EPIDEMIOLOGICAL STUDIES IN PSYCHOSOMATIC MEDICINE

Primary peptic ulcer in childhood. Psychosocial, psychological and psychiatric aspects

Twenty-five children with radiologically confirmed primary peptic ulcers were investigated. All patients suffered from duodenal ulcer and there was an unexpected female preponderance. The frequency of introverted personalities was greater in the patients than in the controls. Five patients suffered from psychiatric disorders, three had histories of suicidal attempts and three reported homosexual experiences. Six patients had nicknames. Eight patients had been operated on for appendicitis. The above parameters were negative in all control cases. The patients had lower mean IQ, worse adaptation to school, more anxious and overprotective parents, higher frequency of faddiness in food and lower frequency of nail-biting than the controls. The onset of symptoms was preceded by psychotraumatic events in eight cases. The findings suggest that the manifestation of the genetic background of duodenal ulcer is strongly influenced by environmental factors and factors associated with the personality of the patients.

Psychiatric disorders after surgery for duodenal ulcer

A prospective trial was conducted to determine the relationship between personality type and the results of surgery for peptic ulcer. Previous investigations had suggested that patients with an obsessional personality fared less well than those who were not obsessional. However, although there was a high incidence of psychiatric disorders in these surgical patients no significant difference was found between the two groups. It was concluded that classifying patients as obsessional and non-obsessional did not have any bearing on the outcome of operation.