S. Levenstein, MD, V. Varvo, PhD, G. Lanari, PhD, S. Spinella, MD, and C. Prantera, MD, Gastroenterology Dept., Nuovo Regina Margherita Hospital, Via Morosini 30, Rome, Italy.
Aims: Stressful life events have been found to be associated with duodenal ulcer disease, but recall bias and the concrete disruption of life by disease might increase reported life events in chronically ill subjects. We therefore examined major life events in patients with recent-onset ulcers, using ulcerative colitis patients as controls.
Methods: The Paykel Interview for Recent Life Experiences, covering 6 months prior to symptom onset, was administered to 33 patients with endoscopically active duodenal ulcer whose current ulcer had given symptoms for <6 months and had been preceded by an asymptomatic , medication-free period of >12 months. In 19, ulcers had also been diagnosed at other times in the past. The same instrument, covering the 6 months immediately before the interview, was administered to 44 outpatients with ulcerative colitis (27 in remission , 14 with minimal symptoms, 3 with moderate symptoms).
Results: Ulcer patients were comparable in sex, occupation, education, and time since first diagnosis to colitis controls; they tended to be older and more were married. Ulcer patients were significantly more likely to report at least one moderately or severely stressful life events than patients with ulcerative colitis. Similar proportions of the life events in both patient groups involved on the job problems, losses and goal frustration .
Conclusions: Patients with active duodenal ulcer report a disproportionately high number of stressful life events, even when chronically symptomatic or refractory cases are excluded , and even when the comparison group consists of patients with another relapsing gastrointestinal disease of similar duration.
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