Life events and chronic duodenal ulcer: a case control study.

The frequency of life events during the two years before an exacerbation of ulcer in a duodenal ulcer population was compared with the frequency of these events over the same time period in an age-sex matched probability sample of the community population. The mean number of events and the associated distress and life change scores were similar for both groups. When events were categorised into areas of activity, such as health, bereavement, family and social life, change of residence, etc. and were further classified on the basis of desirability, separation from persons, and problem chronicity, only one significant difference was found between patients and controls-more patients changed residence (p=0.0005). Frequency distributions of the number of events and the distress and life change scores were similar for both groups. Concerning individual events, the only significant differences in frequency were that more patients changed residence in Sydney (p=0.006) and more controls had a child leave home for reasons other than marriage (p=0.03). Patients and controls experienced the same four most frequent events. Among patients, no correlation existed between age and either the number of events experienced or distress and life change scores. Among controls, age was negatively correlated with the number of events experienced (p=0.0004) and the life change scores (p<0.003). It is concluded, therefore, that an excess of stress, as measured by the number of life events experienced and by distress and life change scores associated with these events, does not appear to be a risk factor for the exacerbation of chronic duodenal ulcer.