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Original ArticleOpen Access
Stress, but not Helicobacter pylori, is Associated with Peptic Ulcer Disease in a Thai Population
Wachirawat W 
,
Hanucharurnkul S ,
Suriyawongpaisal P ,
Boonyapisit S ,
Levenstein S ,
Jearanaisilavong J ,
Atisook K ,
Boontong T ,
C
,
Hanucharurnkul S ,
Suriyawongpaisal P ,
Boonyapisit S ,
Levenstein S ,
Jearanaisilavong J ,
Atisook K ,
Boontong T ,
C The purpose of this study was to clarify the relation between psychological and other risk
factors, notably
helicobacter pylori
(H.
pylori)
infection, in contributing to the occurrence of peptic
ulcer (PU) disease. A retrospective case-control study was conducted at Siriraj Hospital, Bangkok from
March to December 2000. Seventy endoscopically diagnosed patients with new PU or peptic perfora-
tion were compared with 70 patients with other diseases as well as blood donors control matched for
age and sex. Historical risk factors,
H.
pylori
Immunoglobulin G antibody
(H.
pylori
lgG Ab), stress
(Perceived Stress Questionnaire) and hostility (MMPI Hostility Scale) were assessed. Data were ana-
lyzed using logistic regression analysis.
The results showed that PU was associated with chronic stress (aOR 2.9, p
=
0.01; 95% Cl,
1.3-6.5) and family history of PU (a OR 2.4, p
<
0.03; 95% Cl, 1.1-5.1 ), with an interaction effect be-
tween stress and irregular mealtimes (aOR 4.8, p
=
0.01; 95% Cl, 1.3-16.9). The incidence rate of
H.
pylori
infection in PU patients was similar to the control group (61.4% and 50.0%, respectively, OR
1.2). The authors conclude that stress and family history, not
H.
pylori
infection, are important risk
factors for PU in this population. This finding supports previous studies in Thailand, showing a high
Vol. 86 No.7
STRESS, BUT NOT
H. PYWRI,
IS ASSOCIATED WITH PU
673
prevalence of
H.
pylori
in the population but a low association with PU, in contrast to developed
countries.
It
remains to be seen whether the impact of a family history is due to genetic factors or
shared life-style patterns.
Key word :
Helicobacter Pylori
Infection, Hostility, Life-Style Factors, Peptic Ulcer Disease, Stress
factors, notably
helicobacter pylori
(H.
pylori)
infection, in contributing to the occurrence of peptic
ulcer (PU) disease. A retrospective case-control study was conducted at Siriraj Hospital, Bangkok from
March to December 2000. Seventy endoscopically diagnosed patients with new PU or peptic perfora-
tion were compared with 70 patients with other diseases as well as blood donors control matched for
age and sex. Historical risk factors,
H.
pylori
Immunoglobulin G antibody
(H.
pylori
lgG Ab), stress
(Perceived Stress Questionnaire) and hostility (MMPI Hostility Scale) were assessed. Data were ana-
lyzed using logistic regression analysis.
The results showed that PU was associated with chronic stress (aOR 2.9, p
=
0.01; 95% Cl,
1.3-6.5) and family history of PU (a OR 2.4, p
<
0.03; 95% Cl, 1.1-5.1 ), with an interaction effect be-
tween stress and irregular mealtimes (aOR 4.8, p
=
0.01; 95% Cl, 1.3-16.9). The incidence rate of
H.
pylori
infection in PU patients was similar to the control group (61.4% and 50.0%, respectively, OR
1.2). The authors conclude that stress and family history, not
H.
pylori
infection, are important risk
factors for PU in this population. This finding supports previous studies in Thailand, showing a high
Vol. 86 No.7
STRESS, BUT NOT
H. PYWRI,
IS ASSOCIATED WITH PU
673
prevalence of
H.
pylori
in the population but a low association with PU, in contrast to developed
countries.
It
remains to be seen whether the impact of a family history is due to genetic factors or
shared life-style patterns.
Key word :
Helicobacter Pylori
Infection, Hostility, Life-Style Factors, Peptic Ulcer Disease, Stress
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