A new study in General Hospital Psychiatry finds evidence of a relationship between anxiety disorders and the prevalence and incidence of ulcer over a 10-year period in a sample of U.S. adults.
Though ulcer prevalence has decreased, approximately 500,000 new cases still occur annually in the U.S., with complications that can result in bleeding, perforation and death. A fairly recent discovery that many, but not all, cases are caused by the bacterium Helicobacter (H.) pylori has resulted in neglecting to investigate other contributing factors, said corresponding author Farah Taha, M.A., in the Department of Psychology at Queens College, City University of New York (CUNY).
"As a team, we specialize in depression and anxiety disorders. In keeping with a biopsychosocial framework, we believe that the etiology of ulcer is unlikely to be attributed to a single cause and is likely complex and multi-factorial," said Taha. "There are individuals with ulcers who don't have the bacterium, and there are people who have the bacterium who don't have ulcers."
The researchers analyzed self-reported data from more than 2,000 adults collected in two waves of the Midlife Development in the United States Survey—1994 to 1995 and 2004 to 2006—to look for a potential connection between reported anxiety and ulcer presence.
The study considered potential confounding roles of child abuse, secondhand smoke exposure, neuroticism, and demographic characteristics such as, age, marital status, gender, education, and income. It also looked at factors such as cigarette smoking and substance use disorders as potential mediators in the relationship between anxiety and development of ulcer and found that "none of these variables affected these relationships in a substantive way."
The researchers suggested interpreting their results "with caution" and Taha proposed a next step to uncover underlying mechanisms not currently understood in the anxiety-ulcer relationship, which include variables such as elevated cortisol levels and increased gastric acid secretion.
"We hope this may lead to the development of prevention protocols," she said.
"The paper is well written and I certainly agree that anxiety states likely aggravate gastric ulcers," said J. Bruce Overmier, Ph.D., a professor in the graduate neuroscience program at the University of Minnesota's Psychology Department, but noted that the paper downplays some obvious related factors. Furthermore, as to whether or not variables such as smoking or income modulate the effect of anxiety and ulcer, it's important to keep in mind that "we are talking about fewer than 56 cases of ulcer in the study [that can't be generalized to the] some 500,000 new cases each year and some 5 million in total current cases."
Farah Taha MA, Joshua D. Lipsitz, Sandro Galea, Ryan T. Demmer, Nicholas J. Talley, Renee D. Goodwin: PII: S0163-8343(14)00174-1: DOI: DOI: 10.1016/j.genhosppsych.2014.07.005