Chronic gastric ulcer and life events

The purpose of this study was to define the frequency of stress preceding or during the course of chronic gastric ulcer (CGU). Stress was measured by the occurrence of 62 selected life events over 2 yr in two groups of CGU patients. One group (A) was studied for events during the 2 yr before their diagnosis (147 patients) and the second group (B) was studied for events occurring after diagnosis (73 patients). The ulcer groups were compared with community controls matched for age, sex, and social grade. Groups A and B did not differ in any significant way in their reported life events, indicating no temporal relationship between stressful life events and CGU. The combined ulcer groups, when compared with controls showed no differences in the number of events experienced or the associated scores for change and distress caused by the events. There was no difference in the order of the three most frequent events. Only the event "minor illness" was more frequent in controls on matched pairs analysis (P less than 0.05). The other 61 events showed no differences. When events were grouped into areas of activity, financial and legal events were reported by 38 patients and 23 controls (P less than 0.05). Significantly, few of these 38 patients were in the 60+ age range (P less than 0.02). Twenty-four patients reported no events, compared to 12 controls (P less than 0.05). Although there is no difference in the life events experienced by CGU patients and their controls, this assessment of stress has not taken account of the significance of the event as perceived by a particular individual, the ulcer patient perhaps reacting differently to stress and the ulcer being one result of this abnormal reaction. Consequently, the role of emotional stress remains open.