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.