title: The association between reflux esophagitis and psychosocial stress.
abstract: BACKGROUND
  The prevalence of reflux esophagitis is increasing in Korea. Reflux esophagitis aggravates the stress and fatigue level of daily life, but less is known about the association with stress and fatigue, which could be bi-directional.
  
  
  OBJECTIVE
  To evaluate the impact of reflux esophagitis on stress and fatigue and to compare the stress level of people with reflux esophagitis with that of controls with peptic ulcer disease and healthy controls.
  
  
  METHODS
  Among a total of 9,033 subjects who underwent a comprehensive medical check-up including upper endoscopy, 6,834 subjects (75.7 %) were enrolled. Stress and fatigue scores were measured by a validated Korean version of the Brief Encounter Psychosocial Instrument and the Fatigue Severity Scale.
  
  
  RESULTS
  Among 6,834 subjects, 13.2 % were in the high-stress group, and reflux esophagitis was found in 6.0 %. After adjustment for confounders, reflux esophagitis was significantly associated with high stress (odds ratio 1.94, 95 % confidence interval 1.25-3.02). Subjects with reflux esophagitis had significantly higher BEPSI-K scores compared with healthy controls (p = 0.027); and however, there was no significant difference in BEPSI-K scores between reflux esophagitis group and peptic ulcer disease controls. Fatigue severity scale was highly correlated with BEPSI-K (p < 0.001); however, there was no significant difference in fatigue severity scale level between the reflux esophagitis group and controls. The severity of reflux esophagitis was significantly correlated with BEPSI-K score (p = 0.008).
  
  
  CONCLUSIONS
  Reflux esophagitis is significantly associated with psychosocial stress, and the severity of reflux esophagitis correlates with the degree of stress.
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, 911-1 Mock-dong, Yangchun-ku, Seoul, 158-710, Korea.
authors.forename: Eun Mi
authors.initials: EM
authors.lastname: Song
authors.forename: Hye-Kyung
authors.initials: HK
authors.lastname: Jung
authors.forename: Ji Min
authors.initials: JM
authors.lastname: Jung
mesh_terms: D000328:Adult; D016099:Endoscopy, Gastrointestinal; D004942:Esophagitis, Peptic / Q000453:epidemiology* / Q000473:pathology / Q000523:psychology; D005221:Fatigue / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012720:Severity of Illness Index; D013276:Stomach Ulcer / Q000453:epidemiology* / Q000473:pathology / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology*