LIFE STRESSORS IN DUODENAL ULCER--TWO SUBPOPULATIONS

准确定位外部应激源的方法学问题和 慢性病在系列病例中的主导地位阻碍了人们对 生活压力与十二指肠溃疡的关系。按适当方式 方法的选择和患者的人群，这项研究旨在阐明 心身过程中的允许和中介因素，以及 定义应激性溃疡的自然病史。这是假设的 生活压力会导致一组不同的溃疡，这个过程是 被胃部过度分泌和一定的人格结构所允许 部分是通过与焦虑相关的酗酒、吸烟、 和咖啡，暂时的压力引起的溃疡可能会慢慢愈合 但会有很好的长期预后。一项初步研究已经给出了支持 应激性溃疡的几个明显特征。设计 呼吁管理经过验证的标准化面谈工具 在意大利，对于内窥镜检查有记录的最近发病的意大利患者 没有慢性症状和没有接受维持治疗的溃疡患者， 为了识别疾病发生前的亚群 痛苦的人生经历。人口统计学和生理学 致溃疡物质的特点、用途、情绪和个性 然后将这一亚组与溃疡的其他亚组进行比较 人口。六周后重复内窥镜检查将检测到 两组近期预后比较，同时定期电话治疗 面谈将允许对他们的长期进程进行比较。

Methodological problems in pinpointing external stressors and the predominance of chronic disease in case series have impeded understanding of the relationship between life stress and duodenal ulcer. By appropriate choice of methods and patient population, this study aims to elucidate permissive and mediating factors in the psychosomatic process, and to define the natural history of stress-induced ulcer. It is hypothesized that life stress causes a distinct subgroup of ulcers, that this process is allowed by gastric hypersecretion and a certain personality structure and is mediated partially through anxiety-related abuse of alcohol, cigarettes, and coffee, and that ulcers arising from temporary stress may heal slowly but will have a good long-term prognosis. A pilot study has given support to several of these distinctive features of stress ulcers. The design calls for administration of a standardized interview instrument, validated in italy, to italian patients with endoscopically documented, recent-onset ulcer who do not have chronic symptoms and are not on maintenance therapy, in order to identify a subpopulation whose disease was preceded by distressing life experiences. The demographic and physiologic characteristics, use of ulcerogenic substances, mood and personality of this subgroup will then be compared with those of the rest of the ulcer population. Repeat endoscopy at six weeks will detect differences in short-term prognosis between the two groups, while periodic telephone interviews will permit comparison of their long-term course.