Psychosocial and Childhood Factors in Essential Dyspepsia: A Case-Control Study

Abstract

A subgroup of patients with endoscopically diagnosed non-ulcer dyspepsia have no definite cause for their symptoms, termed essential dyspepsia; such patients have been considered to have ‘nervous dyspepsia’. To determine whether social and environmental factors are of importance, both in childhood (before the onset of symptoms) and in adult life, 109 patients with essential dyspepsia and 109 randomly selected dyspepsia-free community controls (matched for age, sex, and one measure of social grade-suburb of residence) were studied. Socioeconomic status, marital status, childhood environment, family structure, and migration were measured. An increased risk of essential dyspepsia was associated with one aspect of social status incongruity; compared with controls, patients had a lower occupational status than their place of residence indicated (OR = 2.3; 95% CI, 1.5-3.5). There was a trend for patients to report an unhappy childhood (OR = 2.4; 95% CI, 0.9-6.7). Being unmarried, undergoing parental separation during childhood, the patient's age at parental separation, the number of siblings, birth order, country of birth, and years of residence were not significantly associated with essential dyspepsia. The importance of psychosocial and childhood factors in essential dyspepsia is probably small.

Key Words:

• Dyspepsia
• essential dyspepsia
• psychology
• social incongruity