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Generalized Anxiety Disorder and Peptic Ulcer Disease Among Adults in the United States

Goodwin, Renee D. PhD; Stein, Murray B. MD

Original Articles

Objective Previous research has suggested a link between chronic anxiety and peptic ulcer disease, though recent evidence documenting an infectious cause (Helicobacter pylori) for ulcer has led to doubt about this association. The goal of the current study was to determine the relationship between generalized anxiety disorder (GAD) and self-reported peptic ulcer disease (PUD) among adults in the community.

Methods Data were drawn from the National Comorbidity Survey, a representative household survey of the adult population of the United States (N = 8098). Multivariate logistic regression analyses were used to determine the relationship between GAD and self-reported ulcer, controlling for differences in sociodemographic characteristics and psychiatric and medical comorbidity.

Results GAD was associated with a significantly increased risk of self-reported PUD (odds ratio = 2.8, 95% confidence interval = 1.4–5.7;p = .0002) after adjusting for differences in sociodemographic characteristics, comorbid mental disorders, and physical morbidity. Further analyses revealed a dose-response relationship between number of GAD symptoms (odds ratio = 1.2, 95% confidence interval = 1.1–1.4;p = .001) and increased risk of self-reported PUD.

Conclusions These findings are consistent with and extend previous clinical and epidemiologic data, providing evidence of a dose-response relationship between GAD and self-reported PUD among adults in the general population. The mechanism of this association remains unknown. Future work investigating the relationship between onset of GAD and development of PUD in prospective, longitudinal, epidemiologic data with objective measures of physical health status and mental health may be useful in improving our understanding of this link.

From the Department of Epidemiology (R.D.G.), Mailman School of Public Health, Columbia University, New York, New York; and the Department of Psychiatry (M.B.S.), University of California–San Diego, La Jolla, California.

Address reprint requests to: Renee D. Goodwin, PhD, 1051 Riverside Dr., Unit 43, New York, NY 10032. Email:

Received for publication September 18, 2001; revision received January 11, 2002.

Copyright © 2002 by American Psychosomatic Society
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