Psychological aspects of non-ulcer dyspepsia: a psychosomatic view focusing on a comparison between the irritable bowel syndrome and peptic ulcer disease.

Abstract

In spite of the fact that both laymen and clinicians have pointed out their relevance, the psychological aspects of gastrointestinal disorders, especially their influence on etiology and pathophysiology, have been a matter of controversy and challenge to researchers. Difficulties in this field arise from several sources, for instance, the sampling methodology in the selection of patients and the heterogeneity of the disorders studied. When the irritable bowel syndrome (IBS) is compared with peptic ulcer disease (PUD), the personality features of IBS have not been described with the same consistency as the dependency traits of PUD. Also, IBS patients have been regarded as more neurotic and depressed than PUD patients. In this study of 101 IBS and 103 PUD patients, our overall impression was that mental symptoms and personality profiles were essentially the same in IBS and PUD, but that both groups differed from a normal population. We conclude that from a psychosomatic point of view IBS and PUD may be looked upon as different facets of the same underlying psychogenic mechanism. Although conclusive evidence of how psychological factors affect physiological processes and contribute to the clinical picture in gastrointestinal disorders is still lacking, it seems reasonable to state that they are often significant and must be considered in treating individual IBS and PUD patients.