scholarly journals Familial Aggregation of Migraine and Depression: Insights From a Large Australian Twin Sample

2016 ◽  
Vol 19 (4) ◽  
pp. 312-321 ◽  
Author(s):  
Yuanhao Yang ◽  
Huiying Zhao ◽  
Andrew C. Heath ◽  
Pamela A. F. Madden ◽  
Nicholas G. Martin ◽  
...  

Objectives: This research examined the familial aggregation of migraine, depression, and their co-occurrence.Methods: Diagnoses of migraine and depression were determined in a sample of 5,319 Australian twins. Migraine was diagnosed by either self-report, the ID migraine™ Screener, or International Headache Society (IHS) criteria. Depression was defined by fulfilling either major depressive disorder (MDD) or minor depressive disorder (MiDD) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria. The relative risks (RR) for migraine and depression were estimated in co-twins of twin probands reporting migraine or depression to evaluate their familial aggregation and co-occurrence.Results: An increased RR of both migraine and depression in co-twins of probands with the same trait was observed, with significantly higher estimates within monozygotic (MZ) twin pairs compared to dizygotic (DZ) twin pairs. For cross-trait analysis, the RR for migraine in co-twins of probands reporting depression was 1.36 (95% CI: 1.24–1.48) in MZ pairs and 1.04 (95% CI: 0.95–1.14) in DZ pairs; and the RR for depression in co-twins of probands reporting migraine was 1.26 (95% CI: 1.14–1.38) in MZ pairs and 1.02 (95% CI: 0.94–1.11) in DZ pairs. The RR for strict IHS migraine in co-twins of probands reporting MDD was 2.23 (95% CI: 1.81–2.75) in MZ pairs and 1.55 (95% CI: 1.34–1.79) in DZ pairs; and the RR for MDD in co-twins of probands reporting IHS migraine was 1.35 (95% CI: 1.13–1.62) in MZ pairs and 1.06 (95% CI: 0.93–1.22) in DZ pairs.Conclusions: We observed significant evidence for a genetic contribution to familial aggregation of migraine and depression. Our findings suggest a bi-directional association between migraine and depression, with an increased risk for depression in relatives of probands reporting migraine, and vice versa. However, the observed risk for migraine in relatives of probands reporting depression was considerably higher than the reverse. These results add further support to previous studies suggesting that patients with comorbid migraine and depression are genetically more similar to patients with only depression than patients with only migraine.

2016 ◽  
Vol 19 (4) ◽  
pp. 341-350 ◽  
Author(s):  
Yuanhao Yang ◽  
Huiying Zhao ◽  
Andrew C. Heath ◽  
Pamela A. F. Madden ◽  
Nicholas G. Martin ◽  
...  

Migraine frequently co-occurs with depression. Using a large sample of Australian twin pairs, we aimed to characterize the extent to which shared genetic factors underlie these two disorders. Migraine was classified using three diagnostic measures, including self-reported migraine, the ID migraine™ screening tool, or migraine without aura (MO) and migraine with aura (MA) based on International Headache Society (IHS) diagnostic criteria. Major depressive disorder (MDD) and minor depressive disorder (MiDD) were classified using the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria. Univariate and bivariate twin models, with and without sex-limitation, were constructed to estimate the univariate and bivariate variance components and genetic correlation for migraine and depression. The univariate heritability of broad migraine (self-reported, ID migraine, or IHS MO/MA) and broad depression (MiDD or MDD) was estimated at 56% (95% confidence interval [CI]: 53–60%) and 42% (95% CI: 37–46%), respectively. A significant additive genetic correlation (rG = 0.36, 95% CI: 0.29–0.43) and bivariate heritability (h2 = 5.5%, 95% CI: 3.6–7.8%) was observed between broad migraine and depression using the bivariate Cholesky model. Notably, both the bivariate h2 (13.3%, 95% CI: 7.0–24.5%) and rG (0.51, 95% CI: 0.37–0.69) estimates significantly increased when analyzing the more narrow clinically accepted diagnoses of IHS MO/MA and MDD. Our results indicate that for both broad and narrow definitions, the observed comorbidity between migraine and depression can be explained almost entirely by shared underlying genetically determined disease mechanisms.


2019 ◽  
Vol 4 (2) ◽  

Delirium is defined in the Diagnostic and Statistical Manual of Mental Disorders: Fifth edition (DSM-V) as a “disturbance and change in attention and awareness from baseline that develops over a short period of time, with fluctuating course” [1]. Delirium occurs as a result of factors related to primary illness, the treatment of that illness, and stressful and disorientating environment of the hospital [2]. There are limited data to describe the incidence of delirium in children hospitalized with cancer [3]. Delirium occurs frequently in adults and is an independent predictor of mortality, increased length of stay, and increased risk for long-term cognitive deficits [3]. The prevalence of delirium in hospitalized adults ages 18-56 with cancer ranges from 18%-44% [4]. Most pediatric studies on delirium focus on the critically ill child in the pediatric intensive care unit (PICU). It is estimated that the incidence of delirium in this population is as high as 29% [5].


2017 ◽  
Vol 52 (2) ◽  
pp. 149-162 ◽  
Author(s):  
Sarah E Johnson ◽  
David Lawrence ◽  
Michael Sawyer ◽  
Stephen R Zubrick

Objective: To describe the extent to which parents report that 4- to 17-year-olds with symptoms meeting Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria for mental disorders need help, the types of help needed, the extent to which this need is being met and factors associated with a need for help. Method: During 2013–2014, a national household survey of the mental health of Australia’s young people (Young Minds Matter) was conducted, involving 6310 parents (and carers) of 4- to 17-year-olds. The survey identified 12-month mental disorders using the Diagnostic Interview Schedule for Children – Version IV ( n = 870) and asked parents about the need for four types of help – information, medication, counselling and life skills. Results: Parents of 79% of 4- to 17-year-olds with mental disorders reported that their child needed help, and of these, only 35% had their needs fully met. The greatest need for help was for those with major depressive disorder (95%) and conduct disorder (93%). Among these, 39% of those with major depressive disorder but only 19% of those with conduct disorder had their needs fully met. Counselling was the type of help most commonly identified as being needed (68%). In multivariate models, need for counselling was higher when children had autism or an intellectual disability, in blended families, when parents were distressed, and in the most advantaged socioeconomic areas. Conclusions: Many children and adolescents meeting Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria for mental disorders have a completely unmet need for help, especially those with conduct disorders. Even with mild disorders, lack of clinical assessment represents an important missed opportunity for early intervention and treatment.


Author(s):  
Daniel N. Klein ◽  
Sarah R. Black

Over the past few decades, there has been increasing recognition of the problem of persistent, or chronic, depression. Chronic depressions account for up to a third of the cases of depression in the community and half the cases in clinical practice. Moreover, as reflected in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), persistent depressive disorder differs in many significant respects from nonpersistent depression. This chapter provides an overview of the current literature on persistent depression, starting with classification, epidemiology, and course. Psychosocial and neurobiological risk factors, including early adversity, genetics, personality/temperament, cognitive style, interpersonal difficulties, neural abnormalities, and chronic stress, are then reviewed. Next, we discuss psychopharmacological and psychotherapeutic interventions for acute and continuation/maintenance treatment of persistent depression. We conclude with suggestions for future research.


2019 ◽  
Vol 25 (1) ◽  
pp. 33-44 ◽  
Author(s):  
Susana Andrés-Pepiñá ◽  
Maria Teresa Plana ◽  
Itziar Flamarique ◽  
Sonia Romero ◽  
Roger Borràs ◽  
...  

Objective: To assess the outcome of adolescents with anorexia nervosa (AN) about 20 years after first treatment. Methods: Sixty-two women diagnosed with AN during adolescence were invited to participate. Of these 62 patients, 38 agreed to participate and were assessed with a battery of questionnaires and interviews. A control group of 30 women of similar age was also assessed. Results: Of the patients who completed the full assessment, 13 (34%) presented some degree of eating disorder (ED) at follow-up (10 (26%) met full Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for an ED and 3 (8%) showed partial remission of an ED). The remaining 25 (66%) patients had fully recovered from AN. The duration of untreated illness before admission was significantly associated with an increased risk of a current ED (odds ratio (OR) = 3.334 (1.3–8.7); p = .014). Of the patients who had recovered totally from their ED, 24% showed another psychiatric disorder. This percentage rose to 70% in patients with a current ED. Conclusion: Sixty-six percent of adolescents who completed the assessment achieved remission of their AN. Comorbidity was more common in the current ED group. The variable that best predicted complete remission was the number of years without treatment, showing the importance of detection and early intervention.


2017 ◽  
Vol 24 (7) ◽  
pp. 990-1001 ◽  
Author(s):  
Marco Antônio Arruda ◽  
Renato Arruda ◽  
Vincenzo Guidetti ◽  
Marcelo Eduardo Bigal

Objective: Recurrent headaches and ADHD are prevalent in the pediatric population. Herein, we assess if ADHD is comorbid to headaches overall, to headache subtypes (e.g., migraine), and to headache frequency. Method: Informed consent and analyzable data were obtained for 5,671 children aged 5 to 12 years (65.9% of the target sample). Parents and teachers were interviewed using validated questionnaires based on the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5). Relative risks were modeled using univariate and multivariate analyses. Results: As contrasted to nonheadache controls, the prevalence of ADHD was significantly higher in children with migraine ( p < .001) but not in those with tension-type headaches. In children with migraine, risk of ADHD increased as a function of headache frequency ( p < .05). Conclusion: Migraine and frequent migraine are comorbid to ADHD. Future studies should focus on the impact of the association on the burden to the children and their families.


2009 ◽  
Vol 62 (3-4) ◽  
pp. 148-152 ◽  
Author(s):  
Tamara Rabi-Zikic ◽  
Aleksandra Nedic ◽  
Marija Zarkov ◽  
Petar Slankamenac ◽  
Dragica Dobrenov ◽  
...  

The diagnosis of depression. Depressive disorder is nowadays diagnosed by the two widely used diagnostic systems - International Classification of Diseases of the World Health Organization, 10th revision and the Diagnostic and Statistical Manual Criteria of the American Psychiatric Organisation, 4th edition. The criteria for depressive disorder used in these two systems are almost identical. Poststroke depression. The diagnosis of depression may be difficult to establish in stroke patients, especially in patients with aphasia/dysphasia, anosognosia and other cognitive dysfunction. Major vs. minor poststroke depression, specificity and sensitivity of depressive symptoms: The phenomenology of major poststroke depression has been found to be similar to that of primary depression, and it appears that minor and major are not stages of the same continuum, but rather separate entities. Contrary to common opinion, non specific somatic symptoms do not hinder the diagnosis of poststroke depression and can be highly discriminative and crucial in the evaluation of poststroke depression. Validity of the poststroke depression diagnosis Studies have shown that a valid diagnosis of poststroke depression may be established successfully using structured or semi-structured neuropsychiatric interviews, according to the current Diagnostic and Statistical Manual Criteria. Conclusion. It appears that no new diagnostic tools specific for major depression in stroke patients are necessary. The existing diagnostic procedures will fail to diagnose or misdiagnose depression only in few stroke patients.


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