Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jul 21, 2009; 15(27): 3405-3410
Published online Jul 21, 2009. doi: 10.3748/wjg.15.3405
Peptic ulcer and childhood adversities experienced by working-aged people
Markku PT Sumanen, Markku J Koskenvuo, Lauri H Sillanmäki, Kari J Mattila
Markku PT Sumanen, Kangasala Health Center, and Medical School, University of Tampere, FI 33014, Finland
Markku J Koskenvuo, Lauri H Sillanmäki, Department of Public Health, University of Helsinki, FI 00014, Finland
Kari J Mattila, Department of General Practice, University of Tampere, Medical School, and Hospital District of Pirkanmaa, FI 33014, Finland
Author contributions: Sumanen MPT wrote the manuscript; Koskenvuo MJ participated in the design of the study and the statistical analyses; Sillanmäki LH participated in the statistical analyses; Mattila KJ conceived of the study, and participated in its design and co-ordination.
Correspondence to: Dr. Markku PT Sumanen, MD, PhD, Medical School, University of Tampere, FI 33014, Finland. markku.sumanen@uta.fi
Telephone: +358-50-5578756
Fax: +358-3-35516722
Received: February 16, 2009
Revised: June 3, 2009
Accepted: June 10, 2009
Published online: July 21, 2009
Abstract

AIM: To study the association between self-reported peptic ulcer and childhood adversities.

METHODS: The Health and Social Support Study (HeSSup) population consisted of a stratified random sample drawn from the Finnish Population Register in four age groups: 20-24, 30-34, 40-44 and 50-54. The survey was carried out by postal questionnaire during 1998, with a response rate of 40.0%. A follow-up questionnaire was sent during 2003 to all those who responded to the first. Altogether 19 626 individuals returned the follow-up questionnaire; a response rate of 75.8%. The subjects were asked whether a doctor had told them that they have or have had peptic ulcer. The analyses covered those who responded affirmatively to both the baseline and the follow-up enquiries (n = 718). Those not reporting a peptic ulcer in either of the two questionnaires (n = 17 677) were taken as controls. The subjects were further requested (through six questions) to think about their childhood adversities.

RESULTS: The most common adversities mentioned were long-lasting financial difficulties in the family, serious conflicts in the family, and a family member seriously or chronically ill. All the adversities reported, except parental divorce, were more common among peptic ulcer patients than among controls (P values varied between < 0.001 and 0.003). Age- and sex-adjusted odds ratios (OR) of childhood adversities in the multivariate logistic analysis for self-reported peptic ulcer varied between 1.45 and 2.01. Adjusting for smoking, heavy drinking, stress and nonsteroidal anti-inflammatory drug use had no further influence (ORs between 1.22 and 1.73).

CONCLUSION: Our findings suggest that childhood adversities maintain a connection with and have a predictive role in the development of peptic ulcer.

Keywords: Peptic ulcer; Working-aged; Childhood adversities; Stress factors; Predictive role