History of childhood maltreatment is associated with comorbid depression in women with migraine.

Posted on December 6, 2007 by Maurice Preter MD
 
Neurology. 2007 Sep 4;69(10):959-68.
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History of childhood maltreatment is associated with comorbid depression in women with migraine.

Tietjen GE, Brandes JL, Digre KB, Baggaley S, Martin VT, Recober A, Geweke LO, Hafeez F, Aurora SK, Herial NA, Utley C, Khuder SA.

Department of Neurology, College of Medicine, The University of Toledo-Health Science Campus, Toledo, OH 43614, USA. gretchen.tietjen@utoledo.edu

BACKGROUND: A bidirectional relationship between migraine and depression suggests a neurobiological link. Adverse experiences, particularly childhood maltreatment, may alter neurobiological systems, and predispose to a multiplicity of adult chronic disorders. Our objective is to determine, within a headache clinic population of women, if depression moderates the abuse-migraine relationship. METHODS: At six headache specialty clinics, women with migraine were diagnosed using ICHD-II criteria, and frequency was recorded. A questionnaire regarding maltreatment history, headache characteristics, current depression, and somatic symptoms was completed. RESULTS: A total of 949 women with migraine completed the survey: 40% had chronic headache (> or =15 headache days/month) and 72% had “very severe” headache-related disability. Major depression was recorded in 18%. Physical or sexual abuse was reported in 38%, and 12% reported both physical and sexual abuse in the past. Migraineurs with current major depression reported physical (p < 0.001) and sexual (p < 0.001) abuse in higher frequencies compared to those without depression. Women with major depression were more likely to report sexual abuse occurring before age 12 years (OR = 2.30, 95% CI: 1.14 to 4.77), and the relationship was stronger when abuse occurred both before and after age 12 years (OR = 5.08, 95% CI: 2.15 to 11.99). Women with major depression were also twice as likely to report multiple types of maltreatment (OR = 2.07, 95% CI: 1.27 to 3.35) compared to those without depression. CONCLUSIONS: Childhood maltreatment was more common in women with migraine and concomitant major depression than in those with migraine alone. The association of childhood sexual abuse with migraine and depression is amplified if abuse also occurs at a later age.

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PMID: 17785664 [PubMed – indexed for MEDLINE]

Posted in Aging |

Gender-specific associations of short sleep duration with prevalent and incident hypertension: the Whitehall II Study.

Posted on December 4, 2007 by Maurice Preter MD
Hypertension. 2007 Oct;50(4):693-700. Epub 2007 Sep 4.
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Erratum in:

  • Hypertension. 2007 Nov;50(5):e170.

Gender-specific associations of short sleep duration with prevalent and incident hypertension: the Whitehall II Study.

Cappuccio FP, Stranges S, Kandala NB, Miller MA, Taggart FM, Kumari M, Ferrie JE, Shipley MJ, Brunner EJ, Marmot MG.

Clinical Sciences Research Institute, Warwick Medical School, Coventry, United Kingdom. sleepresearch@warwick.ac.uk

Sleep deprivation (<or=5 hour per night) was associated with a higher risk of hypertension in middle-aged American adults but not among older individuals. However, the outcome was based on self-reported diagnosis of incident hypertension, and no gender-specific analyses were included. We examined cross-sectional and prospective associations of sleep duration with prevalent and incident hypertension in a cohort of 10,308 British civil servants aged 35 to 55 years at baseline (phase 1: 1985-1988). Data were gathered from phase 5 (1997-1999) and phase 7 (2003-2004). Sleep duration and other covariates were assessed at phase 5. At both examinations, hypertension was defined as blood pressure >or=140/90 mm Hg or regular use of antihypertensive medications. In cross-sectional analyses at phase 5 (n=5766), short duration of sleep (<or=5 hour per night) was associated with higher risk of hypertension compared with the group sleeping 7 hours, among women (odds ratio: 1.72[corrected]; 95% CI: 1.07[corrected] to 2.75[corrected]), independent of confounders, with an inverse linear trend across decreasing hours of sleep (P=0.037[corrected]). No association was detected in men. In prospective analyses (mean follow-up: 5 years), the cumulative incidence of hypertension was 20.0% (n=740) among 3691 normotensive individuals at phase 5. In women, short duration of sleep was associated with a higher risk of hypertension in a reduced model (age and employment) (6 hours per night: odds ratio: 1.56 [95% CI: 1.07 to 2.27]; <or=5 hour per night: odds ratio: 1.94 [95% CI: 1.08 to 3.50] versus 7 hours). The associations were attenuated after accounting for cardiovascular risk factors and psychiatric comorbidities (odds ratio: 1.42 [95% CI: 0.94 to 2.16]; odds ratio: 1.31 [95% CI: 0.65 to 2.63], respectively). Sleep deprivation may produce detrimental cardiovascular effects among women.

Publication Types:

PMID: 17785629 [PubMed – indexed for MEDLINE]

Posted in Psychiatry/Neurology |

Complicated Pain Management in a CYP450 2D6 Poor Metabolizer.

Posted on November 12, 2007 by Maurice Preter MD
Pain Pract. 2007 Nov 6; [Epub ahead of print]
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Complicated Pain Management in a CYP450 2D6 Poor Metabolizer.

Foster A, Mobley E, Wang Z.

Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta, Georgia, USA.

We describe the case of a patient with significant adverse effects from posttraumatic analgesic therapy with opioid analgesics who was found by microarray analysis to have a CYP2D6 genotype predictive of a poor metabolizer phenotype. In addition to her poor tolerance and limited response to opioid analgesics, she developed further discomfort when the antiemetic promethazine was administered to treat her gastrointestinal adverse effects. In our discussion we review the literature about the clinical impact of CYP450 2D6 polymorphisms in treatment with the commonly used opioid analgesics codeine, oxycodone, hydrocodone, hydromorphone, and morphine, as well as the antiemetic promethazine. The case we present, as well as the literature we review, demonstrates the clinical utility of CYP2D6 genotyping in patients with adverse effects from analgesia therapy.

PMID: 17986163 [PubMed – as supplied by publisher]

Posted in News | Tagged |

Rat brain opioid peptides-circadian rhythm is under control of melatonin.

Posted on November 10, 2007 by Maurice Preter MD
Neuropeptides. 2007 Nov 5; [Epub ahead of print]
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Rat brain opioid peptides-circadian rhythm is under control of melatonin.

Miguel Asai MA, Lilian Mayagoitia LM, David García DG, Gilberto Matamoros-Trejo GM, Marcela Valdés-Tovar MV, Phillipe Leff PL.

Laboratorio de Análisis Químicos, Instituto Nacional de Psiquiatría, Calzada México-Xochimilco #101, Col. San Lorenzo Huipulco, C.P. 14370, México D.F., Mexico.

Several experiments have revealed an Endogenous Opioid System (EOS)-circadian rhythm. The brain-borne hormone, melatonin (MEL) has been shown to regulate the organism photoperiodic activity and may be implicated in the EOS-circadian rhythm. To explore this hypothesis, we studied the effect of functional pinealectomy on the EOS-circadian rhythm by measuring the immunoreactive content of Met-Enkephalin, Leu-Enkephalin and Synenkephalin in both hypothalamus and hippocampus of the rat brain, using standard radioimmunoassay procedures. Experimental animals exposed to white fluorescent light (WFL) for 15days (<50lux), displayed a disruption of the EOS-circadian rhythm, showing that absence of MEL induced a significant decrease of tissue content of enkephalin peptides at 01:00h during the dark-phase of the 24-h circadian rhythm, when compared to control rats. Functional pinealectomized rats exposed to 4 or 6h period of darkness (used to revert the effects induced by the absence of melatonin) significantly increased the tissue content of ME-IR and LE-IR, when compared to both controls and non-exposed WFL-treated rats. In addition, subcutaneous administration of exogenous melatonin (10, 100, 150, 300, 600mug/kg), in WFL-treated animals produced significant dose-dependent increases of ME-IR in both brain regions tested. Finally, luzindole (melatonin receptor antagonist) administration, was not able to prevent the enkephalin tissue increase, induced with the MEL administration (150mug/kg). This data suggest that MEL not only regulates the EOS-circadian rhythm, but also appears to modulate their synthesis in the rat brain from their respective neurons.

PMID: 17988732 [PubMed – as supplied by publisher]

Posted in Psychiatry/Neurology |

Undzere Kinder Workshop

Posted on November 4, 2007 by Maurice Preter MD

Institute for Psychoanalytic Training and Research
Center for Jewish History
YIVO Institute for Jewish Research

Childhood Trauma in Film: Unzere Kinder
(Our Children; Poland 1948)
אינדזערע קינדער
November 4, 2007 2-5 PM

This workshop screens and discusses the last Yiddish-language movie made in Poland. In this part docu-drama, part melancholic comedy produced (but never shown) in Poland in 1948, famous Yiddish comedians Dzigan and Szumacher visit the Helanowek orphanage near the city of Lodz to perform for an audience of Jewish orphans who survived the Holocaust. Their theatrical performance, although well-intentioned, stirs up painful memories of recent events, but also offends the children by the sentimentalized and naïve depiction of wartime conditions. Having all lived through the reality of separation and loss, the children start telling their stories…

In what has become a tradition during medical-psychiatric and psychoanalytic conferences around the world (e.g., International Academy of Law and Mental Health, Padua 2007; International Psychoanalytic Association Meeting, Rio de Janeiro 2005), Dr. Preter and colleagues continue their exploration of post-Shoah psychological trauma and its representation in film.

Moderators:
Maurice Preter, MD, Psychiatrist and Neurologist, Columbia University, New York
Isaac Tylim, PsyD, Psychologist and Psychoanalyst, IPTAR, New York

Panelists:
Harold J. Bursztajn, MD, Psychiatrist and Psychoanalyst, Harvard Medical School, Cambridge, Mass
Eva Kantor, PhD, Psychologist and Psychoanalyst, IPTAR, New York
Shimon Redlich, PhD (recorded video interview), Historian, Professor Emeritus; Ben-Gurion University of the Negev, Israel
Marek Web, Senior Research Scholar and former Chief Archivist (1970-2002); YIVO Institute for Jewish Research, New York;
Eva Weil, PhD, Psychologist and Psychoanalyst, Paris Psychoanalytic Society, Paris/France.

Format:
Rather than a traditional panel discussion, this workshop will focus on group process and interaction as much among members of the audience as between the audience and the panelists. We would like participants to introduce themselves to their neighbors, form small groups (of 2, and then 4) and share their impressions of the film. Likewise, panelists will be interviewed in a one-on-one setting and share their personal histories, impressions, reactions, thoughts etc. about the film.

Notes:
This event is sponsored by the Center for Jewish History, the Institute for Psychoanalytic Training and Research IPTAR (Art, Psychoanalysis, and Society Project) and the YIVO Institute for Jewish Research
Please note that this event will be recorded and may later be used for educational purposes and possible broadcasting.
For any questions, and to continue the discussion on-line, please contact Dr. Preter at mp2285@columbia.edu

Suggested Links:
Summary of the “Undzere Kinder” workshop at the 44th Congress of the International Psychoanalytical Association. Rio de Janeiro, Brazil
Shimon Redlich: Between History and Biography. Memories from Postwar Lodz. 2006
Joanna Michlic: The Children Accuse. SHCY. Winter 2007

Interview with Historian Shimon Redlich (child actor in Undzere Kinder)

Posted in Events |