Urinary catechol amine levels, gastric secretion and specific psychological factors in ulcer and non-ulcer patients

Abstract

INTRODUCTION A CONSIDERABLE body of mformatlon has been gathered whch has suggested that the pathophyslology of duodenal ulcers is Influenced by psychological factors operatmg through the effects of the central and autonomic nervous system on gastric physiology. However, until recent years, there has been a paucity of experimental studies m which multiple interacting predlsposmg and preclpltatmg elements could be demonstrated. Many of the earlier studies were hmlted to the mvestlgatlon of the specific physlologlcal preclpltants of duodenal ulcerations or the specific psychodynamic or personality correlates found m patients with peptlc ulcers. (TVY et al 1950, GROSSMAN 1951, HUNT and KAY 1954, ALEXANDER et al. 1934, KAPP et al. 1947, SZASZ et a/ 1947, RUESCH 1948, GILDEA 1949, STREITFELD 1954; MINSKI and DESAI 1955, WEISMAN 1956) The hlghhghtmg of a limited number of specific factors m each mdlvldual study led to the amasslng of a large body of research data which has remained relatively unintegrated from an experlmental point of view Hence, there has been scant data to support the emplrlcally developed concepts that peptlc ulcer was a “psychosomatic” dysfunction. Because of this there has been no general agreement among the chmcal specialties concernmg the “proper” management program of patients with ulcers which would incorporate principles based on a conslderatlon of the multiple determlnants of the cause and the course of the disease The work which will be reported m this paper represents the convergence of three mvestlgatlons which orlgmally were unrelated However, the data from the studies suggested an experimental design which would allow for the testing of an hypothesis of the interaction of psychological, gastnc, physlologlcal and neuro-humoral factors m the development of duodenal ulcers.