Psychological stress may increase the incidence of peptic ulcer, according to a population-based study in Denmark. The studys investigators collected blood samples and psychological, medical and socioeconomic data from 3,379 Danish residents without prior peptic ulcers from 1982 to 1983. During 12 years of follow-up, based on participant interviews and hospital discharge data, 76 patients developed peptic ulcers. A 0- to 10-point stress index scale was used to measure stress on the basis of concrete life stressors and perceived distress.
On the basis of the stress index scale, ulcer incidence was significantly higher among subjects in the highest tertile of stress scores (3.5%) compared with the lowest tertile (1.6%), according to the study abstract. A one-point increase in the stress score increased the ulcer risk by 19% (1.19 odds ratio), according to the study abstract. This was unaffected by Helicobacter pylori status. Adjusting for socioeconomic status decreased the odds ratio to 1.17, and adjusting for smoking, use of nonsteroidal anti-inflammatory drugs and lack of exercise further decreased it to 1.11. On multivariable analysis, stress, socioeconomic status, smoking, H. pylori infection, and use of nonsteroidal anti-inflammatory drugs were independent predictors of ulcer.
The study concluded that psychological stress increased the incidence of peptic ulcer, in part by influencing health risk behaviors. Stress had similar effects on ulcers associated with H. pylori infection and those unrelated to either H. pylori or use of NSAIDs.
Read the abstract at http://www.cghjournal.org/article/S1542-3565(14)01136-7/fulltext.