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Orr SL. Parental mental health and migraine in youth: An evolving story historically plagued with sparse and inadequate literature and mother-blaming. Headache 2024; 64:1073-1075. [PMID: 38934206 DOI: 10.1111/head.14779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024]
Affiliation(s)
- Serena L Orr
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Section of Neurology, Alberta Children's Hospital, Calgary, Alberta, Canada
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Kozlowska K, Scher S. Recent advances in understanding the neurobiology of pediatric functional neurological disorder. Expert Rev Neurother 2024; 24:497-516. [PMID: 38591353 DOI: 10.1080/14737175.2024.2333390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 03/18/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Functional neurological disorder (FND) is a neuropsychiatric disorder that manifests in a broad array of functional motor, sensory, or cognitive symptoms, which arise from complex interactions between brain, mind, body, and context. Children with FND make up 10%-20% of presentations to neurology services in children's hospitals and up to 20% of adolescents admitted to hospital for the management of intractable seizures. AREAS COVERED The current review focuses on the neurobiology of pediatric FND. The authors present an overview of the small but growing body of research pertaining to the biological, emotion-processing, cognitive, mental health, physical health, and social system levels. EXPERT OPINION Emerging research suggests that pediatric FND is underpinned by aberrant changes within and between neuron-glial (brain) networks, with a variety of factors - on multiple system levels - contributing to brain network changes. In pediatric practice, adverse childhood experiences (ACEs) are commonly reported, and activation or dysregulation of stress-system components is a frequent finding. Our growing understanding of the neurobiology of pediatric FND has yielded important flow-on effects for assessing and diagnosing FND, for developing targeted treatment interventions, and for improving the treatment outcomes of children and adolescents with FND.
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Affiliation(s)
- Kasia Kozlowska
- The Children's Hospital at Westmead, Westmead, NSW, Australia
- Brain Dynamics Centre, Westmead Institute of Medical Research, Westmead, NSW, Australia
- University of Sydney Medical School, Camperdown, NSW, Australia
| | - Stephen Scher
- University of Sydney Medical School, Camperdown, NSW, Australia
- Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
- McLean Hospital, Belmont, MA, USA
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Ballesio A, Santamaria T, Furio S, Parisi P, Polese D, Micheli F, Baccini F, Di Nardo G, Lombardo C. Associations between immune biomarkers and symptoms of anxiety, depression, and insomnia in paediatric inflammatory bowel disease: A preliminary longitudinal analysis. Physiol Behav 2024; 278:114510. [PMID: 38479583 DOI: 10.1016/j.physbeh.2024.114510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/26/2024] [Accepted: 03/09/2024] [Indexed: 04/07/2024]
Abstract
Innate immunity may influence the onset of affective symptoms and alter sleep patterns in chronic inflammatory conditions. Here, we tested the prospective associations between baseline serum C-reactive protein (CRP), albumin, and CRP/albumin ratio (CAR, i.e., an emerging biomarker of disease activity), and self-reported symptoms of anxiety, depression, and insomnia at 1-year follow up in paediatric inflammatory bowel disease (n = 17). After controlling for baseline values, CAR (ρ = 0.591, p = 0.026) predicted anxiety symptoms, while albumin predicted both anxiety (ρ = -0.687, p = 0.007) and insomnia symptoms (ρ = -0.648, p = 0.012). Current findings preliminarily suggest that inflammation may influence anxiety and sleep disturbance in paediatric IBD.
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Affiliation(s)
- Andrea Ballesio
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy.
| | - Tiziana Santamaria
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Silvia Furio
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Pediatric Unit, Sant'Andrea University Hospital, Rome, Italy
| | - Pasquale Parisi
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Pediatric Unit, Sant'Andrea University Hospital, Rome, Italy
| | - Daniela Polese
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Pediatric Unit, Sant'Andrea University Hospital, Rome, Italy
| | - Federica Micheli
- Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Italy
| | - Flavia Baccini
- Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Italy
| | - Giovanni Di Nardo
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Pediatric Unit, Sant'Andrea University Hospital, Rome, Italy
| | - Caterina Lombardo
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
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Gerstl B, Ahinkorah BO, Nguyen TP, John JR, Hawker P, Winata T, Brice F, Bowden M, Eapen V. Evidence-based long term interventions targeting acute mental health presentations for children and adolescents: systematic review. Front Psychiatry 2024; 15:1324220. [PMID: 38510802 PMCID: PMC10950959 DOI: 10.3389/fpsyt.2024.1324220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/12/2024] [Indexed: 03/22/2024] Open
Abstract
Background Long term intervention services have proven to be effective in improving mental health (MH) outcomes and the quality of life for children and young people (CYP). Aim To synthesize evidence on the effectiveness of long-term interventions in improving MH outcomes for CYP, 0-17 years, presenting with MH conditions. Methods A systematic search was carried out and the methodological quality of included long term MH intervention studies were assessed. Six databases were searched for peer-reviewed articles between January 2000 and September 2022. Results We found 30 studies that reported on the effectiveness of a range of long-term MH interventions in the form of (i) group therapy, (ii) multisystemic behavior therapy, (iii) general services, (iv) integrated services, (v) psychotherapy, (vi) intensive intervention services, (vii) comprehensive collaborative care, (viii) parent training, and (ix) home outreach service. Among the included studies, seven were rated as high level of evidence based on the National Health and Medical Research Council (NHMRC) levels of evidence hierarchy scale and seven were of moderate quality evidence. Others were rated as lower-quality evidence. Among the studies providing high quality evidence, most were reported for group therapy, general services, and psychotherapy studies demonstrating beneficial effects. Conclusion This systematic review provides evidence to demonstrate the benefits of a range of long-term interventions, in a range of settings, can be effective in improving MH outcomes for CYP and their families. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42022323324.
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Affiliation(s)
- Brigitte Gerstl
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Bright Opoku Ahinkorah
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Thomas P. Nguyen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
- Mental Health, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - James Rufus John
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Patrick Hawker
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Teresa Winata
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
- Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Sydney, NSW, Australia
| | - Febe Brice
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
| | - Michael Bowden
- Child and Youth Mental Health, NSW Ministry of Health, Sydney, NSW, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- Psychological Medicine, Sydney Children’s Hospitals Network, Sydney, NSW, Australia
| | - Valsamma Eapen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
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Dadras O, Takashi N. Traditional, cyberbullying, and suicidal behaviors in Argentinian adolescents: the protective role of school, parental, and peer connectedness. Front Psychiatry 2024; 15:1351629. [PMID: 38501081 PMCID: PMC10944925 DOI: 10.3389/fpsyt.2024.1351629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/16/2024] [Indexed: 03/20/2024] Open
Abstract
Introduction Bullying, both in person and online, is a significant risk factor for a range of negative outcomes including suicidal behaviors among adolescents and it is crucial to explore the protective effects of parental, school, and peer connectedness on suicidal behaviors among victims. Methods This study is a secondary analysis of the Argentina Global School-based Student Health Survey (GSHS 2018). Logistic regression analysis, adjusting for age and sex, determines the likelihood of suicidal thoughts and attempts among bullying victims. To explore the modifying effect of school, parental, and peer connectedness on the association between bullying and suicide behaviors, the interaction term was included. Sampling design and weights were applied in all analyses in STATA 17. Results The study included 56,783 students in grades 8-12, with over half being female. Adolescents aged 14-15 exhibited the highest prevalence of bullying, cyberbullying, suicidal thoughts, and attempts, with females displaying a higher prevalence in all measured categories. The study found that adolescents who reported being bullied or cyberbullied demonstrated a significantly higher likelihood of experiencing suicidal thoughts and attempting suicide. Furthermore, protective factors such as school, parental, and peer connectedness were found to play a critical role in mitigating the adverse impacts of bullying and cyberbullying on suicidal thoughts and attempts. Conclusion The findings underscore the critical prevalence of both bullying and cyberbullying among school-going Argentinian adolescents and their profound association with suicidal behaviors. The study emphasizes the importance of supportive family environments and peer and school connectedness in mitigating the negative effects of bullying and cyberbullying on mental health and suicide risk among adolescents.
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Affiliation(s)
- Omid Dadras
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
| | - Naoki Takashi
- Department of Health Economics, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
- Department of Health Informatics, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Polese D, Costanzi F, Bianchi P, Frega A, Bellati F, De Marco MP, Parisi P, Bruni O, Caserta D, Cozza G. The impact of COVID-19 on menstrual cycle's alterations, in relation to depression and sleep disturbances: a prospective observational study in a population of medical students. BMC Womens Health 2024; 24:130. [PMID: 38373995 PMCID: PMC10877769 DOI: 10.1186/s12905-024-02971-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/12/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND The sars-Cov-2 pandemic has determined psychological stress, particularly in the young population of medical students. We studied the impact of the pandemic on menstrual cycle alteration in relation to psychological stress, presence of depression, sleep disturbances and post-traumatic stress, on a population of medical students. METHODS 293 female students at the Faculty of Medicine and Psychology of the Sapienza University of Rome (23.08 years old ± 3.8) were enrolled. In March 2021, one year after quarantine, a personal data sheet on menstrual cycle, examining the quality of the menstrual cycle during the pandemic, compared to the previous period. Concomitantly, the Beck Depression Inventory and the Impact of Event Scale have been administered. A Pearson chi-square test was assessed to evaluate the difference between the characteristics of the menstrual cycle and the scores obtained with the questionnaires. RESULTS A statistically significant association between menstrual alterations and stress during pandemic had been found. The onset of depressive symptoms and sleep disturbances was observed in 57.1% and in 58.1% of young women with cycle's alterations, respectively. Amenorrhea was three times more common in female students with depressive symptoms, premenstrual syndrome had a significant correlation with both depression and sleep disturbances. The pandemic has been related to menstrual alterations, with depressive symptoms and sleep disorders. Amenorrhea is connected to depression, as observed on the functional hypothalamic amenorrhea. CONCLUSIONS The pandemic affected the menstrual cycle as well as the depressive symptoms and sleep. Practical implications of the study lead to the development of strategies for psychological intervention during the pandemic experience, in order to help medical trainees, with specific attention to women's needs. Future studies should analyze the impact of other types of social stress events, on sleep, depression and the menstrual cycle beside the pandemic.
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Affiliation(s)
- Daniela Polese
- PhD Program on Sensorineural Plasticity, Department of Neuroscience, Mental Health and Sensory Organs NESMOS, Sapienza University of Rome, Sant'Andrea University Hospital, Via di Grottarossa 1035-1039, Rome, 00189, Italy.
| | - Flavia Costanzi
- Gynecology Division, Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, Via di Grottarossa 1035-1039, Rome, 00189, Italy
| | - Paola Bianchi
- Gynecology Division, Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, Via di Grottarossa 1035-1039, Rome, 00189, Italy
| | - Antonio Frega
- Gynecology Division, Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, Via di Grottarossa 1035-1039, Rome, 00189, Italy
| | - Filippo Bellati
- Gynecology Division, Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, Via di Grottarossa 1035-1039, Rome, 00189, Italy
| | - Maria Paola De Marco
- Gynecology Division, Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, Via di Grottarossa 1035-1039, Rome, 00189, Italy
| | - Pasquale Parisi
- Chair of Pediatrics, NESMOS Department, Faculty of Medicine & Psychology, Sapienza University c/o Sant'Andrea University Hospital, Via di Grottarossa 1035-1039, Rome, 00189, Italy
| | - Oliviero Bruni
- Department of Social and Developmental Psychology, Sapienza University, Via dei Marsi 78, Rome, 00185, Italy
| | - Donatella Caserta
- Gynecology Division, Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, Via di Grottarossa 1035-1039, Rome, 00189, Italy
| | - Giuliana Cozza
- Gynecology Division, Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, Via di Grottarossa 1035-1039, Rome, 00189, Italy
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Ricci M, Pozzi G, Caraglia N, Chieffo DPR, Polese D, Galiuto L. Psychological Distress Affects Performance during Exercise-Based Cardiac Rehabilitation. Life (Basel) 2024; 14:236. [PMID: 38398745 PMCID: PMC10890595 DOI: 10.3390/life14020236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/29/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND It is known that psychosocial distress affects the morbidity and mortality of patients with cardiovascular disease of every age. The aim of this study was to produce novel information on how psychological distress can influence cardiovascular performance in patients after cardiac surgery undergoing multidisciplinary cardiac rehabilitation. METHODS Patients (n = 57) admitted after cardiac surgery for valvular or coronary disease underwent, within 5 days of admission, the Symptom Checklist-90-Revised (SCL-90-R) self-report questionnaire to measure psychiatric symptoms and the 12-item General Health Questionnaire (GHQ-12) to assess the level of psychological distress. The Positive Symptom Distress Index (PSDI) was measured to indicate the amplitude of symptom distress. Cardiovascular performance was assessed by a 6 min walking test (6MWT) at admission and discharge, and oxygen consumption (VO2 max) was derived. RESULTS Within the SCL-90-R score, somatic symptoms (47.4%), depressive and anxiety symptoms (36.8% and 33.3%, respectively), symptoms of phobic anxiety (21.1%), and psychoticism (24.6%) were over-represented. As for the GHQ-12, 75.4% of the sample reported an abnormally negative perception of their health status. An inverse correlation was shown between the variation in 6MWT and SCL depression (p = 0.048), PSDI (p = 0.022), and the GHQ-12 (p = 0.040). Similarly, an inverse correlation was shown between the variation in the VO2 max, GHQ-12 (p = 0.041), and the PSDI (p = 0.023). CONCLUSIONS Post-cardiac surgery cardiac rehabilitation was associated with increased symptoms of psychological discomfort, as compared with the general population. The amplitude of psychological distress, depression, and hostility are associated with limited improvement in performance. These data strengthen the need for psychological support during cardiac rehabilitation programs.
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Affiliation(s)
- Marta Ricci
- Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, 00189 Rome, Italy;
- UOC of Cardiology, Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Gino Pozzi
- Department of Psychiatry, Fondazione Policlinico A. Gemelli-IRCCS, Catholic University, 00153 Rome, Italy;
| | - Naike Caraglia
- Clinical Psychology Unit, Fondazione Policlinico A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.C.); (D.P.R.C.)
- Memory Clinic, Foundation Policlinico A. Gemelli-IRCCS, 00168 Rome, Italy
| | - Daniela P. R. Chieffo
- Clinical Psychology Unit, Fondazione Policlinico A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.C.); (D.P.R.C.)
| | - Daniela Polese
- UOD of Childhood Neuropsychiatry, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy;
- Department of Neuroscience, Mental Health and Sensory Organs NESMOS, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Leonarda Galiuto
- Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, 00189 Rome, Italy;
- UOC of Cardiology, Sant’Andrea University Hospital, 00189 Rome, Italy
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Sikorski C, Mavromanoli AC, Manji K, Behzad D, Kreatsoulas C. Adverse Childhood Experiences and Primary Headache Disorders: A Systematic Review, Meta-analysis, and Application of a Biological Theory. Neurology 2023; 101:e2151-e2161. [PMID: 37879940 PMCID: PMC10663032 DOI: 10.1212/wnl.0000000000207910] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/15/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Headache disorders are among the leading causes of disability worldwide. While an association between adverse childhood experiences and primary headaches has been reported, the pooled magnitude across studies and pathways of the association are unknown. Our objectives were (1) to estimate the pooled effect of ≥1 adverse childhood experience (ACE) on primary headache disorders in adulthood and (2) to test the hypothesis that ACEs categorized as "threat" traumas or "deprivation" traumas have distinct effects on primary headaches based on a selected theory from our narrative review of how ACEs affect human development along the life course. METHODS PubMed, EMBASE, MEDLINE, Web of Science, Google Scholar, Biological Psychiatry, and gray literature were searched up to March 16, 2023 (PROSPERO, CRD42020223403). Selected articles included (1) observational studies with a comparator group, (2) ACEs that occurred before 18 years of age, and (3) primary headaches occurring at or after 21 years of age. Pooled odds ratios (ORs) were calculated using multilevel linear random-effects modeling. The narrative review included theories that describe how ACEs affect human development and disease across the life course. We selected a theory from our narrative review and tested ACEs categorized according to this theory for any modification of point estimates. RESULTS Our search identified 32 studies, of which 28 were eligible for meta-analysis (n = 154,739 participants, 19 countries). The occurrence of ≥1 adverse childhood experience(s) was associated with primary headaches (pooled OR = 1.48 [95% CI 1.36-1.61]; high-quality evidence, 134,696 participants). As the number of ACEs increased, the odds of primary headaches increased (range: 1 ACE OR = 1.24 [95% CI 1.14-1.35] to ≥4 ACEs OR = 2.09 [95% CI 1.83-2.38], p for trend <0.0001). From the narrative review, a neurodevelopmental theory that categorizes ACEs into threat or deprivation was tested, and both were independently associated with primary headaches (threat OR = 1.46 [95% CI 1.32-1.60] and deprivation OR = 1.35 [95% CI 1.23-1.49], respectively), accounting for heterogeneity (p = 0.021). DISCUSSION This systematic review and meta-analysis confirm that ACEs are important risk factors of primary headache disorders in adulthood. Our findings provide epidemiologic support that ACEs categorized as threat and deprivation may manifest as distinct pathways of early adversity.
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Affiliation(s)
- Claudia Sikorski
- From the Department of Health Research Methods, Evidence, and Impact (C.S.), McMaster University Hamilton, Ontario, Canada; University Medical Center of the Johannes Gutenberg University (A.C.M.), Mainz, Germany; Department of Family and Community Medicine (K.M.), University of Toronto, Ontario, Canada; Department of Health Sciences (D.B.), Brock University St. Catherines, Ontario, Canada; and Health Policy and Management (C.K.), Harvard T.H. Chan School of Public Health, Boston, MA.
| | - Anna C Mavromanoli
- From the Department of Health Research Methods, Evidence, and Impact (C.S.), McMaster University Hamilton, Ontario, Canada; University Medical Center of the Johannes Gutenberg University (A.C.M.), Mainz, Germany; Department of Family and Community Medicine (K.M.), University of Toronto, Ontario, Canada; Department of Health Sciences (D.B.), Brock University St. Catherines, Ontario, Canada; and Health Policy and Management (C.K.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Karishma Manji
- From the Department of Health Research Methods, Evidence, and Impact (C.S.), McMaster University Hamilton, Ontario, Canada; University Medical Center of the Johannes Gutenberg University (A.C.M.), Mainz, Germany; Department of Family and Community Medicine (K.M.), University of Toronto, Ontario, Canada; Department of Health Sciences (D.B.), Brock University St. Catherines, Ontario, Canada; and Health Policy and Management (C.K.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Danial Behzad
- From the Department of Health Research Methods, Evidence, and Impact (C.S.), McMaster University Hamilton, Ontario, Canada; University Medical Center of the Johannes Gutenberg University (A.C.M.), Mainz, Germany; Department of Family and Community Medicine (K.M.), University of Toronto, Ontario, Canada; Department of Health Sciences (D.B.), Brock University St. Catherines, Ontario, Canada; and Health Policy and Management (C.K.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Catherine Kreatsoulas
- From the Department of Health Research Methods, Evidence, and Impact (C.S.), McMaster University Hamilton, Ontario, Canada; University Medical Center of the Johannes Gutenberg University (A.C.M.), Mainz, Germany; Department of Family and Community Medicine (K.M.), University of Toronto, Ontario, Canada; Department of Health Sciences (D.B.), Brock University St. Catherines, Ontario, Canada; and Health Policy and Management (C.K.), Harvard T.H. Chan School of Public Health, Boston, MA
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Nilles C, Williams JVA, Patten S, Pringsheim T, Orr SL. Association Between Peer Victimization, Gender Diversity, Mental Health, and Recurrent Headaches in Adolescents: A Canadian Population-Based Study. Neurology 2023; 101:e1654-e1664. [PMID: 37532511 PMCID: PMC10624480 DOI: 10.1212/wnl.0000000000207738] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/20/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVES It is unknown whether bullying and gender diversity are associated with increased headache frequency in adolescents. Our study aimed to assess the association between peer victimization, gender diversity, and frequent recurrent headaches in adolescents, while controlling for age, sex, socioeconomic status, and potential confounders (mood and anxiety disorders, suicidality). METHODS This was a cross-sectional observational study of adolescents aged 12-17 years using data from a Canadian population-based health survey. Headache frequency was dichotomized into "≤once/wk" or ">once/wk" (i.e., frequent recurrent headaches). Logistic regression was used to quantify the association between frequent peer victimization (overt or relational), gender diversity (female sex at birth + male gender, male sex at birth + female gender, or gender diverse), mood/anxiety disorder, suicidality, and the odds of frequent recurrent headaches. The fully adjusted multivariable logistic regression model included all exposures and was controlled for age, sex, and socioeconomic status. Bootstrap replicate weighting was used to account for survey design effects. RESULTS There were an estimated 2,268,840 eligible participants (weighted sample size) (mean age = 14.4 years, 48.8% female, 0.5% gender diverse), and 11.2% reported frequent recurrent headaches. Frequent recurrent headaches were associated with older age (odds ratio [OR] = 1.26 per year of age, 95% CI 1.20-1.31), female sex (OR = 2.89, 95% CI 2.47-3.37), and being gender diverse (OR = 3.30, 95% CI 1.64-6.63, adjusted for age/sex). Youth with frequent headaches had higher odds of experiencing both overt and relational bullying compared with peers (OR = 2.69, 95% CI 2.31-3.14, and OR = 3.03, 95% CI 2.58-3.54, adjusted for age/sex). In the fully adjusted model, frequent headaches were no longer associated with gender diversity (OR = 1.53, 95% CI 0.63-3.69) but were still associated with frequent overt and relational peer victimization (OR = 1.82, 95% CI 1.41-2.34, and OR = 1.54, 95% CI 1.17-2.03, respectively), suicidality (OR = 1.83, 95% CI 1.44-2.32), and having a mood or anxiety disorder (OR = 1.50, 95% CI 1.01-2.21, and OR = 1.74, 95% CI 1.24-2.45, respectively). In a model adjusted for age, sex, and mood/anxiety disorders, the risk of suicidality increased incrementally with headache frequency. DISCUSSION Peer victimization and suicidality may be associated with higher headache frequency in adolescents with headaches, independently of mood and anxiety symptoms. Gender-diverse adolescents may have a higher risk of experiencing frequent headaches when compared with cisgender peers, and this may be explained by associated psychosocial factors (anxiety, depression, suicidality, and peer victimization).
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Affiliation(s)
- Christelle Nilles
- From the Department of Clinical Neurosciences (C.N., S.P., T.P.), Psychiatry, Pediatrics and Community Health Sciences, University of Calgary; Departments of Community Health Sciences (J.V.A.W.) and Clinical Neurosciences (T.P., S.L.O.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.P., T.P., S.L.O.); Hotchkiss Brain Institute (T.P., S.L.O.), University of Calgary; and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Jeanne V A Williams
- From the Department of Clinical Neurosciences (C.N., S.P., T.P.), Psychiatry, Pediatrics and Community Health Sciences, University of Calgary; Departments of Community Health Sciences (J.V.A.W.) and Clinical Neurosciences (T.P., S.L.O.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.P., T.P., S.L.O.); Hotchkiss Brain Institute (T.P., S.L.O.), University of Calgary; and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Scott Patten
- From the Department of Clinical Neurosciences (C.N., S.P., T.P.), Psychiatry, Pediatrics and Community Health Sciences, University of Calgary; Departments of Community Health Sciences (J.V.A.W.) and Clinical Neurosciences (T.P., S.L.O.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.P., T.P., S.L.O.); Hotchkiss Brain Institute (T.P., S.L.O.), University of Calgary; and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Tamara Pringsheim
- From the Department of Clinical Neurosciences (C.N., S.P., T.P.), Psychiatry, Pediatrics and Community Health Sciences, University of Calgary; Departments of Community Health Sciences (J.V.A.W.) and Clinical Neurosciences (T.P., S.L.O.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.P., T.P., S.L.O.); Hotchkiss Brain Institute (T.P., S.L.O.), University of Calgary; and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Serena L Orr
- From the Department of Clinical Neurosciences (C.N., S.P., T.P.), Psychiatry, Pediatrics and Community Health Sciences, University of Calgary; Departments of Community Health Sciences (J.V.A.W.) and Clinical Neurosciences (T.P., S.L.O.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.P., T.P., S.L.O.); Hotchkiss Brain Institute (T.P., S.L.O.), University of Calgary; and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada.
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Baglioni V, Orecchio S, Esposito D, Faedda N, Natalucci G, Guidetti V. Tension-Type Headache in Children and Adolescents. Life (Basel) 2023; 13:life13030825. [PMID: 36983980 PMCID: PMC10056425 DOI: 10.3390/life13030825] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/12/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
In pediatric neurology, tension-type headache (TTH) represents a very common type of primary headache during the pediatric age. Despite the high prevalence of TTH, this diagnosis is often underestimated in childhood, with relevant difficulties in the differential diagnosis of TTH from secondary and primary headache manifestations. Even among primary headaches, a clinical overlap is not so infrequent in children: migraine attacks could present tension headache-like features while tension-type headaches may display migraine-like symptoms as well. Several variables play a role in the complex trajectory of headache evolution, such as hormonal changes during adolescence, triggers and genetic and epigenetic factors. The trajectories and outcomes of juvenile migraine and TTH, as well as the transition of one form to the other, have been investigated in several long-term prospective studies. Thus, the aim of this paper is to review the current literature on the differential diagnosis workout of TTH in pediatrics, the possible outcomes during the developmental age and the appropriate therapeutic strategies. Indeed, TTH represents a challenging diagnostic entity in pediatrics, both from a clinical and a therapeutic point of view, in which early diagnosis and appropriate treatment are recommended.
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Affiliation(s)
- Valentina Baglioni
- Child Neurology and Psychiatry Unit, Department of Human Neuroscience, Sapienza University, Via dei Sabelli 108, 00185 Rome, Italy
| | - Silvia Orecchio
- Child Neurology and Psychiatry Unit, Department of Human Neuroscience, Sapienza University, Via dei Sabelli 108, 00185 Rome, Italy
| | - Dario Esposito
- Child Neurology and Psychiatry Unit, Department of Human Neuroscience, Sapienza University, Via dei Sabelli 108, 00185 Rome, Italy
| | - Noemi Faedda
- Child Neurology and Psychiatry Unit, Department of Human Neuroscience, Sapienza University, Via dei Sabelli 108, 00185 Rome, Italy
| | - Giulia Natalucci
- Child Neurology and Psychiatry Unit, Department of Human Neuroscience, Sapienza University, Via dei Sabelli 108, 00185 Rome, Italy
| | - Vincenzo Guidetti
- Child Neurology and Psychiatry Unit, Department of Human Neuroscience, Sapienza University, Via dei Sabelli 108, 00185 Rome, Italy
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Tao H, Zeng X, Hou M, Chen S, Shen J, Liao X, Zou C. Association of adverse childhood experiences and depression among medical students: the role of family functioning and insomnia. Front Psychol 2023; 14:1134631. [PMID: 37205075 PMCID: PMC10185847 DOI: 10.3389/fpsyg.2023.1134631] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/11/2023] [Indexed: 05/21/2023] Open
Abstract
Background Few studies have explored the mechanisms linking adverse childhood experiences (ACEs) to depression in medical students. This study aimed to investigate the relationship between ACEs and depression through the serial mediation effect of family functioning and insomnia. Methods A cross-sectional survey was conducted with 368 medical students from university in Chengdu in 2021. The participants were asked to complete four self-report questionnaires, including ACEs scale, the family APGAR index, the ISI and PHQ-9. Singe and serial mediation analyses were conducted using structural equation modeling by Mplus 8.3. Results ACEs had a significant direct effect on depression (β = 0.438, p < 0.001) and through three significantly indirect pathways: (1) through family functioning (β = 0.026, 95% CI: 0.007-0.060), accounting for 5.9% of the total effect; (2) through insomnia (β = 0.103, 95% CI: 0.011-0.187), accounting for 23.5% of the total effect; and (3) through the serial mediators involving in family functioning and insomnia (β = 0.038, 95% CI: 0.015-0.078), accounting for 8.7% of the total effect. The total indirect effect was 38.1%. Limitations This cross-sectional study prevented us from establishing causality. Conclusion This study highlights the role of family functioning and insomnia as serial mediators of the relationship between ACEs and depression. Findings help to elucidate the mechanism that underlines the pathway between ACEs and depression in medical students. These findings may indicate developing measures to strengthen family functioning and improve insomnia aiming to reduce depression in medical students with ACEs.
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Affiliation(s)
- Hongxia Tao
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- The Department of General Practice, Chengdu Fifth People’s Hospital, Chengdu University of TCM, Chengdu, China
| | - Xin Zeng
- The Department of General Practice, Chengdu Fifth People’s Hospital, Chengdu University of TCM, Chengdu, China
| | - Mutian Hou
- Psychological Research and Counseling Center, Southwest Jiaotong University, Chengdu, China
| | - Shanping Chen
- The Department of Geriatric Medicine, Chengdu Fifth People’s Hospital, Chengdu University of TCM, Chengdu, China
| | - Jing Shen
- The Department of General Practice, Chengdu Fifth People’s Hospital, Chengdu University of TCM, Chengdu, China
| | - Xiaoyang Liao
- General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Xiaoyang Liao, ; Chuan Zou,
| | - Chuan Zou
- The Department of General Practice, Chengdu Fifth People’s Hospital, Chengdu University of TCM, Chengdu, China
- *Correspondence: Xiaoyang Liao, ; Chuan Zou,
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Parental post-traumatic stress disorder and increased risk of chronic pain conditions and major psychiatric disorders in their offspring. Gen Hosp Psychiatry 2022; 79:152-157. [PMID: 36379154 DOI: 10.1016/j.genhosppsych.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/15/2022] [Accepted: 10/13/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Previous research suggests that individuals with post-traumatic stress disorder (PTSD) have higher risk of chronic pain symptoms. It remains unknown whether risk of chronic pain symptoms occurs in the offspring of parents with PTSD. This study aimed to explore the risk of chronic pain conditions and depression in the offspring of parents with PTSD. METHODS Between 1996 and 2011, we included subjects whose parents had PTSD and controls with parents without PTSD or any major psychiatric disorders (MPDs) from the Taiwan National Health Research Database. The controls (1:10) were matched for age, sex, time of birth, income, and residence. Poisson regression was applied to estimate the risk of chronic pain conditions and MPDs between case and control cohorts during the study period. The chronic pain conditions assessed were migraine, tension headache, fibromyalgia, peripheral neuropathy, dorsopathies, dysmenorrhea, irritable bowel syndrome (IBS), and dyspepsia. RESULTS We included 1139 cases and 11,390 matched controls. After adjusting for demographics and family history of psychiatric comorbidities, offspring of parents with PTSD had higher risk for depressive disorder [reported as odds ratio (OR) with 95% confidence interval (CI): 2.59, 1.71-3.92] than controls. For chronic pain conditions, offspring of parents with PTSD had higher risk for migraine (2.01, 1.01-3.98) and IBS (1.55, 1.02-2.34) than controls. CONCLUSIONS Healthcare workers should be aware that offspring of parents with PTSD have a higher risk of chronic pain conditions and depressive disorder. Further intervention to mitigate the risk is warranted.
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