Psychological group counseling for the prevention of ulcer relapses. A controlled randomized trial in duodenal and prepyloric ulcer disease.
The effect of psychological counseling on 1-year ulcer relapse rate of recurrent duodenal and prepyloric ulcer disease was evaluated in 148 patients randomly allocated into three treatment groups; psychological counseling group, maintenance cimetidine (400 mg at bedtime), and placebo cimetidine at bedtime. Ulcer relapses were monitored by endoscopy at 6 and 12 months after inclusion and at symptomatic recurrence. The estimated proportion of relapse-free patients after 12 months follow-up in the psychological counseling group (0.43 +/- 0.08) did not differ significantly from the placebo group (0.47 +/- 0.07), whereas the corresponding value for the cimetidine group (0.70 +/- 0.07) was significantly higher (p less than 0.01). The effect of cimetidine on ulcer recurrence, however, was confined to smokers; relapse risk among nonsmokers did not differ significantly between the treatment groups. The negative outcome of psychological counseling raises doubts as to whether duodenal or prepyloric ulcer recurrences can be prevented by such a therapeutic approach.
Lööf
L
L
Department of Internal Medicine, University Hospital, Uppsala, Sweden.
Adami
H O
HO
Bates
S
S
Fagerström
K O
KO
Gustavsson
S
S
Nyberg
A
A
Nyrén
O
O
Brodin
U
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D002927:Cimetidine / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003376:Counseling / Q000379:methods*; D004381:Duodenal Ulcer / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011615:Psychotherapy, Group; D011897:Random Allocation; D012008:Recurrence; D012307:Risk Factors; D012907:Smoking; D013276:Stomach Ulcer / Q000628:therapy*
D002927:Cimetidine