title: Decreased stress resilience in young men significantly increases the risk of subsequent peptic ulcer disease - a prospective study of 233 093 men in Sweden.
abstract: BACKGROUND
  Psychosocial stress may influence peptic ulcer disease (PUD) risk, but it can be difficult to identify reliably whether stressful exposures pre-dated disease. The association of stress resilience (susceptibility to stress) with subsequent PUD risk has been incompletely investigated.
  
  
  OBJECTIVE
  To assess if stress resilience in adolescence is associated with subsequent PUD risk.
  
  
  METHODS
  The participants comprised of 233 093 men resident in Sweden, born 1952-1956 and assessed for compulsory military conscription during 1969-1976, with data provided by national Swedish registers. Stress resilience was evaluated through semi-structured interviews by a certified psychologist. Cox regression assessed the association between stress resilience in adolescence and the risk of PUD from 1985 to 2009, between ages 28 and 57 years, with adjustment for parental socioeconomic index, household crowding and number of siblings in childhood, as well as cognitive function and erythrocyte sedimentation rate in adolescence.
  
  
  RESULTS
  In total, 2259 first PUD diagnoses were identified. Lower stress resilience in adolescence is associated with a higher risk of PUD in subsequent adulthood: compared with high resilience, the adjusted hazard ratios (and 95% CI) are 1.84 (1.61-2.10) and 1.23 (1.09-1.38) for low and moderate stress resilience, respectively.
  
  
  CONCLUSIONS
  Stress may be implicated in the aetiology of PUD and low stress resilience is a marker of risk.
authors: Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
authors: C
authors: C
authors: Melinder
authors: R
authors: R
authors: Udumyan
authors: A
authors: A
authors: Hiyoshi
authors: R J
authors: RJ
authors: Brummer
authors: S
authors: S
authors: Montgomery
mesh_terms: D000293:Adolescent; D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D012306:Risk; D013315:Stress, Psychological / Q000150:complications* / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult