title: Perceived stress as a risk factor for dyspepsia: a register-based cohort study.
abstract: OBJECTIVE
  Dyspepsia is a common condition and has a huge impact on quality of life and working capacity, but its causes are not well understood. An association between stress and dyspepsia has been debated for decades, but the issue has not been resolved. We examined the 3-year risk of redeeming a proton-pump inhibitor or an H2-receptor antagonist as a proxy of dyspepsia according to the level of perceived stress.
  
  
  METHODS
  Perceived stress was measured in a general health survey of 16 124 Danes aged older than 16 years of age in 2010 using Cohen's Perceived Stress Scale. Data were linked individually to national registries, including the Danish National Prescription Registry. The risk of redeeming a proton-pump inhibitor or an H2-receptor antagonist for quintiles of stress level was estimated using Cox proportional hazard regression.
  
  
  RESULTS
  In total, 2703 redeemed one of these drugs during the 33 months of follow-up. The cumulative incidence proportion of dyspepsia increased gradually, from 11.6 to 24.9%, with quintiles of stress. After full model adjustment, the four highest stress quintiles had a statistically significantly increased risk of redeeming a drug compared with the lowest stress quintile. The hazard ratios were 1.16 [95% confidence interval (CI): 1.00-1.34] for the second quintile, 1.21 (95% CI: 1.06-1.39) for the third quintile, 1.20 (95% CI: 1.05-1.38) for the fourth quintile, and 1.30 (95% CI: 1.12-1.50) for the fifth quintile.
  
  
  CONCLUSIONS
  Higher levels of self-reported perceived everyday life stress increased the risk of redeeming a drug for dyspepsia significantly during 33 months of follow-up.
authors.affiliation: aDepartment of Health Science and Technology, Public Health and Epidemiology Group, Aalborg University bDepartment of Clinical Epidemiology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Deding
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.forename: Henrik
authors.initials: H
authors.lastname: Bøggild
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D004363:Drug Utilization / Q000706:statistics & numerical data; D004415:Dyspepsia / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006306:Health Surveys; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012042:Registries; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D057566:Self Report; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications* / Q000453:epidemiology
chemical_list: D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors