Decreased stress resilience in young men significantly increases the risk of subsequent peptic ulcer disease – a prospective study of 233 093 men in Sweden

Melinder, Carren; Udumyan, Ruzan; Hiyoshi, Ayako; Brummer, Robert Jan; Montgomery, Scott

doi:10.1111/apt.13168

Cited by 27 publications

(17 citation statements)

References 41 publications

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“…Earlier studies investigating peptic ulcer with stress measured preceding the ulcer also found significant increases in risk. Melinder et al found that low stress resilience in adolescent males increased the risk of peptic ulcers in adulthood (HR 1.84) compared with high stress resilience [16]. Ruigomez et al reported increased odds of peptic ulcers (OR 1.58) in a nested case control study among patients who had been diagnosed with stress before their peptic ulcer diagnosis [13], and Levenstein et al found an increased risk in another Danish sample (OR 2.2) using a stress index preceding 12 years of follow-up.…”

Section: Resultsmentioning

confidence: 99%

“…This hypothesis was supported by several recent studies. In a sample of 233,093 Swedish males, decreased stress resilience significantly increased the risk of peptic ulcers [16]. Levenstein et al [10] concluded that psychological stress increased the incidence of peptic ulcers, regardless of H. pylori infection or NSAID use.…”

Section: Introductionmentioning

confidence: 99%

“…A number of factors have been identified as possible determinants in the development of peptic ulcers (smoking [2, 17–24], NSAID use [2, 5, 7, 17, 20], gender [9, 17, 25, 26], age [17, 21, 26], socioeconomic status [9, 25, 27–29], alcohol consumption [18, 22, 24], gastric acid secretion [3, 16], lack of sleep [18], home crowding [16], strenuous work [9, 29], family history [30] and body weight [15, 21]). Furthermore, a number of studies indicated stress or stress-related incidents as a risk factor for the development of a peptic ulcer [5, 13, 16, 17, 21, 30].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, a number of studies indicated stress or stress-related incidents as a risk factor for the development of a peptic ulcer [5, 13, 16, 17, 21, 30]. Other studies have found no evidence that peptic ulcers are a psychosomatic disorder [22, 31, 32].…”

Section: Introductionmentioning

confidence: 99%

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Perceived stress as a risk factor for peptic ulcers: a register-based cohort study

et al. 2016

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BackgroundThe association between stress and peptic ulcers has been questioned since the discovery of helicobacter pylori. This study examined whether high perceived everyday life stress was associated with an increased risk of either receiving a triple treatment or being diagnosed with a peptic ulcer.MethodsCohen’s perceived stress scale measured the level of stress in a general health survey in 2010 of 17,525 residents of northern Jutland, Denmark, and was linked with National Danish registers on prescription drugs and hospital diagnoses. Cox proportional hazard regression was used to estimate the risk of either receiving a triple treatment or being diagnosed in a hospital with a peptic ulcer, in relation to quintiles of stress levels.ResultsA total of 121 peptic ulcer incidents were recorded within 33 months of follow-up. The lowest stress group had a cumulative incidence proportion of either receiving triple treatment or being diagnosed with peptic ulcer of approximately 0.4%, whereas the highest stress group had a cumulative incidence proportion of approximately 1.2%. Compared with that of the lowest stress group, those in the highest stress group had a 2.2-fold increase in risk of either receiving triple treatment or being diagnosed with peptic ulcer (HR 2.24; CI 95% 1.16:4.35) after adjustment for age, gender, socioeconomic status, non-steroid anti-inflammatory drug use, former ulcer and health behaviours. There was no difference in risk between the four least stressed quintiles. Subgroup analysis of diagnosed peptic ulcer patients revealed the same pattern as the main analysis, although the results were not significant.ConclusionThe highest level of perceived everyday life stress raised the risk of either receiving triple treatment or being diagnosed with peptic ulcer during the following 33 months more than twice compared with that of the lowest level of perceived stress.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Perceived stress as a risk factor for peptic ulcers: a register-based cohort study

et al. 2016

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“…A validation study in which 30 recorded interviews from 1972-1973 were scored by 30 psychologists reported high interrater reliability (correlation 0.86) [15]. Low stress resilience using these data has previously been examined in relation to other outcomes, including coronary heart disease [16], stroke [17] and peptic ulcer disease [18]. …”

Section: Methodsmentioning

confidence: 99%

Stress resilience and subsequent risk of type 2 diabetes in 1.5 million young men

et al. 2016

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Aims/hypothesis Psychosocial stress in adulthood is associated with a higher risk of type 2 diabetes, possibly mediated by behavioural and physiological factors. However, it is unknown whether low stress resilience earlier in life is related to subsequent development of type 2 diabetes. We examined whether low stress resilience in late adolescence is associated with an increased risk of type 2 diabetes in adulthood. Methods We conducted a national cohort study of all 1,534,425 military conscripts in Sweden during 1969-1997 (97-98% of all 18-year-old men nationwide each year) without prior diagnosis of diabetes, who underwent standardised psychological assessment for stress resilience (on a scale of 1-9) and were followed up for type 2 diabetes identified from outpatient and inpatient diagnoses during 1987-2012 (maximum attained age 62 years). Results There were 34,008 men diagnosed with type 2 diabetes in 39.4 million person-years of follow-up. Low stress resilience was associated with an increased risk of developing type 2 diabetes after adjusting for BMI, family history of diabetes, and individual and neighbourhood socioeconomic factors (HR for lowest vs highest quintile: 1.51; 95% CI 1.46, 1.57; p<0.0001), including a strong linear trend across the full range of stress resilience (ptrend<0.0001). This association did not vary by BMI level, family history of diabetes or socioeconomic factors. Conclusions/interpretation These findings suggest that low stress resilience may play an important long-term role in aetiological pathways for type 2 diabetes. Further elucidation of the underlying causal factors may help inform more effective preventive interventions across the lifespan.

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Association of Late Adolescent Personality With Risk for Subsequent Serious Mental Illness Among Men in a Swedish Nationwide Cohort Study

et al. 2017

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Decreased stress resilience in young men significantly increases the risk of subsequent peptic ulcer disease – a prospective study of 233 093 men in Sweden

Cited by 27 publications

References 41 publications

Perceived stress as a risk factor for peptic ulcers: a register-based cohort study

Perceived stress as a risk factor for peptic ulcers: a register-based cohort study

Stress resilience and subsequent risk of type 2 diabetes in 1.5 million young men

Association of Late Adolescent Personality With Risk for Subsequent Serious Mental Illness Among Men in a Swedish Nationwide Cohort Study

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