Psychiatric comorbidity and suicide risk in adolescents with chronic daily headache

Posted on April 30, 2007 by Maurice Preter MD
 
Worried and unwell: Panic and migraine are highly comorbid, in Taiwan too.
 
 
 NEUROLOGY 2007;68:1468-1473
© 2007 American Academy of Neurology

Psychiatric comorbidity and suicide risk in adolescents with chronic daily headache

Shuu-Jiun Wang, MD, Kai-Dih Juang, MD, Jong-Ling Fuh, MD and Shiang-Ru Lu, MD

From the Departments of Neurology (S.-J.W., J.-L.F.) and Psychiatry (K.-D.J.), National Yang-Ming University School of Medicine, Taipei; Neurological Institute (S.-J.W., J.-L.F.), Taipei Veterans General Hospital; and the Department of Neurology (S.-R.L.), Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan.

Address correspondence and reprint requests to Dr. Shuu-Jiun Wang, The Neurological Institute, Taipei Veterans General Hospital, Taipei, 112, Taiwan sjwang@vghtpe.gov.tw

Objectives: To investigate the prevalence and correlates of comorbid psychiatric disorders and suicidal risk in community-based adolescents with chronic daily headache (CDH).

Methods: We identified and recruited 122 adolescents with CDH from a non-referral student sample (n = 7,900). CDH subtypes were classified according to the most updated criteria of the International Classification of Headache Disorders, 2nd edition (ICHD-2). An in-person psychiatric interview was performed with each subject with CDH to assess depressive and anxiety disorders and suicidal risk based on the Mini-International Neuropsychiatric Interview–Kid (MINI-Kid). Clinical correlates and impacts were investigated.

Results: A total of 121 subjects (31 male/90 female, mean age 13.8 years) finished the psychiatric interview. Fifty-seven subjects (47%) had ≥1 assessed psychiatric comorbidity with major depression (21%) and panic disorder (19%) as the two most common diagnoses. Current suicidal risk was assessed as high (score ≥ 10) in 20% of subjects. Female gender and older age were associated with depressive disorders. Presence of migraine was associated with psychiatric comorbidities (OR = 3.5, p = 0.002). The associations with psychiatric disorders were stronger for migraine with aura than for migraine without aura. Migraine with aura also independently predicted a high suicidal risk (score ≥ 10) (adjusted OR = 6.0, p = 0.028). In contrast, CDH subtypes, headache frequencies, or medication overuse were not correlated. Comorbid psychiatric disorders were not related to physician consultations or more days of sick leave.

Conclusions: This community-based study showed high comorbidity of psychiatric disorders and suicidal risk in adolescents with chronic daily headache. The presence of migraine attacks, especially migraine with aura, was the major predictor for these associations.

Received October 17, 2006. Accepted in final form December 31,

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Tai chi chuan exercise decreases A1C levels along with increase of regulatory T-cells and decrease of cytotoxic T-cell population in type 2 diabetic patients

Posted on April 30, 2007 by Maurice Preter MD
 
Diabetes Care. 2007 Mar;30(3):716-8. Related Articles, Links
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Tai chi chuan exercise decreases A1C levels along with increase of regulatory T-cells and decrease of cytotoxic T-cell population in type 2 diabetic patients.

Yeh SH, Chuang H, Lin LW, Hsiao CY, Wang PW, Yang KD.

Department of Nursing, Chang Gung Institute of Technology, Kwei-Shan, Taoyuan, Taiwan.

Publication Types:

PMID: 17327347 [PubMed – indexed for MEDLINE]

Posted in Health, Psychiatry/Neurology |

Relation between headache in childhood and physical and psychiatric symptoms in adulthood: national birth cohort study

Posted on April 30, 2007 by Maurice Preter MD
 
BMJ. 2001 May 12;322(7295):1145. Cited Articles, Free in PMC, LinkOut

Relation between headache in childhood and physical and psychiatric symptoms in adulthood: national birth cohort study.

Institute of Psychiatry and Guy’s, King’s and St Thomas’s School of Medicine, De Crespigny Park, London SE5 8AF. p.fearon@iop.kcl.ac.uk

OBJECTIVE: To elucidate the associations between frequent headache and psychosocial factors in childhood and to determine whether such children are at an increased risk of headache, multiple physical symptoms, and psychiatric symptoms in adulthood. DESIGN: Population based birth cohort study. SETTING: General population. PARTICIPANTS: People participating in the national child development study, a population based birth cohort study established in 1958. Main outcome measures: Headache, multiple physical symptoms, and psychiatric morbidity at age 33. RESULTS: Headache in childhood was associated with several psychosocial factors. Prospectively, children with frequent headache had an increased risk in adulthood of headache (odds ratio 2.22, 95% confidence interval 1.62 to 3.06), multiple physical symptoms (1.75, 1.46 to 2.10), and psychiatric morbidity (1.41, 1.20 to 1.66). The outcomes of headache and multiple physical symptoms were not accounted for by psychiatric morbidity. CONCLUSION: Children with headache are at an increased risk of recurring headache in adulthood and may complain of other physical and psychiatric symptoms. Strategies for coping with psychosocial adversity in childhood may improve the prognosis in adulthood.

PMID: 11348907 [PubMed – indexed for MEDLINE]

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Psychosocial adjustment and physical health of children living with maternal chronic pain

Posted on April 30, 2007 by Maurice Preter MD
Speaking of epigenetics (see review below).
See also the excellent prospective study on childhood headache by Fearon&Hotopf, above.
J Paediatr Child Health. 2007 Apr;43(4):262-70. Related Articles, Links
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Psychosocial adjustment and physical health of children living with maternal chronic pain.

Evans S, Keenan TR, Shipton EA.

Department of Health and Social Care, University of Canterbury, New Zealand.

Aim: There is limited research examining the functioning of children living with parental chronic pain and illness. The aim of this study was to examine the psychosocial adjustment and physical health of children living with a mother experiencing chronic pain. Methods: One-hundred and three children aged 6-12 years served as participants, with approximately equal numbers of children in maternal chronic pain (n = 55) and control groups (n = 48). Children completed self-reports about their internalising behaviour, health and attachment security. Mothers, fathers and teachers completed questionnaires relating to children’s internalising and externalising behaviour, social behaviour and physical health. Results: Reports from children, mothers and fathers indicated significantly more internalising, externalising, insecure attachment and social and health problems for children in the maternal chronic pain group compared with control children. Teachers reported decreased social skills and increased pain complaints for children in the maternal chronic pain group. Boys in the maternal chronic pain group appear to be affected more than girls. Boys reported more anxiety and insecure attachment, while mothers reported greater social problems and increased illness behaviour for boys. Characteristics of the mother’s pain condition, such as, severity, length and frequency were generally unrelated to child functioning. Conclusions: The study demonstrates the importance of maternal and family variables to child outcomes. The results are discussed in terms of maternal chronic pain comprising a considerable, yet rarely studied, influence in the lives of young children.

PMID: 17444828 [PubMed – in process]

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Surgical management of neck and low back pain

Posted on April 29, 2007 by Maurice Preter MD
Neurol Clin. 2007 May;25(2):507-22. Related Articles, Links
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Surgical management of neck and low back pain.

Krishnaney AA, Park J, Benzel EC.

Cleveland Clinic Center for Spine Health and Department of Neurosurgery, Cleveland Clinic Neurological Institute, Cleveland Clinic, 9500 Euclid Ave., S-80, Cleveland, OH 44195-001, USA.

Surgical intervention for neck pain and low back pain may be of benefit to some patients. It should be considered, however, only in cases where medical management has failed and there is a clearly identifiable anatomic lesion that likely is the pain generator. Indications, preoperative evaluation, and common surgical procedures are reviewed.

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