1. Psychosocial factors and their association with reflux oesophagitis, Barrett's oesophagus and oesophageal adenocarcinoma.
- Author
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Denver P, Donnelly M, Murray LJ, and Anderson LA
- Subjects
- Adenocarcinoma epidemiology, Aged, Barrett Esophagus epidemiology, Chi-Square Distribution, Depression epidemiology, Depression psychology, Esophageal Neoplasms epidemiology, Esophagitis, Peptic epidemiology, Female, Humans, Ireland epidemiology, Life Style, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Prognosis, Repression, Psychology, Retrospective Studies, Risk Factors, Self Concept, Self Efficacy, Social Support, Stress, Psychological epidemiology, Stress, Psychological psychology, Adenocarcinoma psychology, Barrett Esophagus psychology, Esophageal Neoplasms psychology, Esophagitis, Peptic psychology
- Abstract
Aim: To investigate the role of psychological characteristics as risk factors for oesophageal adenocarcinoma (OAC), as well as the reflux-mediated precursor pathway., Methods: An all-Ireland population-based case-control study recruited 230 reflux oesophagitis (RO), 224 Barrett's oesophagus (BO) and 227 OAC patients and 260 controls. Each case/control group completed measures of stress, depression, self-efficacy, self-esteem, repression and social support. A comparative analysis was undertaken using polytomous logistic regression adjusted for potential confounders., Results: Compared to controls, OAC patients were almost half as likely to report high stress levels over their lifetime (P = 0.010, OR 0.51; 95%CI: 0.29-0.90) and 36% less likely to report having experienced depression (OR 0.64; 95%CI: 0.42-0.98). RO patients reported significantly higher stress than controls particularly during middle- and senior-years (P for trends < 0.001). RO patients were 37% less likely to report having been highly emotionally repressed (OR 0.63; 95%CI: 0.41-0.95). All case groups (OAC, RO and BO) were more likely than controls to report having had substantial amounts of social support (OR 2.84; 95%CI: 1.63-4.97; OR 1.97; 95%CI: 1.13-3.44 and OR 1.83; 95%CI: 1.03-3.24, respectively)., Conclusion: The improved psychological profile of OAC patients may be explained by response shift. The role of psychological factors in the development of OAC requires further investigation.
- Published
- 2013
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