The perception of life events and daily stress in nonulcer dyspepsia

Previous studies on the association of nonulcer dyspepsia with major life events were performed without emphasis on the perception of these events, and have yielded conflicting results. The present study examined the perception of life events and, in addition, the role of daily "hassles" (stressful events) in patients with nonulcer dyspepsia. Thirty-three dyspeptic patients as defined by normal endoscopy and ultrasonogram and 33 controls of comparable sex, age, and social class were recruited for study. Both groups were asked to select from 56 major life events those they had experienced and to give a rating on how they perceived them. They were further asked to select similarly from 117 items of daily stress and to rate the severity of each item. The results demonstrated that the number of positive and negative events and the positive score were similar in both dyspeptic patients and controls, but dyspeptic patients had a higher perceived magnitude of negative events and a higher score of total life change as given by the summation of magnitude of positive and negative events (both p less than 0.05). The "hassles" scores were not significantly different between dyspeptic patients and controls. Analysis of individual life events revealed that dyspeptic patients had significantly (p less than 0.05) higher scores than controls in items of minor law violations, major change in closeness of family members, and major personal illness or injury. We conclude that patients with nonulcer dyspepsia have higher negative perception of major life events, which indicates that psychological factors may play a role in the pathogenesis of nonulcer dyspepsia.