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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred patients with functional dyspepsia, 100 patients with duodenal ulcer and 100 healthy controls were assessed on anamnestic factors, somatic symptoms and psychological measures. Patients with functional dyspepsia had significantly higher levels of state-trait anxiety, general psychopathology, depression, a lower general level of functioning and more somatic complaints from different organ systems, especially the musculo-skeletal system, compared to patients with duodenal ulcer and healthy controls. Patients with functional dyspepsia had more frequent dyspepsia symptoms and a longer disease history than duodenal ulcer patients. Discriminant analyses using a model of fifteen psychological and anamnestic variables, classified correctly 71.5% of the subjects due to diagnoses. The test for multiple somatic complaints (Giessener Beschwerdebogen) was the most important discriminating factor (Eigenvalue 0.78). Seventy-five per cent of the patients were correctly classified, 71% by diagnosis with respect to diagnoses of duodenal ulcer and functional dyspepsia using frequency of dyspeptic symptoms as discriminating factor (Eigenvalue 0.40). Functional dyspepsia seems to be a disease entity of its own, distinct from duodenal ulcer and strongly associated with psychological factors.
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PMID:Psychological factors and somatic symptoms in functional dyspepsia. A comparison with duodenal ulcer and healthy controls. 806 46

The authors review the current literature on psychosocial aspects of duodenal ulcer. The initial simple psychosomatic approach, has evolved to a multifactorial schema in which stress and individual vulnerability plays an important role. Psychological features (personality, Type A behaviour, alexithymia, anxiety, depression) and socioenvironmental factors (stress, life events, coping, social support) are analyzed. Newer aspects like the probable stress influence on immunity and infection by Helicobacter pylori are considered.
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PMID:[Psychosocial factors in patients with duodenal ulcer]. 807 75

Emotional stress (ES) has been proposed as a possible factor in the pathogenesis of duodenal ulcer (DU) disease. Modern, well-controlled studies on the effect of ES on gastric acid secretion (GAS) in both normal healthy subjects and patients with inactive DU are lacking. Ten normal (N) men and 10 men with inactive DU were observed on 2 separate days. In random order, subjects either underwent dichotomous listening (DL) to induce stress or a control (non-DL) test. In addition to measuring GAS in 15-min periods, heart rate and blood pressure were measured every 7.5 min, and visual analog scale measures of emotion (relaxation, anxiety, anger, tension, and depression) were monitored. Subjects underwent 2 separate study days, 1 h of a basal period followed by 1 h of a DL session or 1 h of a basal period followed by 1 h of a non-DL control session; the order of the days was randomized. In both N and DU emotional stress by DL induced these parameters significantly: increased heart rate; raised systolic and diastolic blood pressures (p < 0.01); increased anxiety, anger, and tension (p < 0.03); and decreased relaxation (p < 0.01). The non-DL control test did not alter cardiovascular or emotion measures in either group. While ES did not alter GAS in N subjects, ES increased GAS when compared to the basal state (p < 0.02) and when compared to the control test (p = 0.07).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The effect of acute emotional stress on gastric acid secretion in normal subjects and duodenal ulcer patients. 840 13

A total of 486 visual display terminal (VDT) workers were surveyed on their health status, working conditions, type A state, and depression state through questionnaires. They were also divided into three groups by self-assessment: technocentered (TC), technoanxious (TA), and neither (N). The weekly working hours and daily VDT operating hours of the type A group were longer than those of non-type A group. Type A subjects had more symptoms than non-type A subjects. The mean weekly working hours of depressive group was 61.3 hr, much longer than that of the others. The TC subjects worked daily with the VDT for longer hours than the other subjects. The TA subjects felt most dissatisfied with their computer training (TC, 47.4%; N, 64.5%; TA, 91.7%). Awkward VDT operators were more often in the TA group (36.1%) than in the others (TC, 3.8%; N, 10.5%). The TA subjects had a higher previous history of duodenal ulcer than the others (TA, 13.9%; N, 4.6%; TC, 3.8%).
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PMID:Relationships between health status and working conditions and personalities among VDT workers. 849 67

The concept that stress and personality are associated with ulcer is widely held by lay persons and to some extent by the medical community. By means of epidemiological techniques and more precise terminology, the role of psychosomatic factors in ulcer disease has been more clearly defined. Regarding acute stress, the number of events experienced and the change and distress they are purported to produce has been found to be similar in ulcer patients and their controls matched on age, sex, and social class. However, chronic difficulties, i.e., events or circumstances that have persisted for > or = 6 months, are twice as common in duodenal ulcer patients as in controls. Events, either acute or chronic, are more strongly associated with duodenal ulcer if they contain a component involving personal threat or goal frustration. Associations that have been found between acute or chronic stress and duodenal ulcer have been relatively weak, with odds ratios of 2 to 3. For some patients, it is possible that depression and social incongruity may have played some role in initiating ulcer disease. Personality studies have shown that ulcer patients are more neurotic than controls, but the difference is small and there is no evidence to indicate an ulcer personality. As regards both stress and personality, gastric ulcer patients do not differ from duodenal ulcer patients.
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PMID:Stress and personality in patients with chronic peptic ulcer. 828 Feb 51

Since 1979 we have treated 149 patients with duodenal ulcer by extended parietal cell vagotomy (EPCV). Electron microscopy of parietal cells from gastric body mucosa and gastric acid secretory test were carried out in 22 randomly selected patients before and after EPCV. It was shown that before EPCV the ultrastructure of parietal cells presented the feature of vigorous section identical to the hyperfunctional secretion of gastric acid. The ultrastructure of parietal cells presented the feature of acute depression of secretory function, which was identical to a significant reduction of secretory function of gastric acid 0.5-6 months after EPCV. Two to 10 years after operation, however, especially over 10 years after EPCV, the ultrastructural changes of parietal cells gradually returned to normal, but gastric acid secretion remained at a low level, without preoperative secretory capacities. The results of this study provide a histological basis for the application of extended parietal cell vagotomy in the treatment of duodenal ulcer and its complications.
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PMID:Ultrastructure of parietal cells before and after extended parietal cell vagotomy in patients with duodenal ulcer and their complications. 872 40

We investigated psychologic influences on duodenal ulcer by examining the effect of personality, stress, and mood, measured at diagnosis, on subsequent ulcer healing. Stressful life events, psychopathology (assessed using the Minnesota Multiphasic Personality Inventory), anxiety, depression, smoking, alcohol consumption, nonsteroidal antiinflammatory drug use, and serum pepsinogen I levels were determined immediately after endoscopy showed duodenal ulcer craters in 70 patients with recent onset of symptoms. Endoscopy was repeated following 6 weeks of ranitidine therapy. Six ulcers (8.6%) persisted, and the duodenum remained inflamed in an additional five cases, for a total of 16% with incomplete healing. The only baseline characteristic significantly associated with poor healing was anxiety (p = 0.03 for ulcer persistence, p = 0.02 for incomplete healing). Being in the highest anxiety tertile was associated with a more than fourfold elevation in the risk of incomplete healing (p = 0.02). The association between anxiety and poor healing was not changed by modification of the anxiety score to eliminate gastrointestinal symptom items or by adjustment for serum pepsinogen, sex, or cigarette smoking. Anxiety inhibits the healing of duodenal ulcers treated with adequate antisecretory therapy.
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PMID:Psychologic predictors of duodenal ulcer healing. 883 14

612 patients with different psychosomatic disorders of gastrointestinal tract (GIT) were examined. They included either 200 patients with organic stomach disease or with duodenal ulcer as well as 412 individuals with various functional disorders of GIT such as psychogenic vomiting, dysphagia, gastralgia and colon irritability syndrome. In 70% of all cases patientc relatives (1-3 degree of relationship) had also some psychosomatic diseases. All the patients suffered in childhood from so-called GIT-variant of children's neuropathia. Being adults they all met intensive or moderate stress and developed psychogenic depression. Two ways of psychosomatic disorders cristallization on the background of depression were observed, exactly reactivation of children's neuropathia symptomes or rapid affect somatization which were followed by psychosomatic cycles formation and by stress tolerance decrease. Several types of psychosomatic development were described: hypochondrial (78.8%), asthenic (12.4%), obsessive (2.3%), hysterical (4.4%) and paranoial (2.1%).
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PMID:[Variants of psychosomatic personality development in diseases of the gastrointestinal tract]. 878 77

A retrospective study of 200 endoscopies performed on 168 children (90 girls and 78 boys) aged 3 months to 18 years (median 6 years) is reported. All procedures were completed successfully in an adult endoscopy unit in a comprehensive health centre. Most children of less than 6 months and above 12 years of age needed no intravenous sedation. One child developed respiratory depression and was successfully resuscitated. Indications for endoscopy were: small intestinal biopsy, 78 (46%); recurrent abdominal pain, 40 (24%); acute epigastric pain, 13 (8%); persistent vomiting, 12 (7%); haemorrhage, 10 (6%); caustic substance ingestion, six (4%); and dysphagia, four (2%) children. Positive diagnoses were obtained in 123 (62%) procedures. Coeliac disease (26 cases) was the most common histological diagnosis, followed by gastritis (19 cases), oesophagitis (18 cases), duodenitis (16 cases), duodenal ulcer (11 cases), hiatus hernia (six cases), gastric ulcer (three cases) and oesophageal stricture (two cases). Where specialized paediatric endoscopy units are not feasible, e.g. in developing countries, endoscopic services for children can be safely provided by paediatric endoscopists as part of an adult endoscopy service, provided that suitable resuscitation equipment is available and the necessary modifications to meet the medical and psychological needs of children and their parents are taken into consideration.
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PMID:Paediatric upper gastro-intestinal endoscopy in developing countries. 898 32

Seventy-five patients with recent-onset dyspepsia and endoscopically visible duodenal ulcer underwent psychological evaluation. Following ranitidine treatment, they were reinterviewed periodically for 12 to 76 months (mean 38.6). Ulcer symptoms were present during a mean of 14.9% of follow-up months. Patients did significantly worse if they had a low-status occupation, low education, depression, stressful life events, or abnormal Minnesota Multiphasic Personality Inventory at baseline. Of patients recalling premorbid life stress, those with a normal MMPI had a particularly benign course, whereas those with an abnormal MMPI did particularly poorly (6% versus 29% of months symptomatic: p < 0.04). Age, gender, smoking, drinking, antiinflammatory drugs, pepsinogen, Helicobacter pylori titers, and initial healing had no prognostic effect. Low socioeconomic status, life stress, depression, and psychopathology each predict a relatively poor symptom outcome for duodenal ulcer treated with antisecretory therapy, but psychologically stable individuals who develop an ulcer under stress have an excellent long-term prognosis.
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PMID:Long-term symptom patterns in duodenal ulcer: psychosocial factors. 903 10


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