Mental vulnerability, Helicobacter pylori, and incidence of hospital-diagnosed peptic ulcer over 28 years in a population-based cohort

TY - JOUR

T1 - Mental vulnerability, Helicobacter pylori, and incidence of hospital-diagnosed peptic ulcer over 28 years in a population-based cohort

AU - Levenstein, Susan

AU - Jacobsen, Rikke Kart

AU - Rosenstock, Steffen

AU - Jørgensen, Torben

PY - 2017

Y1 - 2017

N2 - Objective: To examine whether mental vulnerability, an enduring personality characteristic, predicts incident hospital-diagnosed ulcer over three decades. Materials and methods: A population-based cohort study enrolled 3365 subjects with no ulcer history, ages 30–60, in 1982–3. Mental vulnerability, Helicobacter pylori IgG antibodies, socioeconomic status, and sleep duration were determined at baseline; non-steroidal antiinflammatory drug use, smoking, leisure time physical activity, and alcohol consumption both at baseline and in 1993–4. Hospital diagnoses of incident ulcer through 2011 were detected using the Danish National Patient Registry. Results: Ulcers were diagnosed in 166 subjects, including 83 complicated by bleeding or perforation. Age-, gender-, and socioeconomic status-adjusted associations were significant for mental vulnerability (Hazard Ratio (HR) 2.0, 95% Confidence Interval 1.4–2.8), Helicobacter pylori (HR 1.7, CI 1.2–2.3), smoking (HR 2.0, CI 1.3–3.1), heavy drinking (HR 1.6, CI 1.1–2.4), abstinence (HR 1.6, CI 1.1–2.5), non-steroidal antiinflammatory drugs (HR 2.1, CI 1.5–3.0), and sedentary lifestyle (HR 1.9, CI 1.4–2.7). Adjusted for all behavioral mediators, the HR for mental vulnerability was 1.5 (CI 1.0–2.2, p =.04). Mental vulnerability raised risk in Helicobacter pylori seropositive subjects and those exposed to neither Helicobacter pylori nor non-steroidal antiinflammatory drugs; its impact was virtually unchanged when analysis was limited to complicated ulcers. Conclusions: A vulnerable personality raises risk for hospital-diagnosed peptic ulcer, in part because of an association with health risk behaviors. Its impact is seen in ‘idiopathic’ and Helicobacter pylori-associated ulcers, and in acute surgical cases.

AB - Objective: To examine whether mental vulnerability, an enduring personality characteristic, predicts incident hospital-diagnosed ulcer over three decades. Materials and methods: A population-based cohort study enrolled 3365 subjects with no ulcer history, ages 30–60, in 1982–3. Mental vulnerability, Helicobacter pylori IgG antibodies, socioeconomic status, and sleep duration were determined at baseline; non-steroidal antiinflammatory drug use, smoking, leisure time physical activity, and alcohol consumption both at baseline and in 1993–4. Hospital diagnoses of incident ulcer through 2011 were detected using the Danish National Patient Registry. Results: Ulcers were diagnosed in 166 subjects, including 83 complicated by bleeding or perforation. Age-, gender-, and socioeconomic status-adjusted associations were significant for mental vulnerability (Hazard Ratio (HR) 2.0, 95% Confidence Interval 1.4–2.8), Helicobacter pylori (HR 1.7, CI 1.2–2.3), smoking (HR 2.0, CI 1.3–3.1), heavy drinking (HR 1.6, CI 1.1–2.4), abstinence (HR 1.6, CI 1.1–2.5), non-steroidal antiinflammatory drugs (HR 2.1, CI 1.5–3.0), and sedentary lifestyle (HR 1.9, CI 1.4–2.7). Adjusted for all behavioral mediators, the HR for mental vulnerability was 1.5 (CI 1.0–2.2, p =.04). Mental vulnerability raised risk in Helicobacter pylori seropositive subjects and those exposed to neither Helicobacter pylori nor non-steroidal antiinflammatory drugs; its impact was virtually unchanged when analysis was limited to complicated ulcers. Conclusions: A vulnerable personality raises risk for hospital-diagnosed peptic ulcer, in part because of an association with health risk behaviors. Its impact is seen in ‘idiopathic’ and Helicobacter pylori-associated ulcers, and in acute surgical cases.

KW - cohort studies

KW - duodenal ulcer

KW - gastric ulcer

KW - Helicobacter pylori

KW - Peptic ulcer

KW - personality

KW - psychosocial factors

U2 - 10.1080/00365521.2017.1324897

DO - 10.1080/00365521.2017.1324897

M3 - Journal article

C2 - 28503971

AN - SCOPUS:85019223904

SN - 0085-5928

VL - 52

SP - 954

EP - 961

JO - Scandinavian Journal of Gastroenterology. Supplement

JF - Scandinavian Journal of Gastroenterology. Supplement

IS - 9

ER -