A link between physician-diagnosed ulcer and anxiety disorders among adults

Ann Epidemiol. 2013 Apr;23(4):189-92. doi: 10.1016/j.annepidem.2013.01.003. Epub 2013 Feb 28.


Purpose: Previous studies have suggested an association between mood and anxiety disorders and peptic ulcer, yet extant work suffers from methodologic limitations. Centrally, previous epidemiologic studies have relied exclusively on self-report of ulcer. This study aimed to investigate the relationship between DSM-IV depression and anxiety disorders and physician-diagnosed ulcer among adults in the general population.

Methods: Data were drawn from a population-based, representative sample of 4181 adults aged 18 to 79 in the German National Health Interview and Examination Survey.

Results: Any anxiety disorder (odds ratio [OR], 2.6), panic disorder (OR, 5.2), panic attacks (OR, 3.8), and social phobia (OR, 3.3) were associated with increased likelihood of physician-diagnosed ulcer, compared with those without ulcer. There was evidence of a dose-response relationship between number of mental disorders and likelihood of current ulcer.

Conclusions: These findings provide initial evidence of a link between anxiety disorders and physician-diagnosed ulcer among adults in the community. Future work, ideally taking into account Helicobacter pylori infection, stress, and mental health problems is needed to improve our understanding of the possible mechanisms that can provide insight into the etiology of peptic ulcers.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology*
  • Anxiety Disorders / psychology
  • Depression / diagnosis
  • Depression / epidemiology*
  • Depression / psychology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Germany / epidemiology
  • Health Surveys
  • Humans
  • Logistic Models
  • Male
  • Mental Disorders / epidemiology
  • Middle Aged
  • Odds Ratio
  • Panic Disorder / epidemiology
  • Peptic Ulcer / diagnosis*
  • Peptic Ulcer / epidemiology
  • Peptic Ulcer / psychology
  • Physicians*
  • Population Surveillance
  • Psychophysiologic Disorders / epidemiology
  • Psychophysiologic Disorders / psychology
  • Socioeconomic Factors
  • Young Adult