Associations between DSM-IV mental disorders and onset of self-reported peptic ulcer in the World Mental Health Surveys

Abstract

Objective Recent research demonstrating concurrent associations between mental disorders and peptic ulcers has renewed interest in links between psychological factors and ulcers. However, little is known about associations between temporally prior mental disorders and subsequent ulcer onset. Nor has the potentially confounding role of childhood adversities been explored. The objective of this study was to examine associations between a wide range of temporally prior DSM-IV mental disorders and subsequent onset of ulcer, without and with adjustment for mental disorder comorbidity and childhood adversities. Methods Face-to-face household surveys conducted in 19 countries (n=52,095; person years=2,096,486).The Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Peptic ulcer onset was assessed in the same interview by self-report of physician’s diagnosis and year of diagnosis. Survival analyses estimated associations between first onset of mental disorders and subsequent ulcer onset. Results After comorbidity and sociodemographic adjustment, depression, social phobia, specific phobia, post-traumatic stress disorder, intermittent explosive disorder, alcohol and drug abuse disorders were significantly associated with ulcer onset (ORs 1.3-1.6). Increasing number of lifetime mental disorders was associated with ulcer onset in a dose-response fashion. These associations were only slightly attenuated by adjustment for childhood adversities. Conclusions A wide range of mental disorders were linked with the self-report of subsequent peptic ulcer onset. These associations require confirmation in prospective designs, but are suggestive of a role for mental disorders in contributing to ulcer vulnerability, possibly through abnormalities in the physiological stress response associated with mental disorders.

Associations between DSM-IV mental disorders and diabetes mellitus: a role for impulse control disorders and depression

“…It is only by using survival analysis that we are able to exclude such episodes from the predictor set because the data are organised in person-year files. Comparable with previous studies using these data [26, 27], we used discrete-time survival analyses [28] with person-year as the unit of analysis to test associations between first onset of mental disorders and diabetes diagnosis. For these analyses, a person-year dataset was created in which each year in the life of each respondent up to and including the age of onset of diabetes or their age at interview (whichever came first) was treated as a separate observational record, with the year of diabetes onset coded 1 and earlier years coded 0 on a dichotomous outcome variable.…”

Is Post-Traumatic Stress Disorder Associated with Premature Senescence? A Review of the Literature

“…Of four studies reporting the association of PTSD with type 2 diabetes mellitus, three (75%) provided positive findings (23, 68, 69), one (25%) provided negative findings (58), and none reported mixed findings (Table 2 and Online Data Supplement Table 3). All four studies that reported on the association of PTSD with gastrointestinal ulcer diseases were positive (21, 62, 70, 71) (Table 2 and Online Data Supplement Table 4). Finally, all three studies (100%) that examined PTSD as a risk factor for dementia reported positive findings (72–74).…”

Association of Mental Disorders With Subsequent Chronic Physical Conditions

“…The cross-sectional design also raises the possibility of spurious or inflated associations through mental disorders at the time of interview affecting self-report of physical conditions; however, sensitivity analyses excluding individuals with mental disorders at the time of the interview found no meaningful alteration in associations. 9 …”