Psychological Predictors of Peptic Ulcer Incidence in the Alameda County Study

Levenstein, Susan; Kaplan, George A.; Smith, Margot

doi:10.1097/00004836-199704000-00004

Cited by 67 publications

(60 citation statements)

References 42 publications

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“…In a longitudinal survey from Alameda County, Levenstein et al [65] reported that the risk of developing peptic ulcer disease was significantly increased in patients with high scores for depression, hostility, personal uncertainty, and anomy (a measure of social unease, alienation, or maladjustment). These measures were combined into a psychological risk index.…”

Section: Psychophysiological Mechanisms For Stress and Ulcer Diseasementioning

confidence: 99%

The role of psychosocial factors in peptic ulcer disease: Beyond Helicobacter pylori and NSAIDs

Jones

2006

Journal of Psychosomatic Research

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Section: Psychophysiological Mechanisms For Stress and Ulcer Diseasementioning

confidence: 99%

The role of psychosocial factors in peptic ulcer disease: Beyond Helicobacter pylori and NSAIDs

Jones

2006

Journal of Psychosomatic Research

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“…Levenstein et al [36] examined 4595 ulcer-free subjects and found a significant relationship between depression and later ulcer development.…”

Section: Specific Medical Illnesses and Increased Prevalence Of Majormentioning

confidence: 99%

Impact of medical comorbid disease on antidepressant treatment of major depressive disorder

Iosifescu

Bankier²,

Fava³

2004

Curr Psychiatry Rep

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A major factor in evaluating and treating depression is the presence of comorbid medical problems. In this paper, the authors will first evaluate studies showing that medical illness is a risk factor for depression. The authors will review a series of randomized, controlled studies of antidepressant treatment in subjects with major depressive disorder (MDD) and comorbid medical illnesses (myocardial infarction, stroke, diabetes, cancer, and rheumatoid arthritis). Most of these studies report an advantage for an active antidepressant over placebo in improvement of depressive symptoms. The authors also will review a series of studies in which the outcome of antidepressant treatment is compared between subjects with MDD with and without comorbid medical illness. In these studies, subjects with medical illness tend to have lower improvement of depressive symptoms and higher rates of depressive relapse with antidepressant treatment compared with MDD subjects with no medical comorbidity. In addition, the authors will review hypotheses on the mechanism of the interaction between medical illness and clinical response in MDD. The paper will conclude that medical comorbidity is a predictor of treatment resistance in MDD.

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“…Considerable prospective evidence has been gathered alongside studies that have found an excess of life stressors in ulcer patients compared with matched controls 15. In one large longitudinal population study, the occurrence of self reported ulcer over a nine year period was more likely in subjects who reported any of several concrete life stressors or psychological distress at baseline 16 17. In another study, self reported stress predicted the occurrence of ulcer disease (diagnosed by a doctor) over the next 13 years 18.…”

Section: Stress and Ulcers: The Evidencementioning

confidence: 99%

Stress and peptic ulcer: life beyond helicobacter

Levenstein¹

1998

BMJ

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The discovery that Helicobacter pylori is a cause of peptic ulcer has tempted many to conclude that psychological factors are unimportant. But this is dichotomised thinking. There is solid evidence that psychological stress triggers many ulcers and impairs response to treatment, while helicobacter is inadequate as a monocausal explanation as most infected people do not develop ulcers. Psychological stress probably functions most often as a cofactor with H pylori. It may act by stimulating the production of gastric acid or by promoting behaviour that causes a risk to health. Unravelling the aetiology of peptic ulcer will make an important contribution to the biopsychosocial model of disease. For this review of the role of psychological stress in the aetiology of peptic ulcer disease, I undertook conventional journal tracking and reference tracing, supplemented by Medline searches using Paperchase. The important keywords used in this search included peptic ulcer; duodenal ulcer—psychology; stress; life change events; and personality. Summary points Psychosomatic factors in the aetiology of peptic ulcer have become unfashionable since the discovery of Helicobacter pylori Most people harbour H pylori so the organism cannot serve as the sole explanation for ulcer disease Psychological stress has an impact on the onset and course of ulcer disease Psychological stress probably interacts with H pylori and other risk factors in causing ulcer disease Peptic ulcer is an important example of the biopsychosocial model of disease

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Psychological Predictors of Peptic Ulcer Incidence in the Alameda County Study

Cited by 67 publications

References 42 publications

The role of psychosocial factors in peptic ulcer disease: Beyond Helicobacter pylori and NSAIDs

The role of psychosocial factors in peptic ulcer disease: Beyond Helicobacter pylori and NSAIDs

Impact of medical comorbid disease on antidepressant treatment of major depressive disorder

Stress and peptic ulcer: life beyond helicobacter

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