LONG-TERM SYMPTOM PATTERNS IN DUODENAL-ULCER - PSYCHOSOCIAL FACTORS

Seventy-five patients with recent-onset dyspepsia and endoscopically v isible duodenal ulcer underwent psychological evaluation. Following ra nitidine treatment, they were reinterviewed periodically for 12 to 76 months (mean 38.6). Ulcer symptoms were present during a mean of 14.9% of followup months. Patients did significantly worse if they had a lo w-status occupation, low education, depression, stressful life events, or abnormal Minnesota Multiphasic Personality Inventory at baseline. Of patients recalling premorbid life stress, those with a normal MMPI had a particularly benign course, whereas those with an abnormal MMPI did particularly poorly (6% Versus 29% of months symptomatic; p<0.04). Age, gender, smoking, drinking, antiinflammatory drugs, pepsinogen, H elicobacter pylori titers, and initial healing had no prognostic effec t. Low socioeconomic status, life stress, depression, and psychopathol ogy each predict a relatively poor symptom outcome for duodenal ulcer treated with antisecretory therapy, but psychologically stable individ uals who develop an ulcer under stress have an excellent long-term pro gnosis. Copyright (C) 1996 Elsevier Science Inc.