The very model of a modern etiology: a biopsychosocial view of peptic ulcer.

摘要: Objective Research on ulcer psychosomatics has plummeted since the early 1970s, to applause of many who argue that is simply an infectious disease. The purpose this article discuss relevance psychogenesis in age Helicobacter pylori. Methods A critical literature review was conducted. Results There a substantial and methodologically sound body prospective studies linking stress with onset course peptic ulcer. Psychosocial factors can be estimated contribute 30% 65% ulcers, whether related nonsteroidal antiinflammatory drugs, H. pylori, or neither. observed association between accounted for, part, by recall bias, misreported diagnoses, confounding low socioeconomic status (a source risk factors, such as pylori on-the-job exertion) distressing medical conditions (which lead use drugs). Of residual, true association, proportion for mediation health behaviors, smoking, sleeplessness, irregular meals, heavy drinking, and, again, drugs. remainder results from psychophysiologic mechanisms probably include increased duodenal acid load, effects hypothalamic-pituitary-adrenal axis activation healing, altered blood flow, impairment gastroduodenal mucosal defenses. Conclusions Peptic valuable model understanding interactions among psychosocial, socioeconomic, behavioral, causing discovery may serve, paradoxically, stimulus researchers whom concepts psychology infection are not necessarily contradiction terms.