Socially isolated children 20 years later: risk of cardiovascular disease.

Posted on October 5, 2009 by Maurice Preter MD

Arch Pediatr Adolesc Med. 2006 Aug;160(8):805-11.Click here to read Cited in PMC, LinkOut

Socially isolated children 20 years later: risk of cardiovascular disease.

Caspi A, Harrington H, Moffitt TE, Milne BJ, Poulton R.

Author Affiliations: Department of Psychology, University of Wisconsin, Madison, USA. a.caspi@iop.kcl.ac.uk

OBJECTIVE: To test the hypothesis that children who occupy peripheral or isolated roles in their peer groups (isolated children) are at risk of poor adult health. DESIGN: Longitudinal study of an entire birth cohort. SETTING: Dunedin, New Zealand. PARTICIPANTS: A total of 1037 children who were followed up from birth to age 26 years. INTERVENTIONS: Measurement of social isolation in childhood, adolescence, and adulthood. MAIN OUTCOME MEASURES: When study members were 26 years old, we measured adult cardiovascular multifactorial risk status (overweight, elevated blood pressure, elevated total cholesterol level, low high-density lipoprotein level, elevated glycated hemoglobin concentration, and low maximum oxygen consumption). RESULTS: Socially isolated children were at significant risk of poor adult health compared with nonisolated children (risk ratio, 1.37; 95% confidence interval, 1.17-1.61). This association was independent of other well-established childhood risk factors for poor adult health (low childhood socioeconomic status, low childhood IQ, childhood overweight), was not accounted for by health-damaging behaviors (lack of exercise, smoking, alcohol misuse), and was not attributable to greater exposure to stressful life events. In addition, longitudinal findings showed that chronic social isolation across multiple developmental periods had a cumulative, dose-response relationship to poor adult health (risk ratio, 2.58; 95% confidence interval, 1.46-4.56). CONCLUSIONS: Longitudinal findings about children followed up to adulthood suggest that social isolation has persistent and cumulative detrimental effects on adult health. The findings underscore the usefulness of a life-course approach to health research, by focusing attention on the effect of the timing of psychosocial risk factors in relation to adult health.

PMID: 16894079 [PubMed – indexed for MEDLINE]

Posted in Health |

Family conflict in childhood: a predictor of later insomnia

Posted on October 5, 2009 by Maurice Preter MD

 Sleep. 2006 Aug 1;29(8):1063-7.Cited in PMC, LinkOut

Family conflict in childhood: a predictor of later insomnia.

Gregory AM, Caspi A, Moffitt TE, Poulton R.

Institute of Psychiatry, King’s College London, United Kingdom. a.gregory@iop.kcl.ac.uk

STUDY OBJECTIVES: To examine the association between childhood exposure to family conflict and insomnia at 18 years of age. DESIGN: Longitudinal prospective data on an entire birth cohort were obtained. Parents completed the Conflict subscale of the Moos Family Environment Scale when the study members were 7, 9, 13, and 15 years of age. Insomnia was examined in a standardized interview when the participants were aged 18 years. SETTING: Participants were born in Dunedin, New Zealand, and were interviewed at this location. PATIENTS OR PARTICIPANTS: One thousand thirty-seven children born between April 1, 1972, and March 31, 1973, enrolled in the study (52% male). At age 18 years, 993 (97% of living cohort members) provided data. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: The mean level of family conflict at age 7 to 15 years predicted insomnia at 18 years after controlling for sex, socioeconomic status, sleep problems at 9 years, and self-reported health (odds ratio [95% confidence interval] = 1.42 [1.17-1.73], p < .001). There was a dose-response relationship, whereby the more assessments at which families scored in the top 25% for conflict, the greater the young person’s likelihood of developing insomnia at age 18 years. This association was present even after controlling for depression at 18 years. CONCLUSIONS: This study demonstrates a modest but robust longitudinal link between family conflict during childhood and insomnia experienced at 18 years of age. Future work needs to replicate this finding in different populations and to elucidate the mechanisms underlying this association.

PMID: 16944675 [PubMed – indexed for MEDLINE]

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Increased prevalence of white matter hyperintensities in patients with panic disorder.

Posted on October 5, 2009 by Maurice Preter MD
J Psychopharmacol. 2008 Nov 21. [Epub ahead of print]Click here to read Links

Increased prevalence of white matter hyperintensities in patients with panic disorder.

Bae S, Kim J, Hwang J, Lee Y, Lee H, Lee J, Lyoo I, Renshaw P, Yoon S.

Interdisciplinary Program in Brain Science and Department of Psychiatry, Seoul National University and Hospital, Seoul, South Korea.

AbstractThe aim of the current study is to compare the prevalence, severity and location of cerebral white matter hyperintensities (WMH) between patients with panic disorder (PD) and healthy control subjects. Patients with PD (n = 24) and matched healthy control subjects (n = 24) were scanned using a 3.0 Tesla whole-body magnetic resonance scanner. Axial T2-weighted and fluid-attenuated inversion recovery images were acquired and evaluated for the prevalence, severity and location of WMH using the modified composite scale of Fazekas and Coffey and coded separately for deep and periventricular WMH. Logistic regression analyses were used to assess the association between WMH and the diagnosis of PD. A greater severity of total WMH was associated with a diagnosis of PD in a dose-dependent pattern (odds ratio [OR] = 8.8, P = 0.005 for mild WMH; OR = 27.7, P = 0.007 for moderate to severe WMH). Deep WMH, where most group differences originated, were predominantly located in the frontal region of the brain (n = 16 in PD, n = 1 in control). The current report is the first study to report an increased prevalence of WMH in patients with PD.

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Increased risk of acute myocardial infarction for patients with panic disorder: a nationwide population-based study.

Posted on October 5, 2009 by Maurice Preter MD
Psychosom Med. 2009 Sep;71(7):798-804. Epub 2009 Jul 10.Click here to read Links

Increased risk of acute myocardial infarction for patients with panic disorder: a nationwide population-based study.

Chen YH, Tsai SY, Lee HC, Lin HC.

School of Public Health, Taipei Medical University, Taipei, Taiwan.

OBJECTIVE: To examine prospectively the relationship between a diagnosis of panic disorder and the risk of acute myocardial infarction within 1 year of follow-up. Panic disorder is associated prospectively with coronary artery disease, but the risk of acute myocardial infarction associated with panic disorder has not been specifically investigated. METHOD: This nationwide population-based study used data from the Taiwan National Health Insurance Research Database covering the years 2000 to 2005. A total of 9641 patients diagnosed with panic disorder in 2004 were included, together with 28,923 matched nonpanic disorder enrollees as a comparison cohort. Cox proportional hazard regressions were conducted to compute hazard ratios, after adjustment for comorbid medical disorders and sociodemographic characteristics. RESULTS: Results indicated that 4.77% of patients with panic disorder (approximately one in 21) experienced an acute myocardial infarction episode within a year, compared with 2.73% of patients in the comparison cohort. The adjusted hazard of acute myocardial infarction was significantly higher (1.75 times, 95% Confidence Interval = 1.55-1.97) for patients with panic disorder, relative to the comparison cohort. The association persisted in further analyses stratified by hypertension, coronary heart diseases, and age. CONCLUSION: Panic disorder was identified as an independent risk factor for subsequent acute myocardial infarction. Comprehensive multidisciplinary approaches are needed to optimize primary and secondary prevention of acute myocardial infarction among patients with panic disorder.

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Primary focal dystonia: evidence for distinct neuropsychiatric and personality profiles.

Posted on October 5, 2009 by Maurice Preter MD
J Neurol Neurosurg Psychiatry. 2009 Oct;80(10):1176-9. Epub 2009 May 21.Click here to read Links
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J Neurol Neurosurg Psychiatry. 2009 Oct;80(10):1059.

Primary focal dystonia: evidence for distinct neuropsychiatric and personality profiles.

Lencer R, Steinlechner S, Stahlberg J, Rehling H, Orth M, Baeumer T, Rumpf HJ, Meyer C, Klein C, Muenchau A, Hagenah J.

Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany. rebekka.lencer@psychiatrie.uk-sh.de

BACKGROUND: Primary focal dystonia (PFD) is characterised by motor symptoms. Frequent co-occurrence of abnormal mental conditions has been mentioned for decades but is less well defined. In this study, prevalence rates of psychiatric disorders, personality disorders and traits in a large cohort of patients with PFD were evaluated. METHODS: Prevalence rates of clinical psychiatric diagnoses in 86 PFD patients were compared with a population based sample (n = 3943) using a multiple regression approach. Furthermore, participants were evaluated for personality traits with the 5 Factor Personality Inventory. RESULTS: Lifetime prevalence for any psychiatric or personality disorder was 70.9%. More specifically, axis I disorders occurred at a 4.5-fold increased chance. Highest odds ratios were found for social phobia (OR 21.6), agoraphobia (OR 16.7) and panic disorder (OR 11.5). Furthermore, an increased prevalence rate of 32.6% for anxious personality disorders comprising obsessive-compulsive (22.1%) and avoidant personality disorders (16.3%) were found. Except for social phobia, psychiatric disorders manifested prior to the occurrence of dystonia symptoms. In the self-rating of personality traits, PFD patients demonstrated pronounced agreeableness, conscientiousness and reduced openness. CONCLUSIONS: Patients with PFD show distinct neuropsychiatric and personality profiles of the anxiety spectrum. PFD should therefore be viewed as a neuropsychiatric disorder rather than a pure movement disorder.

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