Inability to cope with environmental stress: peptic ulcers in mentally retarded persons

Mentally retarded persons in the protective environment of an institution developed more peptic ulcers than the general population. We sought to determine whether their physical and mental handicaps may have a relationship to this disease. Thirty seven mentally retarded institutionalized ulcer patients were compared to 37 non-ulcer controls matched for age and sex, who were also similar in IQ and mental retardation diagnoses. A stepwise discriminant analysis demonstrated that the ulcer group was more limited by chronic diseases and inability to ambulate. Also differentiating the groups were ulcer patients having more cerebral palsy, more visual deficit, and more limited motor and sphincter control than non-ulcer subjects. We conclude that helplessness in responding to environmental demands produces stress sufficient to induce peptic ulcers, even in severely mentally retarded persons.