Abstract
This study was aimed to explore the bidirectional association between depression and peptic ulcers. The ≥20-year-old participants of the Korean National Health Insurance Service-National Sample Cohort from 2002 to 2013 were included in the study. In study I, 30,306 depression patients were 1:4 matched with 121,224 control I participants. In study II, 127,590 peptic ulcer patients were 1:1 matched with 127,590 control II participants. The stratified Cox-proportional hazards models were used to analyse the hazard ratio (HR) of depression for peptic ulcers (study I) and of peptic ulcers for depression (study II). A total of 8.9% (2,703/ 30,306) of depression patients and 7.3% (8,896/ 121,224) of patients in the control I group had peptic ulcers (P < 0.001). The depression group had an adjusted HR for peptic ulcers that was 1.14-fold higher than that of the control I group (95% confidence interval [95% CI] = 1.09–1.19, P < 0.001). A total of 6.4% (8,144/ 127,590) of peptic ulcer patients and 3.5% (4,515/127,590) of patients in the control II group had depression (P < 0.001). The peptic ulcer group had an adjusted HR for depression that was 1.68-fold higher than that of the control II group (95% CI = 1.62–1.74, P < 0.001). Depression and peptic ulcers exhibited a bidirectional relationship.
Highlights
This study was aimed to explore the bidirectional association between depression and peptic ulcers
The depression group demonstrated 1.14 of adjusted hazard ratio (HR) for peptic ulcers (95% CI = 1.09–1.19, P < 0.001, Table 2 and Fig. 1(a))
Depression was associated with the elevated the risk of peptic ulcer disease
Summary
This study was aimed to explore the bidirectional association between depression and peptic ulcers. The disturbances of metabolism, immune-inflammatory responses, autonomic regulation, and hypothalamic-pituitary-adrenal-axis in depression patients were suggested to be linked with the elevated risk of chronic diseases[3]. Inflammation and the disease burdens of pain, poor quality of life, and stress in peptic ulcer patients were presumed to contribute to the elevated risk of depression in peptic ulcer patients[9]. The high rate of depression in peptic ulcer patients in previous cross-sectional studies could be due to the mutual relationship between depression and peptic ulcers. To prove this hypothesis, this study investigated two independent follow-up cohort studies using control groups matched for demographic factors
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