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Scand J Gastroenterol. 2017 Sep;52(9):954-961. doi: 10.1080/00365521.2017.1324897. Epub 2017 May 14.

Mental vulnerability, Helicobacter pylori, and incidence of hospital-diagnosed peptic ulcer over 28 years in a population-based cohort.

Author information

1
a Aventino Medical Group , Rome , Italy.
2
b Research Centre for Prevention and Health, The Capital Region of Denmark , Glostrup , Denmark.
3
c Gastroenterology Department , Surgical Section, Hvidovre University Hospital , Copenhagen , Denmark.
4
d Department of Public Health, Faculty of Health Science , University of Copenhagen , Copenhagen , Denmark.
5
e Faculty of Medicine , Aalborg University , Aalborg , Denmark.

Abstract

OBJECTIVE:

To examine whether mental vulnerability, an enduring personality characteristic, predicts incident hospital-diagnosed ulcer over three decades.

MATERIALS AND METHODS:

A population-based cohort study enrolled 3365 subjects with no ulcer history, ages 30-60, in 1982-3. Mental vulnerability, Helicobacter pylori IgG antibodies, socioeconomic status, and sleep duration were determined at baseline; non-steroidal antiinflammatory drug use, smoking, leisure time physical activity, and alcohol consumption both at baseline and in 1993-4. Hospital diagnoses of incident ulcer through 2011 were detected using the Danish National Patient Registry.

RESULTS:

Ulcers were diagnosed in 166 subjects, including 83 complicated by bleeding or perforation. Age-, gender-, and socioeconomic status-adjusted associations were significant for mental vulnerability (Hazard Ratio (HR) 2.0, 95% Confidence Interval 1.4-2.8), Helicobacter pylori (HR 1.7, CI 1.2-2.3), smoking (HR 2.0, CI 1.3-3.1), heavy drinking (HR 1.6, CI 1.1-2.4), abstinence (HR 1.6, CI 1.1-2.5), non-steroidal antiinflammatory drugs (HR 2.1, CI 1.5-3.0), and sedentary lifestyle (HR 1.9, CI 1.4-2.7). Adjusted for all behavioral mediators, the HR for mental vulnerability was 1.5 (CI 1.0-2.2, p = .04). Mental vulnerability raised risk in Helicobacter pylori seropositive subjects and those exposed to neither Helicobacter pylori nor non-steroidal antiinflammatory drugs; its impact was virtually unchanged when analysis was limited to complicated ulcers.

CONCLUSIONS:

A vulnerable personality raises risk for hospital-diagnosed peptic ulcer, in part because of an association with health risk behaviors. Its impact is seen in 'idiopathic' and Helicobacter pylori-associated ulcers, and in acute surgical cases.

KEYWORDS:

Helicobacter pylori; Peptic ulcer; cohort studies; duodenal ulcer; gastric ulcer; personality; psychosocial factors

PMID:
28503971
DOI:
10.1080/00365521.2017.1324897
[Indexed for MEDLINE]

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