The personality pattern of duodenal ulcer patients in relation to spontaneous ulcer healing and relapse

Abstract

One hundred consecutive out-patients with duodenal ulceration from a hospital and a gastroenterological clinic were tested with the Minnesota Multiphasic Personality Inventory (MMPI). This was carried out in order to investigate whether neuroticism or other personality disorders were characteristics of duodenal ulcer patients, and whether the presence of such possible personality disorders might influence the prognosis of the disease. Neuroticism occurred in 53% of the patients, but only in 5% of controls (P less than 0.0001). Overall, personality disorders were present in 69% of the patients compared with 30% of the controls (P less than 0.0001). Neuroticism was connected with a high frequency of relapse (P less than 0.05) whereas failure of spontaneous ulcer healing had no certain relation to personality disorders. Patients with non-neurotic personality disorders had more frequently suffered stressful life events before entrance to the study (P less than 0.05) and, like the neurotic patients, they had lower ego-strength to cope with such events (P less than 0.05). The results indicate that personality assessments make it possible to distinguish between subgroups of duodenal ulcer patients with different course of the disease.

Psychosocial factors in peptic ulcer and inflammatory bowel disease.

“…Following the model of Spicer's classic demonstration that perforated peptic ulcer increased in London during German bombing raids (Spicer, Stewart, & Winser, 1944), recent researchers have looked at periods of economic collapse in Sofia, Bulgaria (Pomakov, Gueorgieva, Stantcheva, Tenev, & Rizov, 1993), at the great Kyoto, Japan, earthquake (Aoyama et al, 1998), and at the mass invasion of Hong Kong, China, by “boat people” (Lam, Hui, Shiu, & Ng, 1995); and they have uniformly found ulcers (diagnosed by upper gastrointestinal X-rays, endoscopy, or perforation) to increase in the aftermath of these catastrophes. Yet another line of research has examined the influence of psychosocial factors on the course of endoscopically diagnosed ulcer; such studies have reported stress, anxiety, and depression to impair endoscopic healing (Holtmann et al, 1992; Levenstein, Prantera, Scribano, et al, 1996) and to promote relapse (Armstrong et al, 1994; Jess et al, 1989; Levenstein, Prantera, Varvo, et al, 1996). The effect of stress seems to be reversible, in that patients who are psychologically stable but who develop an ulcer following traumatic life events tend to have a particularly favorable long-term course (Levenstein, Prantera, Varvo, et al, 1996).…”