Self-Perceived Stress and the Risk of Peptic Ulcer Disease

Anda, Robert F.; Williamson, David F.; Escobedo, Luis G.; Remington, Patrick L.; Mast, Eric E.; Madans, Jennifer H.

doi:10.1001/archinte.1992.00400160119023

Cited by 52 publications

(8 citation statements)

References 21 publications

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“…Anda et al found an increased risk of peptic ulcers (OR 1.8) in individuals with self-perceived stress during the month preceding baseline. The study further found evidence of a graded relationship between levels of self-perceived stress and the risk of a peptic ulcer (OR 1.4–2.9) [17]. Our study cannot confirm a graded relationship as only participants in the highest stress quintile were significantly more at risk of developing ulcers compared to participants in the lowest quintile.…”

Section: Resultscontrasting

confidence: 56%

“…Our study cannot confirm a graded relationship as only participants in the highest stress quintile were significantly more at risk of developing ulcers compared to participants in the lowest quintile. Anda et al excluded all respondents with former ulcers [17], whereas this study adjusted for former ulcers as we assumed that the disease was cured after treatment. In current study, stratified analysis based on former ulcers did not suggest a graded relationship and, therefore, it is probably not the reason for the discrepancy.…”

Section: Resultsmentioning

confidence: 99%

“…In current study, stratified analysis based on former ulcers did not suggest a graded relationship and, therefore, it is probably not the reason for the discrepancy. Although Anda et al also measured perceived stress during the last month, they based the degree of stress on one interview question [17], whereas the current study used 10 items. Wachirawat et al also found evidence of higher increased odds of a peptic ulcer in patients with high self-perceived stress levels (OR 2.9).…”

Section: Resultsmentioning

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: Resultscontrasting

confidence: 56%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

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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Lifestyle, Stress, and Genes in Peptic Ulcer Disease

Räihä

Kemppainen²,

Kaprio³

et al. 1998

Arch Intern Med

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The questionnaire and hospital usage data on peptic ulcer disease in the population-based twin cohort suggest that the familial aggregation of the disease is modest, and attributable almost solely to genetic factors. Environmental effects not shared by family members were significant predictors of disease, and they were attributable to smoking and stress in men and the use of analgesics in women. The minor effects of shared environment to disease liability do not support the concept that the clustering of risk factors, such as H pylori infection, would explain the familial accumulation of peptic ulcer disease.

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