We read with interest the article by Mak et al.1 The authors have provided some of the first stringent data linking psychological distress and functional dyspepsia (FD) defined by Rome III criteria. We suggest, however, that the authors' assertion that coincident onset between major depressive episodes and generalised anxiety disorder and FD is probably premature. We reiterate the authors' point that making causal inferences from cross-sectional data is problematic. Participants in this study were asked for their respective ages when each disorder first came on in their lives, to estimate the chronological association of the disorders.
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