Incidence and Risk Factors of Chronic Daily Headache in Young Adolescents: A School Cohort Study.

Incidence and Risk Factors of Chronic Daily Headache in Young Adolescents: A School Cohort Study.

Pediatrics. 2013 Jun 17;
Lu SR, Fuh JL, Wang SJ, Juang KD, Chen SP, Liao YC, Wang YF

OBJECTIVES:This study investigated the incidence and risk factors of chronic daily headache (CDH) and its major subtypes in young adolescents.METHODS:A field cohort of 3342 adolescents aged 13 to 14 was established in 3 middle schools in Taitung, Taiwan, from 2005 to 2007. Participants without CDH at baseline were annually followed up for 1 to 2 years using the same questionnaires, including the Adolescent Depression Inventory and Pediatric Migraine Disability Assessment. The neurologists made the headache diagnoses based on clinical interviews and headache diaries. The person-time incidence rates and risk factors of incident CDH and its subtypes (ie, chronic migraine [CM] and chronic tension-type headache [CTTH]) were calculated by using Cox proportional hazards models.RESULTS:The cohort completed 5586 person-years (PYs) of follow-up. Sixty-three subjects (21 boys/42 girls) developed incident CDH with an incidence rate of 1.13 per 100 PYs, including 37 with CM (0.66 per 100 PYs) and 22 with CTTH (0.39 per 100 PYs). Thirty-three subjects (52%) had a baseline diagnosis of migraine. The independent risk factors for incident CDH included female gender, acute family financial distress, obesity, higher headache frequency, and a baseline diagnosis of migraine. A higher headache frequency was the only identical risk factor for CDH, CM, and CTTH. A baseline diagnosis of migraine and obesity were significant predictors for both CM and CDH. Female gender was a significant predictor for both CTTH and CDH.CONCLUSIONS:Incident CDH was common in young adolescents. Some risk factors for incident CM and CTTH were different. HubMed – depression


Phenolic metabolites of benzene induced caspase-dependent cytotoxicities to K562 cells accompanied with decrease in cell surface sialic acids.

Environ Toxicol. 2013 Jun 17;
Wang Y, Zhang GY, Han QL, Wang J, Suriguga , Li Y, Yu CH, Li YR, Yi ZC

Benzene-induced erythropoietic depression has been proposed to be due to the production of toxic metabolites. Presently, the cytotoxicities of benzene metabolites, including phenol, catechol, hydroquinone, and 1,2,4-benzenetriol, to erythroid progenitor-like K562 cells were investigated. After exposure to these metabolites, K562 cells showed significant inhibition of viability and apoptotic characteristics. Each metabolite caused a significant increase in activities of caspase-3, -8, and -9, and pretreatment with caspase-3, -8, and -9 inhibitors significantly inhibited benzene metabolites-induced phosphatidylserine exposure. These metabolites also elevated expression of Fas and FasL on the cell surface. After exposure to benzene metabolites, K562 cells showed an increase in reactive oxygen species level, and pretreatment with N-acetyl-l-cysteine significantly protected against the cytotoxicity of each metabolite. Interestingly, the control K562 cells and the phenol-exposed cells aggregated together, but the cells exposed to other metabolites were scattered. Further analysis showed that hydroquione, catechol, and 1,2,4-benzenetriol induced a decrease in the cell surface sialic acid levels and an increase in the cell surface sialidase activity, but phenol did not cause any changes in sialic acid levels and sialidase activity. Consistently, an increase in expression level of sialidase Neu3 mRNA and a decrease in mRNA level of sialyltransferase ST3GAL3 gene were detected in hydroquione-, catechol-, or 1,2,4-benzenetriol-treated cells, but no change in mRNA levels of two genes were found in phenol-treated cells. In conclusion, these benzene metabolites could induce apoptosis of K562 cells mainly through caspase-8-dependent pathway and ROS production, and sialic acid metabolism might play a role in the apoptotic process. © 2013 Wiley Periodicals, Inc. Environ Toxicol, 2013. HubMed – depression


Association of Antidepressant and Atypical Antipsychotic Use with Cardiovascular Events and Mortality in a Veteran Population.

Pharmacotherapy. 2013 Jun 17;
Acharya T, Acharya S, Tringali S, Huang J

STUDY OBJECTIVES: To determine the patterns of antidepressant and atypical antipsychotic use in a veteran population with depression, and to determine if an association exists between specific antidepressant classes and atypical antipsychotics and the occurrence of cardiovascular events and all-cause mortality. DESIGN: Retrospective, cross-sectional study. SETTING: Primary care clinic at a Veterans Affairs hospital. PATIENTS: A total of 1136 patients diagnosed with depression who were receiving antidepressant monotherapy (664 patients) or no antidepressant therapy (472 patients [controls]) between June 2009 and December 2010. MEASUREMENTS AND MAIN RESULTS: Data on patient demographics, disease diagnoses, laboratory data, and drug therapy profiles were collected through medical record review. Of the 1136 patients, the mean patient age was 61 years, 90% were men, and 77% were smokers. Mean body mass index was 30.4 kg/m(2) , blood pressure 126/73 mm Hg, hemoglobin A1c 6%, low-density lipoprotein cholesterol level 106.7 mg/dl, and Framingham score 17. Patients receiving antidepressant monotherapy were grouped according to antidepressant class; selective serotonin reuptake inhibitors (SSRIs) were most common. Concomitant use of atypical antipsychotics was more common with the serotonin-norepinephrine reuptake inhibitor (venlafaxine), SSRI, and serotonin receptor antagonist (trazodone) classes (p=0.0067). After adjusting for demographics, concomitant drugs, and comorbidities, SSRI use was significantly associated with lower all-cause mortality (odds ratio [OR] 0.37, 95% confidence interval [CI] 0.19-0.71, p=0.0028). Notably, noradrenergic and specific serotonergic antidepressant (mirtazapine) use was significantly associated with higher prevalence of heart failure (OR 3.26, 95% CI 1.029-10.38, p=0.0445). Use of atypical antipsychotics was significantly associated with a higher prevalence of cerebrovascular events (OR 2.23, 95% CI 1.29-3.83, p=0.0036) and all-cause mortality (OR 2.05, 95% CI 1.03-4.1, p=0.04). CONCLUSION: Our results favor treatment of depression with SSRIs among patients at increased cardiovascular risk due to the potential mortality benefit of this class of drugs. Atypical antipsychotics should be used with caution in the elderly population. Mirtazapine use in patients with heart failure and depression deserves further investigation. HubMed – depression


Prevalence and Predictors of the Short-Term Trajectory of Anxiety and Depression in the First Year After a Cancer Diagnosis: A Population-Based Longitudinal Study.

J Clin Oncol. 2013 Jun 17;
Boyes AW, Girgis A, D’Este CA, Zucca AC, Lecathelinais C

PURPOSEFew studies have examined psychological adjustment for cancer survivors in late treatment and early survivorship stages. Our study investigated the prevalence and short-term trajectories of anxiety, depression, and comorbid anxiety-depression among adult cancer survivors, and identified the individual, disease, health behavior, psychological, and social predictors of chronic and late psychological morbidity. METHODSA heterogeneous sample of adult cancer survivors was recruited from two state-based cancer registries. A total of 1,154 survivors completed self-report questionnaires at 6 (Time 1) and 12 months (Time 2) postdiagnosis. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale with cases identified by a subscale cutoff score ? 8. Logistic regression analyses identified Time 1 characteristics associated with anxiety and/or depression at Time 2.ResultsThe point prevalence of anxiety (Time 1, 22%; Time 2, 21%), depression (13% at both timepoints) and comorbid anxiety-depression (9% at both timepoints) was similar at 6 and 12 months postdiagnosis. The most prevalent Time 1 to Time 2 trajectory was noncase for anxiety (70%), depression (82%), and comorbid anxiety-depression (87%). While psychological morbidity at Time 1 was the strongest predictor of psychological morbidity at Time 2, being diagnosed with lung cancer and health risk behaviors (smoking, insufficient physical activity) were also strong predictors. CONCLUSIONTargeted psychological screening of vulnerable survivors and early intervention may prevent the onset and/or reduce the severity of psychological morbidity in early survivorship. Trials of risk reduction interventions targeting psychological functioning and health risk behaviors seem warranted. HubMed – depression


Spiritual beliefs near the end of life: a prospective cohort study of people with cancer receiving palliative care.

Psychooncology. 2013 Jun 17;
King M, Llewellyn H, Leurent B, Owen F, Leavey G, Tookman A, Jones L

OBJECTIVES: Despite growing research interest in spirituality and health, and recommendations on the importance of spiritual care in advanced cancer and palliative care, relationships between spiritual belief and psychological health near death remain unclear. We investigated (i) relationships between strength of spiritual beliefs and anxiety and depression, intake of psychotropic/analgesic medications and survival in patients with advanced disease; and (ii) whether the strength of spiritual belief changes as death approaches. METHODS: We conducted a prospective cohort study of 170 patients receiving palliative care at home, 97% of whom had a diagnosis of advanced cancer. Data on strength of spiritual beliefs (Beliefs and Values Scale [BVS]), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), psychotropic/analgesic medications, daily functioning, global health and social support were collected at recruitment then 3 and 10?weeks later. Mortality data were collected up to 34?months after the first patient was recruited. RESULTS: Regression analysis showed a slight increase in strength of spiritual belief over time approaching statistical significance (+0.16 BVS points per week, 95% CI [-0.01, 0.33], p?=?0.073). Belief was unrelated to anxiety and depression (-0.15 points decrease in HADS for 10 points increased in BVS (95% CI [-0.57, 0.27], p?=?0.49) or consumption of psychotropic medication). There was a non-significant trend for decreasing analgesic prescription with increasing belief. Mortality was higher over 6?months in participants with lower belief at recruitment. CONCLUSION: Results suggest that although religious and spiritual beliefs might increase marginally as death approaches, they do not affect levels of anxiety or depression in patients with advanced cancer. © 2013 The Authors. Psycho-Oncology published by John Wiley & Sons, Ltd. HubMed – depression



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