Reduced relapse rate in duodenal ulcer disease leads to normalization of psychological distress: twelve-year follow-up.
BACKGROUND
The aim of this study was to elucidate the relationship between duodenal ulcer (DU) disease and psychological symptoms.


METHODS
Sixty-four Helicobacter pylori-positive patients with frequently relapsing DUs (patient group 1) were compared with 78 control subjects without dyspepsia, starting 2 years before and ending 10 years after eradication of H. pylori. Seven non-relapsing and untreated patients (patient group 2) were also followed-up.


RESULTS
The relapse rate was reduced from 100% per year in the two years before anti-H. pylori treatment to 0.3% per year after treatment in patient group 1. The reinfection rate was 0.7% per year. Anxiety and neuroticism were high at inclusion, but had normalized at the 10-year follow-up in relapse-free patients. There was no increase of gastro-oesophageal reflux symptoms during the 10 years after H. pylori eradication.


CONCLUSIONS
Normalization of anxiety and neuroticism following cure of DU disease supports the view that the increased anxiety and neuroticism are consequences, and not causes, of the disease.
Wilhelmsen
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Institute of Medicine, University of Bergen, Norway. Ingvard.Wilhelmsen@med.uib.no
Berstad
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D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000150:complications / Q000628:therapy; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000382:microbiology / Q000523:psychology*; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D008875:Middle Aged; D009497:Neurotic Disorders / Q000150:complications / Q000628:therapy*; D010556:Personality Tests; D012008:Recurrence