title: Associations between DSM-IV mental disorders and onset of self-reported peptic ulcer in the World Mental Health Surveys.
abstract: OBJECTIVE
  Recent research demonstrating concurrent associations between mental disorders and peptic ulcers has renewed interest in links between psychological factors and ulcers. However, little is known about associations between temporally prior mental disorders and subsequent ulcer onset. Nor has the potentially confounding role of childhood adversities been explored. The objective of this study was to examine associations between a wide range of temporally prior DSM-IV mental disorders and subsequent onset of ulcer, without and with adjustment for mental disorder comorbidity and childhood adversities.
  
  
  METHODS
  Face-to-face household surveys conducted in 19 countries (n=52,095; person years=2,096,486). The Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Peptic ulcer onset was assessed in the same interview by self-report of physician's diagnosis and year of diagnosis. Survival analyses estimated associations between first onset of mental disorders and subsequent ulcer onset.
  
  
  RESULTS
  After comorbidity and sociodemographic adjustment, depression, social phobia, specific phobia, post-traumatic stress disorder, intermittent explosive disorder, alcohol and drug abuse disorders were significantly associated with ulcer onset (ORs 1.3-1.6). Increasing number of lifetime mental disorders was associated with ulcer onset in a dose-response fashion. These associations were only slightly attenuated by adjustment for childhood adversities.
  
  
  CONCLUSIONS
  A wide range of mental disorders were linked with the self-report of subsequent peptic ulcer onset. These associations require confirmation in prospective designs, but are suggestive of a role for mental disorders in contributing to ulcer vulnerability, possibly through abnormalities in the physiological stress response associated with mental disorders.
authors.affiliation: Department of Psychological Medicine, Otago University, PO Box 913, Dunedin, New Zealand. kate.scott@otago.ac.nz
authors.forename: Kate M
authors.initials: KM
authors.lastname: Scott
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.forename: Peter
authors.initials: P
authors.lastname: de Jonge
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Viana
authors.forename: Zhaorui
authors.initials: Z
authors.lastname: Liu
authors.forename: Siobhan
authors.initials: S
authors.lastname: O'Neill
authors.forename: Sergio
authors.initials: S
authors.lastname: Aguilar-Gaxiola
authors.forename: Ronny
authors.initials: R
authors.lastname: Bruffaerts
authors.forename: Jose Miguel
authors.initials: JM
authors.lastname: Caldas-de-Almeida
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.forename: Matthias
authors.initials: M
authors.lastname: Angermeyer
authors.forename: Corina
authors.initials: C
authors.lastname: Benjet
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.forename: Ingrid-Laura
authors.initials: IL
authors.lastname: Firuleasa
authors.forename: Chiyi
authors.initials: C
authors.lastname: Hu
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kiejna
authors.forename: Viviane
authors.initials: V
authors.lastname: Kovess-Masfety
authors.forename: Daphna
authors.initials: D
authors.lastname: Levinson
authors.forename: Yoshibumi
authors.initials: Y
authors.lastname: Nakane
authors.forename: Marina
authors.initials: M
authors.lastname: Piazza
authors.forename: José A
authors.initials: JA
authors.lastname: Posada-Villa
authors.forename: Mohammad Salih
authors.initials: MS
authors.lastname: Khalaf
authors.forename: Carmen C W
authors.initials: CC
authors.lastname: Lim
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D010437:Peptic Ulcer / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies
keywords: Alcohol abuse and dependence; Anxiety; Depression; Mental disorders; Peptic ulcer
references.citation: Psychosom Med. 2007 Apr;69(3):242-8
references.pmid: 17401056
references.citation: Am J Public Health. 2003 Jul;93(7):1065-7
references.pmid: 12835180
references.citation: Am J Psychiatry. 1997 Oct;154(10):1405-11
references.pmid: 9326823
references.citation: Epidemiology. 2000 Jul;11(4):434-9
references.pmid: 10874551
references.citation: Vital Health Stat 2. 1994 Feb;(120):1-116
references.pmid: 8135024
references.citation: J Psychopharmacol. 2010 May;24(5):633-8
references.pmid: 19346282
references.citation: Psychol Med. 2004 Aug;34(6):1001-11
references.pmid: 15554571
references.citation: Epidemiology. 1997 Jul;8(4):420-4
references.pmid: 9209857
references.citation: Epidemiology. 2001 Mar;12(2):209-14
references.pmid: 11246582
references.citation: Epidemiol Rev. 1995;17(1):221-7
references.pmid: 8521941
references.citation: J Clin Gastroenterol. 1997 Apr;24(3):140-6
references.pmid: 9179731
references.citation: Biol Psychiatry. 2004 Jul 15;56(2):113-20
references.pmid: 15231443
references.citation: Arch Gen Psychiatry. 2010 Jul;67(7):712-9
references.pmid: 20603452
references.citation: Int J Methods Psychiatr Res. 2006;15(4):167-80
references.pmid: 17266013
references.citation: JAMA. 1999 Jan 6;281(1):10-1
references.pmid: 9892430
references.citation: Br J Psychiatry. 2010 Nov;197(5):378-85
references.pmid: 21037215
references.citation: Arch Gen Psychiatry. 2011 Aug;68(8):838-44
references.pmid: 21810647
references.citation: Am J Epidemiol. 1998 May 15;147(10):969-77
references.pmid: 9596475
references.citation: Psychosom Med. 2000 Mar-Apr;62(2):176-85
references.pmid: 10772394
references.citation: Psychosom Med. 2002 Nov-Dec;64(6):862-6
references.pmid: 12461190
references.citation: Int J Methods Psychiatr Res. 2004;13(2):93-121
references.pmid: 15297906
references.citation: Psychosom Med. 2009 May;71(4):463-8
references.pmid: 19443694
references.citation: Psychol Med. 2004 Apr;34(3):509-20
references.pmid: 15259836
references.citation: Gut. 1990 Sep;31(9):989-92
references.pmid: 2210467
references.citation: J Psychosom Res. 2006 Apr;60(4):407-12
references.pmid: 16581366
references.citation: Health Psychol. 2002 Nov;21(6):531-41
references.pmid: 12433005
references.citation: Psychosom Med. 2008 Nov;70(9):1035-43
references.pmid: 18941133
references.citation: J Interpers Violence. 2011 Nov;26(16):3225-47
references.pmid: 21282122
references.citation: Psychosom Med. 2011 Feb-Mar;73(2):114-26
references.pmid: 21257974
references.citation: Neuro Endocrinol Lett. 2008 Feb;29(1):117-24
references.pmid: 18283240
references.citation: Neurosci Biobehav Rev. 2007;31(4):530-57
references.pmid: 17270271
references.citation: Gut. 1993 Jun;34(6):762-8
references.pmid: 8314508
references.citation: Appl Psychol Health Well Being. 2013 Mar;5(1):5-27
references.pmid: 23457084
references.citation: Soc Sci Med. 2009 Jul;69(1):138-46
references.pmid: 19446943
references.citation: Gut. 2000 Dec;47(6):861-9
references.pmid: 11076888
references.citation: Psychol Med. 1991 Aug;21(3):713-21
references.pmid: 1946860
references.citation: Am J Psychiatry. 1995 Jul;152(7):1026-32
references.pmid: 7793438