It has often been suggested that mood and personality predispose to peptic ulcer, but little prospective evidence exists. We used longitudinal data from the Alameda County Study to seek associations of psychological characteristics with later ulcer development, taking into account the possible confounding or mediating, taking into account the possible confounding or mediating roles of nonpsychological factors. Among 4,595 Alameda County Study subjects ulcer-free in 1965, we studied five baseline psychological measures (depression, hostility, ego resiliency, social alienation or anomy, and personal uncertainty) with respect to reported ulcer in 1973-1974. All five measures had significant age-adjusted associations with incident ulcer [odds ratio (O.R.) 1.8-2.6]. After adjustment for smoking, drinking, skipping breakfast, lack of sleep, painful medical conditions, and liver disease, three measures remained significant: depression, anomy, and hostility. The age-adjusted O.R. of 2.8 [95% confidence interval (C.I.) 1.6, 4.8] for an upper versus a lower tertile index of independently predictive psychological factors fell to 2.1 with adjustment for health-related behaviors and medical conditions, and reached 1.7 (C.I. 1.0, 3.1) after addition of education to the model. We conclude that depression, maladjustment, and hostility are prospectively associated with peptic ulcer. These associations are partially accounted for by confounding or mediation by standard risk factors, and are to some extent related to socioeconomic status.

译文

通常有人认为情绪和人格易患消化性溃疡,但几乎没有前瞻性证据。我们使用了来自阿拉米达县研究的纵向数据,以寻求心理特征与以后溃疡发展的关联,同时考虑了可能的混杂或中介作用,并考虑了非心理因素的可能混杂或中介作用。在4,595名阿拉米达县研究对象的无溃疡1965年中,我们研究了1973-1974年报告的溃疡的五种基线心理指标 (抑郁,敌意,自我弹性,社会疏远或失范以及个人不确定性)。所有五项指标均具有显着的年龄校正与溃疡的相关性 [优势比 (O.R.) 1.8-2.6]。在调整了吸烟,饮酒,不吃早餐,睡眠不足,痛苦的医疗条件和肝脏疾病后,三种措施仍然很重要: 抑郁,失范和敌对。年龄调整后的2.8 [95% 置信区间 (C.I.) 1.6,4.8] 的独立预测心理因素的高三元指数与低三元指数随着健康相关行为和医疗条件的调整而降至2.1,并达到1.7 (C.I. 1.0,3.1) 添加教育后的模型。我们得出的结论是,抑郁,适应不良和敌意与消化性溃疡有关。这些关联部分是通过标准风险因素的混淆或调解来解释的,并且在一定程度上与社会经济地位有关。

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