Psychic disorders and peptic ulcer disease: a systematic review with meta-analysis



Psychic Disorder, Peptic Ulcer Disease, Meta-analysis


Introduction: Psychological Disorders (PD) are characterized by clinically significant cognitive disorders, while Peptic Ulcer Disease (PUD) is a resulting condition of gastric and/or duodenal erosions formations. The multifactorial model of PUD’s etiology shows a way to analyze the psychic aspects about the pathology of this disease. Objective: To evaluate the correlation between PD and PUD. To discuss the possible influence of pathophysiological efts in the PUD development, of patients with PD; To identify the association between PD and the PUD’s environmental risk factors. Methods: This is a systematic review with meta-analysis of scientific articles consulted through research in PubMed database on October 9, 2019. We selected documents from journals written in English, and studied selection strategies were adopted, with identification, initial filter, application of inclusion-exclusion criteria and quality control, to perform the extraction and data collection of the eligible articles. Results: A total of 534 articles were identified and we found obtained 10 eligible studies (cross-sectional studies included for qualitative sample composition and 6 cohort studies for quantitative analysis of the meta-analysis). The results demonstrated that the patients with PD are more likely to develop DUP (OR = 1,642; 95% CI: 1,369-1,968; z = 5,361; p <0.001). Conclusion: The present study demonstrated an association between PD and DUP, with a higher prevalence and strong association in the PD’s direction leading to DUP.


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Rezende, JM. À sombra do plátano: crônicas de história da medicina [online]. São Paulo: Editora Unifesp, 2009. Úlcera péptica e a ilusão do conhecimento: um exemplo de falácia das evidências em medicina. pp. 201-220. ISBN 978-85-61673-63-5.

Pires, Nelson, Pinho, Alvaro Rubim de e Pinto Filho, HeitorPsicogênese das úlceras pépticas. Arquivos de Neuro-Psiquiatria [online]. 1955, v. 13, n. 3 [Acessado 11 Janeiro 2022] , pp. 203-216. Disponível em: <>. Epub 08 Abr 2014. ISSN 1678-4227.

Hsia, N. et al. Increased risk of peptic ulcer in patients with early-onset cataracts?: A nationwide population-based study. PLoS ONE, v. 13, n. 11, p. 1–8, 2018.

Malfertheiner, P.; Chan, F. K. L.; Mccoll, K. E. L. Peptic ulcer disease. The Lancet, v. 374, n. 9699, p. 1449–1461, 2009.

Tonolini, M. et al. Non-perforated peptic ulcer disease?: multidetector CT findings , complications, and differential diagnosis. Insights Imaging, v. 8, p. 455–469, 2017.

Sonnenberg, A. Time Trends of Ulcer Mortality in Europe. GASTROENTEROLOGY, v. 132, p. 2320–2327, 2007.

Di Mario F, Goni E. Gastric acid secretion: changes during a century. Best Pract Res Clin Gastroenterol 2014;28:953–65.

Sierra, D. et al. Pediatric Gastritis, Gastropathy , and Peptic Ulcer Disease. Pediatrics in Review, v. 39, n. 1, p. 542-549, 2018.

Ramakrishnan, K.; Salinas, R.C. Peptic Ulcer Disease. Am Fam Physician, v. 76, n. 7, p. 1005-12, 2007.

Alp MH, Court JH, Grant AK. Personality pattern and emotional stress in the genesis of gastric ulcer. Gut 1970;11:773–7.

Levenstein, S. et al. Psychological stress increases risk for peptic ulcer, regardless of Helicobacter pylori infection or use of nonsteroidal anti-inflammatory drugs. Clin Gastroenterol Hepatol, v. 13, p. 498, 2015.

Jones MP. The role of psychosocial factors in peptic ulcer disease: beyond Helicobacter pylori and NSAIDs. J Psychosom Res 2006;60:407–12.

American Psychiatry Association (2013). DSM-V: Manual diagnóstico e estatístico de transtornos mentais (5ª Ed.). Porto Alegre: Artmed,2014.

Williams, L. et al. (2016). The prevalence and age of onset of psychiatric disorders in Australian men. Australian & New Zealand Journal of Psychiatry. 50(7), 678–684. doi: 10.1177/0004867415614105.

Hayashi, S. et al. Endoscopic features of lymphoid follicles in Helicobacter pylori-associated chronic gastritis. Dig. Endosc., ago. 2014.

Lopez-Medina, G. et al. Gastric emphysema a spectrum of pneumatosis intestinalis: a case report and literature review. Case Rep. Gastrointest. Med., v. 2014, ID 891360, 5p. 2014.

Peixoto, Leonardo. Estresse afeta saúde gastrointestinal e causa sintomas como azia e diarreia., 2020. <>.

Ribeiro, L. et al. Influência da resposta individual ao estresse e comorbidades psiquiátricas na síndrome do intestino irritável. Rev. psiquiatr. clin. [Internet]. 2011 [citado 2020 abr 08]; 38 (2): 77-83.

T. Jerry et al. Métodos de Pesquisa em atividade física. 6ª ed. Porto Alegre: Artmed 2012.

GA Wells. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses;, 2020.

MedCalc Statistical Software versão 19.3.1 (MedCalc Software bv, Ostend, Bélgica;; 2020).

Fang B, Yang S, Liu H, Zhang Y, Xu R, Chen G. Association between depression and subsequent peptic ulcer occurrence among older people living alone: A prospective study investigating the role of change in social engagement. J Psy Res. 2019, April; 122; 94-103.

Goodwin R, Talley N, Hotopf M, Cowles R, Galea S, Jacobi F. A link between physician-diagnosed ulcer and anxiety disorders among adults. Annals Epidem. 2013, Jan; 23; 189-192.

Hsu C, Hsu Y, Chang K, Lee C, Chong L, Lin C et al. Depression and the Risk of Peptic Ulcer Disease: A Nationwide Population-Based Study. Medicine. 2015, Dec; 94 (51): e2333.

Hsu C, Hsu Y, Chang K, Lee C, Chong L, Lin C et al. Increased Subsequent Risk of Peptic Ulcer Diseases in Patients With Bipolar Disorders. Medicine. 2015, Jul; 94 (29): e1203.

Hsu C, Hsu Y, Chang K, Lee C, Chong L, Lin C et al. Association of Dementia and Peptic Ulcer Disease: A Nationwide Population-Based Study. American Journal of Alzheimer’s Disease & Other Dementias. 2016, Jan. 31 (5); 389-394.

Liao C, Chang C, Chang S, Muo C, Lane H, Sung F et al. The association of peptic ulcer and schizophrenia: A population-based study. J Psy Res. 2014, Aug.77; 541-546.

Lee Y, Yu J, Chol H, Jeon B, Kim H, Kim S et al. The association between peptic ulcer diseases and mental health problems. Medicine. 2017, Jul. 96 (34): e7828.

Lim W, Subramanian M, Abdin E, Vaingankar J, Chong S. Peptic ulcer disease and mental illnesses. GHPJ. 2014, Sep. 36; 63-67

Messias E, Saini A, Sinato P, Welch S. Bearing grudges and physical health: relationship to smoking, cardiovascular health and ulcers. Soc Psy Epidem. 2010, 45; 183-187.

Schuster J, Limosin F, Levenstein S, Strat Y. Association Between Peptic Ulcer and Personality Disorders in a Nationally Representative US Sample. American Psy Soc. 2010, Jul. 72; 941-946.

Carabotti M, Scirocco A, Maselli MA, Severi C. The gut-brain axis: Interactions between enteric microbiota, central and enteric nervous systems. Annals of Gastroenterology. 2015;28 (2):203-209.

Ma, Q., Xing, C., Long, W. et al. Impact of microbiota on central nervous system and neurological diseases: the gut-brain axis. J Neuroinflammation 16, 53 (2019).

Liu WZ, et al. Fifth Chinese National Consensus Report On the Management of Helicobacter Pylori Infection. Helicobacter. 2018;23(2):e12475. PubMed PMID: 29512258.

Scott KM, Alonso J, de Jonge P, Viana MC, Liu Z, O'Neill S et al. Associations between DSM-IV mental disorders and onset of self-reported peptic ulcer in the World Mental Health Surveys. Journal of Psychosomatic Research. 2013 Aug; 75 (2):121-127.

L.S. Pyo, S. In-Kyung, K.J. Hwan, et al., The effect of emotional estress and depression on the prevalence of digestive diseases, J. Neurogastroenterol. Motil. 21 (2) (2015) 273-282.

D. Oliveira Miranda, Soares de Lima, Taís Aparecida, L. Ribeiro Azevedo, et al., Proinflammatory cytokines correlate with depression and anxiety in colorectal câncer patients, Biomed. Res. Int. (2014) 1-5.

Sugimoto M, Furuta T, Shirai N, et al. Effects of interleukin-10 gene polymorphism on the development of gastric cancer and peptic ulcer in Japanese subjects. Journal of Gastroenterology and Hepatology. 2007 Sep; 22 (9):1443-1449. DOI: 10.1111/j.1440-1746.2006.04613.x.

Goodwin, D, Keyes, M, Stein, B et al. Peptic ulcer and mental disorders among adults in the community: the role of nicotine and alcohol use disorders. Psychosomatic medicine vol. 71, 4 (2009): 463-8. doi:10.1097/PSY.0b013e3181988137.

Maity, P., Biswas, K., Roy, S., Banerjee, R. K., & Bandyopadhyay, U. Smoking and the pathogenesis of gastroduodenal ulcer--recent mechanistic update. 2013. Molecular and cellular biochemistry, 253(1-2), 329–338.

Berwanger O, Suzumura E, Buehler A, Oliveira J. Como avaliar criticamente revisões sistemáticas e metanálises?. Rev. bras. ter. intensiva [Internet]. 2007 Dez [citado 2020 Jun 30] ; 19( 4 ): 475-480.



How to Cite

Andrade, B. C. de M., Matos, C. A. G. de, Cardoso, T. M., Santos, R. C. dos ., Peixoto, E. L. O. ., Silva, J. C. de A., & Silveira, Y. V. R. da. (2022). Psychic disorders and peptic ulcer disease: a systematic review with meta-analysis. Journal of Multiprofessional Health Research, 2(3), e03.169-e03.185. Retrieved from




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