg/kg), and MH+Dlys groups by a random number table, 8 rats in each group. And 32 mice were randomly divided into wild-type, MH (18 mg/kg), growth hormone secretagogue receptor-knockout (GHSR-KO), and GHSR+MH groups, 8 mice in each group. The forced swimming test (FST), open field test (OFT), tail suspension test (TST), gastric emptying (GE) test, and intestinal transit (IT) test were used to assess antidepressant and prokinetic (AP) effects after drug single administration for 30 min with absorbable identification in rats and mice, respectively. The protein expression levels of brain-derived neurotrophic factor (BDNF) and phosphorylated mammalian target of rapamycin (p-mTOR) in the hippocampus of rats were evaluated by Western blot. The differences in functional brain changes were determined via 7.0 T functional magnetic resonance imaging-blood oxygen level-dependent (fMRI-BOLD).

RESULTS

MH treatment improved depression-like behavior (FST, OFT) and hypomotility (GE, IT) in the acute forced swimming (FS) rats (all P<0.05), and the effects are similar to the parent formula CSP. The ghrelin antagonist [D-Lys3]-GHRP-6 inhibited the effect of MH on FST and GE (P<0.05). Similarly, MH treatment also alleviated depression-like behavior (FST, TST) in the wild-type mice, however, no effects were found in the GHSR KO mice. Additionally, administration of MH significantly stimulated BDNF and p-mTOR protein expressions in the hippocampus (both P<0.01), which were also prevented by [D-Lys3]-GHRP-6 (P<0.01). Besides, 3 main BOLD foci following acute FS rats implicated activity in hippocampus-thalamus-basal ganglia (HTB) circuits. The [D-Lys3]-GHRP-6 synchronously inhibited BOLD HTB foci. As expected, prokinetic mosapride only had effects on the thalamus and basal ganglia, but not on the hippocampus. Within the HTB, the hippocampus is implicated in depression and FD.

CONCLUSIONS

MH accounts for part of AP effects of parent formula CSP in acute FS rats, mainly via ghrelin-related shared regulation coupled to BOLD signals in brain areas. This novel functionally connection of HTB following acute stress, treatment, and regulation highlights anti-depression unified theory.

The difference of disrupted rhythms of life, work and entertainment between patients with FGIDs and healthy people and their associations with psychological disorders under COVID-19 pandemic

AIMS

To investigate the differences in disrupted rhythms between healthy people and patients with functional gastrointestinal disorders (FGIDs) and their associations with mood disorders during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

The rhythm scales were composed of subscales 1 and 2 for the assessment of life-work and entertainment rhythms, respectively; Zung's Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to assess mood disorders.

RESULTS

A total of 671 patients with FGIDs and 4373 healthy people successfully participated. The scores of subscales 1 and 2 for patients with FGIDs were significantly higher than those for healthy people (p < .005). The SAS and SDS scores, their prevalence rates were significantly higher than those for the healthy group (all p < .001). Health status, current occupation, life-work rhythm, SDS, and SAS were independent related factors of FGIDs. The score of life-work-entertainment rhythm was significantly positively correlated with SDS and SAS (both p < .001).

CONCLUSION

Disrupted rhythms in patients with FGIDs under the COVID-19 pandemic were more frequently and significantly positively associated with mood disorders.

The role of amygdala neuropsin/serpinb6 pathway in the regulation of gastric hypersensitivity and anxiety by electroacupuncture

OBJECTIVE

To investigate whether the neuropsin pathway in the amygdala and stomach may participate in the development of anxiety-related gastric hypersensitivity, and whether electroacupuncture (EA) at the Zusanli acupoint could improve this condition by regulating such pathway in the rat model of functional dyspepsia (FD).

METHODS

A total of 48 SD rats were randomly divided into the control group, FD model group and FD + EA group (stimulation at Zusanli acupoint for 30 min daily for 7 consecutive days). Abdominal withdrawal reflex (AWR) score and open field test were used to evaluate visceral hypersensitivity and anxiety-like disorder, respectively. Electrical activity in the amygdala nucleus in each group was recorded by extracellular electrophysiology. Neuropsin and serpinb6 protein expressions in the amygdala and stomach were detected by Western blot.

RESULTS

AWR score in the FD group increased but did not differ after EA therapy than that in the contro group. Both the center square entries and center entries ratio in the FD group were lower than those in the control and FD + EA groups. The total number and frequency of amygdala nucleus discharges induced by gastric distension in the FD group were significantly higher than those in the control and FD + EA groups. Expression of neuropsin increased and that of serpinb6 decreased in the gastric mucosa and amygdale in the FD group, while no change was observed in gastric mucosa after EA therapy.

CONCLUSION

EA stimulation at the Zusanli acupoint may improve visceral hypersensitivity and anxiety in FD rats through the neuropsin/serpinb6 pathway.

Impact of Best-Fitted Control Selection on Effect Size: An Example in Functional GI Disorder Case-Control Studies

BACKGROUND

Effect sizes are the most useful quantities for communicating the practical significance of results and helping to facilitate cumulative science. We hypothesize that the selection of the best-fitted controls can significantly affect the estimated effect sizes in case-control studies. Therefore, we decided to exemplify and clarify this effect on effect size using a large data set. The objective of this study was to investigate the association among variables in functional gastrointestinal disorders (FGIDs) and mental health problems, common ailments that reduce the quality of life of a large proportion of the community worldwide.

METHOD

In this methodological study, we constitute case and control groups in our study framework using the Epidemiology of Psychological, Alimentary Health and Nutrition (SEPAHAN) dataset of 4763 participants. We devised four definitions for control in this extensive database of FGID patients and analyzed the effect of these definitions on the odds ratio (OR): 1. conventional control: without target disorder/syndrome (sample size 4040); 2. without any positive criteria: criterion-free control (sample size 1053); 3. syndrome-free control: without any disorder/syndrome (sample size 847); 4. symptom-free control: without any symptoms (sample size 204). We considered a fixed case group that included 723 patients with a Rome III-based definition of functional dyspepsia. Psychological distress, anxiety, and depression were considered as dependent variables in the analysis. Logistic regression was used for association analysis, and the odds ratio and 95% confidence interval (95%CI) for OR were reported as the effect size.

RESULTS

The estimated ORs indicate that the strength of the association in the first case-control group is the lowest, and the fourth case-control group, including controls with completely asymptomatic people, is the highest. Ascending effect sizes were obtained in the conventional, criterion-free, syndrome-free, and symptom-free control groups. These results are consistent for all three psychological disorders, psychological distress, anxiety, and depression.

CONCLUSIONS

This study shows that a precise definition of the control is mandatory in every case-control study and affects the estimated effect size. In clinical settings, the selection of symptomatic controls using the conventional definition could significantly diminish the effect size.

The Usefulness of Symptom-based Subtypes of Functional Dyspepsia for Predicting Underlying Pathophysiologic Mechanisms and Choosing Appropriate Therapeutic Agents

Functional dyspepsia (FD) is considered to be a heterogeneous disorder with different pathophysiological mechanisms or pathogenetic factors. In addition to traditional mechanisms, novel concepts regarding pathophysiologic mechanisms of FD have been proposed. Candidates of therapeutic agents based on novel concepts have also been suggested. FD is a symptom complex and currently diagnosed by symptom-based Rome criteria. In the Rome criteria, symptom-based subtypes of FD including postprandial distress syndrome and epigastric pain syndrome are recommended to be used, based on the assumption that each subtype is more homogenous in terms of underlying pathophysiologic mechanisms than FD as a whole. In this review, the usefulness of symptombased subtypes of FD for predicting underlying pathophysiologic mechanisms and choosing appropriate therapeutic agents was evaluated. Although several classic pathophysiologic mechanisms are suggested to be associated with individual dyspeptic symptoms, symptom-based subtypes of FD are not specific for a certain pathogenetic factor or pathophysiologic mechanism, and may be frequently associated with multiple pathophysiologic abnormalities. Novel concepts on the pathophysiology of FD show complex interactions between pathophysiologic mechanisms and pathogenetic factors, and prediction of underlying mechanisms of individual patients simply by the symptom pattern or symptom-based subtypes may not be accurate in a considerable proportion of cases. Therefore, subtyping by the Rome criteria appears to have limited value to guide therapeutic strategy, suggesting that the addition of objective parameters or subclassification reflecting physiologic or pathologic tests may be necessary for the targeted therapeutic approaches, particularly when therapeutic agents targeting novel mechanisms are available.

Impaired pain empathic abilities among patients with functional dyspepsia

INTRODUCTION

Brain structure or functioning abnormality in regions such as insula and anterior cingulate cortex (ACC) is associated with functional dyspepsia (FD) and pain empathy, but the relationship between FD and pain empathy remains unclear. The aim of this study was to compare the pain empathic abilities of FD patients and healthy controls (HCs) and investigate the association of pain empathy with clinical characteristics and quality of life of FD patients.

METHODS

Pain empathic abilities was measured in 30 FD patients and 30 HCs using a validated pain empathy paradigm. Demographic characteristics, Helicobacter pylori status, duration, dyspeptic symptom score and Nepean Dyspepsia Life Quality Index (NDLQI) were obtained from all patients.

RESULTS

FD patients scored higher than HCs when rating painful pictures, but the accuracy for painful pictures was significantly lower than HCs. Pearson correlation analysis showed significant negative correlation between NDLQI and pain rating scores for painful pictures. When sex, age, educational level, the number of complaints, duration, H. pylori infection and NDLQI were included in multiple linear regression analysis, NDLQI was independently associated with pain ratings.

CONCLUSIONS

FD patients showed abnormally enhanced pain empathic abilities, which may be associated with the severity of symptoms and quality of life.

Update on Indigestion

Dyspepsia affects a large percentage of the general population and can lead to lost work productivity and reduced quality of life. Patients with dyspepsia younger than 60 should not routinely undergo endoscopy but instead should pursue Helicobacter pylori test-and-treat approach. For patients 60 and older, endoscopy should be performed. Patients without any identifiable cause for their symptoms are diagnosed with functional dyspepsia. Guideline-based treatment includes H pylori eradication and proton pump inhibitor use. If acid suppression is not adequate, treatment with a tricyclic antidepressant followed by a prokinetic agent and psychological therapy are considered. Complementary therapies are not recommended due to limited evidence.

Correlation between lifestyle and social factors in functional dyspepsia among college freshmen

Objective

We aimed to examine the relationship between the prevalence of functional dyspepsia (FD) and lifestyle habits, to identify social factors that may contribute to psychosocial disorders.

Methods

We enrolled 759 university freshmen in this study, who were categorized into the FD group and healthy group. All participants completed the validated Self-Rating Depression Scale and Self-Rating Anxiety Scale questionnaires, to assess lifestyle and social factors among participants.

Results

The proportion of participants with FD was 16.86%, and 67.97% were women. Diet irregularities and sleep impairment may have an effect on FD. Tea consumption may play a role in preventing FD. Participants with FD were more likely to have mood disorders than healthy participants. Most participants with FD who had mood disorders experienced mild anxiety or depression. Participants’ main sources of stress arose from daily life, development, social life, life events, and participants’ daily schedule.

Conclusion

Sex and lifestyle habits, including sleeping patterns and dietary habits, can have an impact on FD. Social stress and mood disorders also have an effect on FD. FD may be prevented by adjusting lifestyle habits and psychological counseling.

Personality traits are related to functional dyspepsia in a large sample of Iranian adults

BACKGROUND AND OBJECTIVE

Few studies have evaluated the association of personality traits with functional dyspepsia (FD). In the present study, we aimed to explore the relationship between different personality traits and FD in a sample of Iranian adults.

METHODS

This cross-sectional study was conducted on 4763 adults. FD was evaluated using a modified and validated Persian version of the Rome III questionnaire for the diagnosis of functional gastrointestinal disorders. Personality traits were assessed using the five-factor model. Logistic regression was used for data analysis.

RESULTS

After controlling for various potential confounders, neuroticism (OR = 1.043; 95% CI: 1.028, 1.059), agreeableness (OR = 0.965; 95% CI: 0.952, 0.978), extraversion (OR = 0.985; 95% CI: 0.970, 0.990), openness (OR = 0.981; 95% CI: 0.966, 0.996), and conscientious (OR = 0.980; 95% CI: 0.968, 0.991) scores were associated with risk of FD. Similar significant associations were observed in stratified analyses by sex, except for openness which tended to decrease the risk of FD marginally in women (OR = 0.983, 95% CI: 0.966, 1.001) and in men (OR = 0.979, 95% CI: 0.955, 1.003) after adjusting for multiple confounding variables.

CONCLUSION

Our study showed that the higher scores of extraversion, conscientiousness, openness, and agreeableness are independently associated with a lower risk of FD in Iranian general population while higher scores of neuroticism increase the risk of FD.

Clinical Practice Guidelines for Functional Dyspepsia in Korea

Functional dyspepsia (FD) is a chronic upper gastrointestinal (GI) symptom complex that routine diagnostic work-up, such as endoscopy, blood laboratory analysis, or radiological examination, fails to identify a cause. It is highly prevalent in the World population, and its response to the various available therapeutic strategies is only modest because of the heterogenous nature of its pathogenesis. Therefore, FD represents a heavy medical burden for healthcare systems. We constituted a guideline development committee to review the existing guidelines on the management of functional dyspepsia. This committee drafted statements and conducted a systematic review and meta-analysis of various studies, guidelines, and randomized control trials. External review was also conducted by selected experts. These clinical practice guidelines for FD were developed based on evidence recently accumulated with the revised version of FD guidelines released in 2011 by the Korean Society of Neurogastroenterology and Motility. These guidelines apply to adults with chronic symptoms of FD and include the diagnostic role of endoscopy, Helicobacter pylori screening, and systematic review and meta-analyses of the various treatment options for FD (proton pump inhibitors, H.pylori eradication, and tricyclic antidepressants), especially according to the FD subtype. The purpose of these new guidelines is to aid the understanding, diagnosis, and treatment of FD, and the targets of the guidelines are clinicians, healthcare workers at the forefront of patient care, patients, and medical students. The guidelines will continue to be revised and updated periodically.

The association between functional dyspepsia and depression: a meta-analysis of observational studies

Concomitant functional dyspepsia (FD) and psychosocial stressors have been reported; however, the association between FD and depression remains controversial and no quantitative meta-analysis exists. Published articles were identified through a comprehensive review of PubMed, Embase, and Web of Science from inception to the 8 July 2018. The pooled odds ratios (ORs) with 95% confidence intervals and subgroup analyses were calculated using a random-effects model. Findings for a total of 59 029 individuals were pooled across 23 studies and examined. Our analyses showed a positive association between FD and depression, with an OR of 2.28 (95% confidence interval: 2.02-3.81; I=100%). In the subgroup analysis, FD patients in Europe (OR=6.19) were more likely to have depression compared with Asians (OR=2.47); the overall significance results decreased the most in subgroup which the overall significance of the subgroup analyses results decreased the most in studies that adjusted for BMI (OR=1.42). Our meta-analysis showed a positive association between FD and depression. Further large-scale prospective cohort studies are needed to investigate the causality between FD and depression.

Gene Polymorphisms and Susceptibility to Functional Dyspepsia: A Systematic Review and Meta-Analysis

Functional dyspepsia (FD) is a common chronic gastrointestinal disorder with a complex, undefined mechanism. Clustering of patients with FD in families highlights the role of genetic factors in the pathogenesis of FD. We performed a systematic review and meta-analysis to clarify the associations between specific gene polymorphisms and FD susceptibility. PubMed, EMBASE, the Cochrane Library, and HuGE database were searched. An additive model was adopted to determine whether previous studied genes are associated with FD susceptibility. Carriers of minor allele in GNB3 825C>T (OR = 1.15, 95% CI 0.99-1.34, P = 0.07), SCL6A4 5HTTLPR (OR = 0.92, 95% CI 0.75-1.12, P = 0.40), and CCK-1R 779T>C (OR = 0.86, 95% CI 0.72-1.03, P = 0.09) genes failed to demonstrate susceptibility to FD. In a subgroup analysis, only minor allele (T) in GNB3 825C>T was associated with an increased susceptibility to the epigastric pain syndrome subtype (OR = 1.34, 95% CI 1.10-1.63, P = 0.003). Our meta-analysis based on available studies using an additive model failed to show that GNB3, SCL6A4, and CCK-1R polymorphisms are associated with FD susceptibility.

Effects of comfort care on symptoms, gastric motility, and mental state of patients with functional dyspepsia

Functional dyspepsia (FD) is a common upper gastrointestinal disorder globally, but the current treatments for FD are still unsatisfactory. This study was aimed at investigating the effects of comfort care on symptoms, gastric motility, and mental state of patients with FD.One hundred consecutive patients with FD treated at the Wuhan Union Hospital (Wuhan, China) between 03/2016 and 02/2018 were randomized to routine nursing and comfort care on the basis of routine nursing (50 patients/group), all for 8 weeks. The primary endpoint was FD symptom score. The secondary endpoint included gastric emptying rate, gastric motility parameters, and depression and anxiety scores. The endpoints were assessed at baseline and after 8 weeks.There were no significant differences between the 2 groups for gender, age, body mass index, types of FD, and course of disease (P > .05). The symptom score in the comfort care group at week 8 was lower than in the routine nursing group (8.3 ± 2.4 vs 10.2 ± 2.4, P < .001). The gastric emptying rate in the comfort care group at week 8 was higher than in the routine nursing group (28.6 ± 5.1 vs 24.3 ± 5.5, P < .001). The fasting and postprandial dominant frequencies of electrogastrogram in the comfort care group at week 8 were higher than in the routine nursing group (1.9 ± 0.9 vs 1.8 ± 1.0, P = .004; 3.1 ± 1.0 vs 2.1 ± 0.9, P < .001). The postprandial dominant power of electrogastrogram in the comfort care group at week 8 was higher than in the routine nursing group (55.7 ± 11.5 vs 42.3 ± 12.5, P < .001). The cases of abnormal electrogastrogram rhythm in the comfort care group at week 8 were significantly less than in the routine nursing group (P = .003). The self-rating depression scale and self-rating anxiety scale in the comfort care group at week 8 were significantly lower than in the routine nursing group (42.5 ± 6.9 vs 47.3 ± 6.4, P = .001; 41.1 ± 7.2 vs 46.3 ± 6.9, P < .001).Comfort care reduces the symptoms of patients with FD, increases gastric emptying rate, improves gastric motility, relieves patient's depression and anxiety, and promotes the rehabilitation of the disease.

Helicobacter pylori Vacuolating Cytotoxin A Causes Anorexia and Anxiety via Hypothalamic Urocortin 1 in Mice

Helicobacter pylori (Hp) infection is related to the pathogenesis of chronic gastric disorders and extragastric diseases. Here, we examined the anorexigenic and anxiogenic effects of Hp vacuolating cytotoxin A (VacA) through activation of hypothalamic urocortin1 (Ucn1). VacA was detected in the hypothalamus after peripheral administration and increased Ucn1 mRNA expression and c-Fos-positive cells in the hypothalamus but not in the nucleus tractus solitarius. c-Fos and Ucn1-double positive cells were detected. CRF1 and CRF2 receptor antagonists suppressed VacA-induced anxiety and anorexia, respectively. VacA activated single paraventricular nucleus neurons and A7r5 cells; this activation was inhibited by phospholipase C (PLC) and protein kinase C (PKC) inhibitors. VacA causes anorexia and anxiety through the intracellular PLC-PKC pathway, migrates across the blood-brain barrier, and activates the Ucn1-CRF receptor axis.

Association between psycho-psychological factors and functional dyspepsia in elderly patients: Effect on activity of daily living score

AIM

To analyze the association between psycho-psychological factors and functional dyspepsia (FD) in elderly patients and the effect on patients' activity of daily living (ADL) score.

METHODS

Sixty elderly psychiatric patients with FD admitted to Shaoxing Seventh People's Hospital from August 2016 to September 2017 were selected as a study group, and 60 patients with FD with good mental status were selected as a control group. Psycho-psychological status and gastric function indexes were tested in both groups. The self-rating anxiety scale, self-rating depression scale, 24 h heart rate variability and water stress test were also used to assess the patients in the two groups.

RESULTS

The self-rating anxiety scale and self-rating depression scale scores of elderly patients in the study group were significantly higher than those in the control group (P < 0.05), and the number of patients with anxiety and depression in the study group was significantly higher than that in the control group (P < 0.05). The initial sensation and maximum tolerance of the water load test in the study group were significantly lower than those in the control group (P < 0.05), and the time to semi-emptying of gastric solids in the study group was significantly longer than that in the control group (P < 0.05). The incidence of adverse reactions in the study group was significantly lower than that in the control group (P < 0.05). ADL scores of elderly patients in the study group were significantly higher than those in the control group before and after treatment (P < 0.05).

CONCLUSION

Psycho-psychological status of patients is closely related to the development and progression of FD, and may cause damage to the gastric sensory function and motor function of the patients.

Definition, Pathogenesis, and Management of That Cursed Dyspepsia

Dyspepsia is an umbrella term used to encompass a number of symptoms thought to originate from the upper gastrointestinal tract. These symptoms are relatively nonspecific; not surprisingly, therefore, a myriad of conditions may present with any one or a combination of these symptoms. Therein lays the clinician's first challenge: detecting the minority who may have a potentially life-threatening disorder, such as gastric cancer, from a population whose symptoms are, for the most part, considered functional in origin. The second challenge lies in the definition and management of those individuals with functional dyspepsia (FD); the major focus of this review. The Rome process has addressed the issue of FD definition and a look back at the evolution of Rome criteria for this disorder illustrates the complexities that have so frustrated us. There has been no shortage of hypotheses to explain symptom pathogenesis in FD; initially focused on gastric sensorimotor dysfunction, these have now strayed well into the duodenum and have come to entertain such factors as immune responses and the microbiome. FD has proven to be an equally challenging area for therapeutics; while the staple approaches of acid suppression and eradication of Helicobacter pylori have some limited efficacy in select populations, strategies to ameliorate symptoms in the majority of sufferers based on presumed pathophysiology have largely foundered. Lacking a validated biomarker(s) FD continues to be an elusive target and is likely to remain so until we can better define the various phenotypes that it must surely contain.

Pharmacokinetic Study of 7 Compounds Following Oral Administration of Fructus Aurantii to Depressive Rats

In the present study, the pharmacokinetics of multi-components (naringenin, nobiletin, meranzin hydrate, narirutin, naringin, hesperidin, and neohesperidin) were investigated in acute depressive rats following oral administration of Fructus Aurantii (Zhi-Qiao, ZQ) extract (20 g/kg). A rapid and reliable liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was established to quantitatively or qualitatively analyze the 7 absorbed ingredients in the plasma, hippocampus and cortex of acute depressive rats. Biological samples were separated on a 300SB-C18 column, and the 7 compounds were detected with sequential positive and negative ionization modes. Our results confirmed that ZQ has antidepressant effects by decreasing the immobility time. In addition, this validated method showed good linearity (r ≥ 0.9987), and the lower limits of quantification were 2.73–16.38 ng/mL for the 7 analytes. This method successfully determined the pharmacokinetics of the 7 compounds and separated two pairs of isomers in plasma of acute depressive rats following oral administration of ZQ extracts. The 7 active ingredients were also identified as marked compounds in target tissues and should be further examined in pharmacokinetic studies with acute depressive rats. So, pharmacokinetic compounds were precisely linked with the antidepressant effect of ZQ in our study. This relationship is well-understood and contributes to the application of Traditional Chinese Medicine (TCM).