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Jin Y, Mazrekaj D. The association between parenthood and health: A comparison of people in same-sex and different-sex relationships. SSM Popul Health 2024; 26:101685. [PMID: 38881819 PMCID: PMC11179624 DOI: 10.1016/j.ssmph.2024.101685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/25/2024] [Accepted: 05/27/2024] [Indexed: 06/18/2024] Open
Abstract
Understanding social inequalities in parental health is crucial for family functioning and child development. Theoretically, the double burden of parenting and minority stress may lead to the negative association between parenthood and health outcomes being stronger for people in same-sex relationships. Moreover, drawn from the social control process and the compensation mechanism, the negative association between parenthood and health risk behaviors may become stronger for people in same-sex relationships. Yet, empirical evidence on parental health disparities between parents in same- and different-sex relationships is limited. Using linear and logistic regression models, coarsened exact matching, and entropy balancing on Dutch data between 2008 and 2021 (196 people in same-sex relationships and 6948 people in different-sex relationships), we investigate the relationship between parenthood and three health outcomes (self-rated health, physical health, and mental health) and two health risk behaviors (smoking and heavy episodic drinking). We find that parents on average are less likely to experience heavy episodic drinking than non-parents. The association between parenthood and health does not differ between people in same-sex and different-sex relationships.
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Affiliation(s)
- Yuxuan Jin
- Netherlands Interdisciplinary Demographic Institute (NIDI) - KNAW/University of Groningen, Lange Houtstraat 19, 2511 CV, Den Haag, the Netherlands
- Department of Sociology, Utrecht University, Padualaan 14, 3584 CH, Utrecht, the Netherlands
| | - Deni Mazrekaj
- Department of Sociology, Utrecht University, Padualaan 14, 3584 CH, Utrecht, the Netherlands
- Nuffield College, University of Oxford, New Road, OX1 1NF, Oxford, UK
- Leuven Economics of Education Research, KU Leuven, Naamsestraat 69, 3000, Leuven, Belgium
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Ning J, Deng J, Li S, Lu C, Zeng P. Meta-analysis of association between caesarean section and postpartum depression risk. Front Psychiatry 2024; 15:1361604. [PMID: 38606408 PMCID: PMC11006970 DOI: 10.3389/fpsyt.2024.1361604] [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: 12/26/2023] [Accepted: 03/19/2024] [Indexed: 04/13/2024] Open
Abstract
Background The association of caesarean section (CS) for postpartum depression (PPD) remains controversial. This study aims to explore the relationship between CS and the risk of PPD, in order to provide a basis for preventing PPD. Material and methods We searched PubMed, Web of Science, Cochrane Library, and EMBASE databases for literature about the correlation between CS and PPD published as of February 2024. The combined odds ratios (ORs) and 95% confidence intervals (Cls) were obtained by flexible use of fixed-effects models or random-effects models. Results A total of 18 publications were ultimately included in the analysis. Among these, 14 were cohort studies and 4 were case-control reports, encompassing 844,328 total cases. All of the included studies were deemed to be of moderate or higher quality. The meta-analysis indicated that the prevalence of PPD among parturients undergoing CS was 13.4% (95% CI: 6.5%-25.5%).The adjusted odds ratio (OR) for the association between CS and PPD was 1.12 (95% CI: 1.04-1.20) compared to the natural vaginal delivery (NVD) group. Specifically, the adjusted OR for the association between CS and PPD was 1.29 (95% CI: 1.18-1.40) during the first 1-6 months postpartum, and 1.23 (95% CI: 1.14-1.33) after 6 months postpartum. Furthermore, in comparison to the NVD group, the adjusted OR for elective caesarean section (ELCS) and emergency caesarean section (EMCS) were 0.96 (0.83, 1.10) and 1.20 (1.08, 1.34), respectively. Conclusion Our findings suggest that PPD risk may rise in the presence of CS. In particular, the risk was increased by 20% in the EMCS group, and the risk of PPD within one to six months postpartum after CS increases by 6% compared to that at six months postpartum. In the future, more rational designs and in-depth studies are needed to obtain more accurate information. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD42023389265.
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Affiliation(s)
- Jiajie Ning
- Nursing College, Guangxi Medical University, Nanning, China
| | - Jing Deng
- Nursing College, Guangxi Medical University, Nanning, China
| | - Shanshan Li
- Nursing College, Guangxi Medical University, Nanning, China
| | - Caina Lu
- Department of Neonatology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Pingping Zeng
- Nursing College, Guangxi Medical University, Nanning, China
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Mainland RL, Skinner CR, Saary J. Aeromedical Risk of Migraine. Aerosp Med Hum Perform 2024; 95:101-112. [PMID: 38263111 DOI: 10.3357/amhp.6291.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
INTRODUCTION: Migraine is a common condition that can carry considerable risk to aeromedical duties. Because randomized controlled trials are not an appropriate method to evaluate flight safety risk for medical conditions that may cause subtle or sudden incapacitation, the determination of fitness-to-fly must be based on risk assessments informed by extrapolated evidence. Therefore, we conducted a review of current literature to provide background information to inform the aeromedical risk assessment of migraine using a risk matrix approach.METHODS: We identified studies on topics pertinent to conducting an aeromedical risk assessment of migraine. We generated an overview of the literature synthesizing the findings of articles retrieved from searches of Scopus, Ovid, PubMed, and the Cochrane Library published in English from all years, in both general and aircrew populations. International headache and neurology guidelines, as well as headache policies from the U.S. Air Force, were also reviewed.RESULTS: This review includes information on the following topics relevant to conducting an evidence-based risk assessment of migraine: diagnosis, prevalence, incidence, natural course, clinical presentation, triggers, comorbidities, neuroimaging, implications of family history, and efficacy of pharmacological and nonpharmacological therapies.DISCUSSION: This review summarizes current literature on migraine for use in a risk matrix approach to the aeromedical assessment of migraine in prospective and current aircrew. Awareness of the most current epidemiological data related to a variety of migraine parameters facilitates an evidence-based risk assessment of migraine in aircrew and requires iterative updates as new information becomes available.Mainland RL, Skinner CR, Saary J. Aeromedical risk of migraine. Aerosp Med Hum Perform. 2024; 95(2):101-112.
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Sgro M, Ray J, Foster E, Mychasiuk R. Making migraine easier to stomach: the role of the gut-brain-immune axis in headache disorders. Eur J Neurol 2023; 30:3605-3621. [PMID: 37329292 DOI: 10.1111/ene.15934] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/30/2023] [Accepted: 06/12/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND AND PURPOSE Headache disorders place a significant burden on the healthcare system, being the leading cause of disability in those under 50 years. Novel studies have interrogated the relationship between headache disorders and gastrointestinal dysfunction, suggesting a link between the gut-brain-immune (GBI) axis and headache pathogenesis. Although the exact mechanisms driving the complex relationship between the GBI axis and headache disorders remain unclear, there is a growing appreciation that a healthy and diverse microbiome is necessary for optimal brain health. METHODS A literature search was performed through multiple reputable databases in search of Q1 journals within the field of headache disorders and gut microbiome research and were critically and appropriately evaluated to investigate and explore the following; the role of the GBI axis in dietary triggers of headache disorders and the evidence indicating that diet can be used to alleviate headache severity and frequency. The relationship between the GBI axis and post-traumatic headache is then synthesized. Finally, the scarcity of literature regarding paediatric headache disorders and the role that the GBI axis plays in mediating the relationship between sex hormones and headache disorders are highlighted. CONCLUSIONS There is potential for novel therapeutic targets for headache disorders if understanding of the GBI axis in their aetiology, pathogenesis and recovery is increased.
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Affiliation(s)
- Marissa Sgro
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Jason Ray
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia
- Department of Neurology, Austin Health, Melbourne, Victoria, Australia
| | - Emma Foster
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Richelle Mychasiuk
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
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Alshareef MH, Alsharif BH. Headache Prevalence and Its Associated Factors in Makkah, Saudi Arabia. Biomedicines 2023; 11:2853. [PMID: 37893226 PMCID: PMC10604832 DOI: 10.3390/biomedicines11102853] [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: 09/14/2023] [Revised: 10/07/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Primary headaches are more prevalent and associated with several risk factors, such as chronic diseases, unhealthy lifestyles, smoking, caffeine intake, work, and stress. However, these factors are not associated with specific headache disorders. We investigated the prevalence of primary headache disorders and the associated risk factors in Makkah. This cross-sectional study, conducted over a 6-month period, used an anonymous survey disseminated through online platforms. The questionnaire was a modified version of a validated questionnaire used to assess headaches in relation to modifiable and non-modifiable risk factors. In total, 1177 participants aged 18-65 (mean, 31.5 ± 12.6) years were included. Headaches were diagnosed among 44.2% of participants aged 20-59 years, with a high prevalence among young adults; additionally, 71.5% of participants with headaches reported experiencing headaches for <15 days per month. Chronic headaches were found in 28.5% of participants. Age, chronic diseases, work, caffeine consumption, and smoking were associated with having a significant effect on headache prevalence. The prevalence of headaches in Makkah has increased in comparison to that reported in previous studies. Certain modifiable and non-modifiable risk factors have been associated with headaches. Headaches impact all life aspects of individuals and communities. An educational program for professionals and patients can improve patient outcomes.
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Affiliation(s)
- Maram H. Alshareef
- Department of Community Medicine and Pilgrims Health, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Bayan Hashim Alsharif
- Hajj and Umrah Research and Epidemiology Administration, King Abdullah Medical City, Makkah 24331, Saudi Arabia;
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Błaszczyk B, Straburzyński M, Więckiewicz M, Budrewicz S, Niemiec P, Staszkiewicz M, Waliszewska-Prosół M. Relationship between alcohol and primary headaches: a systematic review and meta-analysis. J Headache Pain 2023; 24:116. [PMID: 37612595 PMCID: PMC10463699 DOI: 10.1186/s10194-023-01653-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 08/15/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Headache is one of the most common neurological symptoms. Many previous studies have indicated a relationship between primary headaches and alcohol. Drinking has been associated with increased risk of tension-type headache (TTH) and migraine. However, recently published studies have not confirmed this relationship. The existing literature is inconclusive; however, migraine patients avoid alcohol. Therefore, the primary objective was to provide a reliable assessment of alcohol intake in people with primary headaches; the secondary objective was to identify any potential relationship between alcohol consumption and headache risk. METHODS This study was based on PubMed, Embase and Web of Science database searches performed on 11 July 2023. This systematic review was registered in PROSPERO (CRD42023412926). Risk of bias for the included studies was assessed using the Joanna Briggs Institute critical appraisal tools. Meta-analyses were performed using Statistica software. The Risk Ratio (RR) was adopted as the measure of the final effect. Analyses were based on a dichotomous division of the respondents into "non-drinkers" and "drinkers" for headache patients and matched non-headache groups. RESULTS From a total of 1892 articles, 22 were included in the meta-analysis. The majority demonstrated a moderate or high risk of bias. The first part of the meta-analysis was performed on data obtained from 19 migraine studies with 126 173 participants. The risk of migraine in alcohol drinkers is approximately 1.5 times lower than in the group of non-drinkers (RR = 0.71; 95% CI: 0.57-0.89). The second part involved 9 TTH studies with 28 715 participants. No relationship was found between TTH diagnosis and alcohol consumption (RR = 1.09; 95% CI: 0.93-1.27). Two of the included cluster-headache articles had inconclusive results. CONCLUSIONS Alcohol consumption and migraine are inversely correlated. The exact mechanism behind this observation may indicate that migraine leads to alcohol-avoidance, rather than alcohol having any protective role against migraine. There was no relationship between TTH and drinking. However, further studies related to primary headaches and alcohol consumption with low risk of bias are required. Additionally, patients and physicians should consider the latest medical data, in order to avoid the myths about alcohol consumption and primary headaches.
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Affiliation(s)
| | - Marcin Straburzyński
- Department of Family Medicine and Infectious Diseases, University of Warmia and Mazury, Olsztyn, Poland
| | - Mieszko Więckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland
| | - Sławomir Budrewicz
- Department of Neurology, Wroclaw Medical University, Borowska 213 Str, 50-556, Wroclaw, Poland
| | - Piotr Niemiec
- Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
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Li Z, Feng J, Yin S, Chen X, Yang Q, Gao X, Che D, Zhou L, Yan H, Zhong Y, Zhu F. Effects of acupuncture on mental health of migraine patients: a systematic review and meta-analysis. BMC Complement Med Ther 2023; 23:278. [PMID: 37542321 PMCID: PMC10401757 DOI: 10.1186/s12906-023-04103-8] [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: 02/05/2023] [Accepted: 07/23/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Migraine is a neurological disease characterized by moderate to severe headache and various neurological symptoms. It is often cause mood and anxiety disorders that can seriously affect quality of life. Acupuncture has been claimed to have a role in treating neuropsychiatric disorders and is becoming increasingly popular. However, it remains unclear whether current evidence is sufficient to support acupuncture in improving mental health in migraine patients. OBJECTIVES This systematic review and meta-analysis aimed to investigate the effect of acupuncture on the management of pain and mood disorders in patients with migraine. METHODS We searched PubMed, Cochrane Library, Embase, Web of Science, Chinese National Knowledge Infrastructure (CNKI) and Wan Fang Data Knowledge Service Platform for reports, conferences and academic papers published before January 1, 2022. Randomized controlled trials (RCTs) including acupuncture, sham acupuncture and medication for migraine were included. Stata 16.0 software and Cochrane RoB2.0 were used for data processing and migration risk analysis. RESULT Thirteen randomized controlled trials containing 1766 migraine patients were included in the present study, the results showed that compared with sham acupuncture and medication, acupuncture seemed to have advantage in improving SAS (WMD: -5.64;95% CI: -10.89, -0.39; p = 0.035) and SDS (WMD: -4.65; 95% CI: -9.25, -0.05; p = 0.048) in migraine patients. And it seems to be more effective in improving MH (SMD: 0.77; 95% CI: 0.19, 1.35; p = 0.009), VAS (SMD: -1.06; 95% CI: -1.73, -0.4; p = 0.002;) and MSQ (WMD: 4.76; 95% CI: 2.36, 7.15; p < 0.001) than sham acupuncture and medication. CONCLUSION The present results suggest that, compared with Western medicine and sham acupuncture, acupuncture seems to be able to effectively improve anxiety and depression in migraine patients.And it may be more effective in improving SF36-mental health, VAS and MSQ than shame acupuncture or Western medicine. The results of this study need to be verified by higher quality RCTs.
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Affiliation(s)
- Zhao Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jie Feng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shao Yin
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xin Chen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qicheng Yang
- Department of Medical Information Engineering, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xu Gao
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Deya Che
- Zigong First People's Hospital, Zigong, China
| | - Li Zhou
- Zigong First People's Hospital, Zigong, China
| | - Hui Yan
- Zigong First People's Hospital, Zigong, China
| | - Yue Zhong
- Zigong First People's Hospital, Zigong, China
| | - Fengya Zhu
- Zigong First People's Hospital, Zigong, China.
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Lee S, Nguyen NHT, Takaoka S, Do AD, Shirayama Y, Nguyen QP, Akutsu Y, Takasaki J, Ohkado A. A Study on the Health-Related Issues and Behavior of Vietnamese Migrants Living in Japan: Developing Risk Communication in the Tuberculosis Response. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6150. [PMID: 37372738 DOI: 10.3390/ijerph20126150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/08/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023]
Abstract
Ensuring a healthy lifestyle for the increasing number of Vietnamese migrants living in Japan is a key public health issue, including infectious disease responses such as tuberculosis (TB). To develop risk communication in relation to the TB response, this study aimed to explore the health issues and health-related behaviors of Vietnamese migrants living in Japan using a mixed method. A survey was conducted on Vietnam-born migrants, aged 18 years and over, in Tokyo. The survey consisted of questions on the following components: (1) demographics; (2) health-related issues and behavior; and (3) health-seeking behavior, information, and communication. A total 165 participants participated in the survey. The majority of the participants were young adults. 13% of the participants responded that they were concerned about their health. Moreover, 22% and 7% of the participants reported weight loss and respiratory symptoms, respectively. 44% of the participants answered they had no one to consult about their health in Japan when they needed it, and 58% answered they had no awareness of any Vietnamese-language health consultation services. Logistic regression analysis revealed that people who contact family members living in Vietnam or overseas using social networking services (SNSs) when they needed to consult someone about their health (adjusted odds ratio (AOR) = 6.09, 95% confidence interval (CI) 1.52-24.43) were more likely to present with one or more of the typical TB symptoms, compared to those who did not consult someone in this manner. Current smokers (OR = 3.08, 95% CI 1.15-8.23) were more likely to have health problems compared to non-smokers. The key informant interviews revealed that individual factors, the health system, and socio-environmental factors may hinder Vietnamese migrants' health-seeking and health-information-seeking behaviors in Japan. TB risk communication approaches for migrants need to be developed considering their health-related behaviors while addressing their health needs.
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Affiliation(s)
- Sangnim Lee
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose City 204-8533, Tokyo, Japan
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Bunkyo-ku 113-8421, Tokyo, Japan
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Shinjuku-ku 162-8655, Tokyo, Japan
- TB Action Network, Kiyose-shi 204-8533, Tokyo, Japan
| | - Nhan Huu Thanh Nguyen
- TB Action Network, Kiyose-shi 204-8533, Tokyo, Japan
- Master's Program in Global Leadership, Vietnam Japan University, Hanoi 77000, Vietnam
| | - Shori Takaoka
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Bunkyo-ku 113-8421, Tokyo, Japan
- TB Action Network, Kiyose-shi 204-8533, Tokyo, Japan
| | - An Dang Do
- TB Action Network, Kiyose-shi 204-8533, Tokyo, Japan
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku 113-0033, Tokyo, Japan
| | - Yoshihisa Shirayama
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Bunkyo-ku 113-8421, Tokyo, Japan
| | - Quy Pham Nguyen
- TB Action Network, Kiyose-shi 204-8533, Tokyo, Japan
- Department of Medical Oncology, Kyoto Miniren Central Hospital, Kyoto-shi 616-8147, Kyoto, Japan
| | - Yusuke Akutsu
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Bunkyo-ku 113-8421, Tokyo, Japan
- TB Action Network, Kiyose-shi 204-8533, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Shinjuku-ku 162-8655, Tokyo, Japan
| | - Akihiro Ohkado
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose City 204-8533, Tokyo, Japan
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Hannon S, Gartland D, Higgins A, Brown SJ, Carroll M, Begley C, Daly D. Physical health and comorbid anxiety and depression across the first year postpartum in Ireland (MAMMI study): A longitudinal population-based study. J Affect Disord 2023; 328:228-237. [PMID: 36801420 DOI: 10.1016/j.jad.2023.02.056] [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: 09/08/2022] [Revised: 02/09/2023] [Accepted: 02/12/2023] [Indexed: 02/21/2023]
Abstract
INTRODUCTION Little is known of the associations between physical health issues and mental health issues such as anxiety, depression and comorbid anxiety and depression (CAD) occurring in the perinatal period. METHODS A longitudinal cohort study with 3009 first-time mothers giving birth in Ireland collected physical and mental health data in pregnancy and at 3, 6, 9 and 12 months postpartum. Mental health was measured using the depression and anxiety subscales of the Depression, Anxiety and Stress Scale. Experience of eight common physical health issues (e.g. severe headaches/migraines, back pain) were assessed in pregnancy, with an additional six assessed at each postpartum data collection point. RESULTS 2.4 % of women reported depression alone in pregnancy and 4 % reported depression across the first postpartum year. Anxiety alone was reported by 3.0 % of women in pregnancy, and 2 % in the first year postpartum. Prevalence of comorbid anxiety/depression (CAD) was 1.5 % in pregnancy and almost 2 % postpartum. A higher proportion of women reporting, compared to women not reporting, postpartum CAD were younger, not partnered, not in paid employment in pregnancy, have fewer years of education, and had a caesarean birth. Extreme tiredness/exhaustion and back pain were the most common physical health issues in pregnancy and postpartum. Constipation, haemorrhoids, bowel issues, breast issues, infection and pain in the perineum or caesarean wound, pelvic pain and urinary tract infections were highest at three months postpartum and gradually decreased thereafter. Women reporting depression alone or anxiety alone were equivalent in terms of physical health issues. However, women without mental health symptoms reported significantly fewer physical health issues than women reporting depressive or anxiety symptoms alone or CAD at every time point. Women with CAD reported a significantly higher number of health issues than women reporting depression alone or anxiety alone at 9 and 12 months postpartum. CONCLUSION Reports of mental health symptoms are associated with higher physical health burden demonstrating a need for integrated approaches in mental and physical health care pathways in perinatal services.
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Affiliation(s)
- Susan Hannon
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin DO2 T283, Ireland; Trinity Centre for Maternity Care Research (TCMCR), School of Nursing and Midwifery, Trinity College Dublin, No. 2 Clare Street, Dublin 2, Ireland.
| | - Deirdre Gartland
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Vic, Australia.
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin DO2 T283, Ireland; Trinity Centre for Maternity Care Research (TCMCR), School of Nursing and Midwifery, Trinity College Dublin, No. 2 Clare Street, Dublin 2, Ireland.
| | - Stephanie J Brown
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic, Australia; Department of General Practice, University of Melbourne, Melbourne, Vic, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Vic, Australia.
| | - Margaret Carroll
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin DO2 T283, Ireland; Trinity Centre for Maternity Care Research (TCMCR), School of Nursing and Midwifery, Trinity College Dublin, No. 2 Clare Street, Dublin 2, Ireland.
| | - Cecily Begley
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin DO2 T283, Ireland; Trinity Centre for Maternity Care Research (TCMCR), School of Nursing and Midwifery, Trinity College Dublin, No. 2 Clare Street, Dublin 2, Ireland.
| | - Déirdre Daly
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin DO2 T283, Ireland; Trinity Centre for Maternity Care Research (TCMCR), School of Nursing and Midwifery, Trinity College Dublin, No. 2 Clare Street, Dublin 2, Ireland.
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Abstract
PURPOSE OF REVIEW Tobacco use is associated with significant health consequences especially for people with medical conditions. Although lifestyle strategies (e.g., sleep, diet) are commonly recommended as part of migraine treatment, tobacco-related strategies (e.g., smoking cessation) are rarely included. This review is aimed at elucidating what is known about tobacco use and migraine and at identifying gaps in the research. RECENT FINDINGS The prevalence of smoking is higher among people with migraine, and people with migraine believe that smoking makes migraine attacks worse. There is also evidence that smoking may exacerbate migraine-related consequences (e.g., stroke). Very few studies have examined other aspects of smoking and migraine or tobacco products other than cigarettes. There are significant gaps in our knowledge of smoking and migraine. More research is needed to understand the relationship of tobacco use to migraine and potential benefits of adding smoking cessation efforts into migraine care.
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Goyal M, Haythornthwaite JA, Jain S, Peterlin BL, Mehrotra M, Levine D, Rosenberg JD, Minges M, Seminowicz DA, Ford DE. Intensive Mindfulness Meditation Reduces Frequency and Burden of Migraine: An Unblinded Single-Arm Trial. Mindfulness (N Y) 2023; 14:406-417. [PMID: 38282695 PMCID: PMC10810247 DOI: 10.1007/s12671-023-02073-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 01/25/2023]
Abstract
Objectives Preventing migraine headaches and improving the quality of life for patients with migraine remains a challenge. We hypothesized intensive meditation training would reduce the disease burden of migraine. Method An unblinded trial was analyzed as a single cohort exposed to a silent 10-day Vipassana meditation retreat that included 100 hr of sitting meditation. Participants with chronic or episodic migraine were enrolled and followed for 1 year. The primary outcome was a change in mean monthly migraine days at 12 months from baseline. Secondary outcomes included headache frequency and intensity, acute medication use, work days missed, home meditation, sleep quality, general health, quality of life, migraine impact, positive and negative affect, perceived stress, mindfulness, and pain catastrophizing. Results Three hundred people were screened and 58 (19%) agreed to participate and enrolled in the intensive meditation training. Forty-six participants with chronic migraine (≥ 15 headaches/month of which ≥ 8 were migraines) and 12 with episodic migraine (< 15 and ≥ 4 migraines/month) attended and 45 (78%) completed the retreat. At 12 months, the average migraine frequency was reduced by 2.7 days (from 16.6 at baseline) per 28 days (95%CI - 4.3, - 1.3) and headaches by 3.4 (20.1 at baseline) per 28 days (- 4.9, - 1.9). Fifty percent responder rate was 29% for migraine. Acute medication use dropped by an average of 2.2 days (- 3.9, - 0.5) per 28 days, and participants reported 2.3 fewer days (- 4.0, - 0.5) on which they reduced their activity due to migraines. The most striking and promising effects were in several secondary outcomes, including migraine-specific quality of life, pain catastrophizing, and perceived stress. The significant improvements observed immediately following the intervention were sustained at 12 months follow-up. Conclusions Training in Vipassana meditation via a 10-day retreat may reduce the frequency and burden of migraine. Preregistration ClinicalTrials.gov: NCT00663585.
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Affiliation(s)
- Madhav Goyal
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
- Center for Primary Care, NorthBay Healthcare, Vacaville, CA, USA
| | | | - Sharat Jain
- Mid-Atlantic Vipassana Association, Claymont, DE, USA
| | - Barbara Lee Peterlin
- Neuroscience Institute, Penn Medicine Lancaster General Health, Lancaster, PA, USA
| | - Megha Mehrotra
- Department of Epidemiology and Biostatistics, Univ of California, San Francisco, USA
| | - David Levine
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Jason D. Rosenberg
- Department of Neurology, Mid-Atantic Permanente Medical Group, MD, Halethorpe, USA
| | - Mary Minges
- Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA
| | - David A. Seminowicz
- Department of Neural & Pain Sciences, School of Dentistry, Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, USA
| | - Daniel E. Ford
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
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Sudershan A, Pushap AC, Younis M, Sudershan S, Bhagat S, Kumar H, Panjalyia RK, Kumar P. Neuroepidemiology study of headache in the region of Jammu of north Indian population: A cross-sectional study. Front Neurol 2023; 13:1030940. [PMID: 36686511 PMCID: PMC9850838 DOI: 10.3389/fneur.2022.1030940] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/01/2022] [Indexed: 01/07/2023] Open
Abstract
Background Headache disorders now represent a major public health problem globally. It is more prevalent in developing countries with the rising trends of headache disorders observed in young adults affecting their quality of life negatively. Very little information is available on the epidemiology of headache disorders in the Jammu Division of the north Indian population. Aim The aim of the present study was to find out the prevalence of headache and its two major types, i.e., migraine and tension-type headache (TTH), in the population of the Jammu Division. Methods The present study was conducted in two phases: (Phase I: face-to-face interview and Phase II: E-based sampling) and the sufferers of headaches were incorporated into the study based on the International Classification of Headache Disorder-3 (ICHD-3) criteria for a representative sample. Frequency distribution and mean ± standard deviation were used in descriptive statistics to describe the data sets, while a t-test, chi-square test, multiple logistic regression, and prevalence ratio were used in inferential statistics. Results In the present study, a total of 3,148 patients were recruited, with an overall prevalence of headache of 53.84%, with a majority of females (38.18%) over males (15.66%). As regards the type of headache, migraine was found to be of the more prevalent (33.25%) type than the TTH (20.58%). Females suffering from migraine showed the highest prevalence (25.28%), in contrast to females suffering from the TTH (12.89%). Sociodemographic variables, such as gender [female; AOR = 2.46, 95% CI (2.12-2.85), p-value < 0.0001] and marital status [married; AOR: 1.46, 95% CI (1.11-1.92) p-value = 0.006], showed a significant association with the headache. Conclusion The present study shows that the prevalence of headache is high in the Jammu Division of Jammu and Kashmir (J&K) India, with migraine being the highly prevalent type.
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Affiliation(s)
- Amrit Sudershan
- Institute of Human Genetics, University of Jammu, Jammu, Jammu and Kashmir, India,Department of Human Genetics, Sri Pratap College Srinagar, Cluster University Srinagar, Srinagar, Jammu and Kashmir, India
| | - Agar Chander Pushap
- Department of Education, University Wing, Dakshina Bharat Hindi Prachar Sabha, Chennai, India
| | - Mohd Younis
- Department of Zoology, University of Jammu, Jammu, Jammu and Kashmir, India
| | - Srishty Sudershan
- Department of Zoology, University of Jammu, Jammu, Jammu and Kashmir, India
| | - Sheetal Bhagat
- Department of Psychology, University of Jammu, Jammu, Jammu and Kashmir, India
| | - Hardeep Kumar
- Department of Neurology, Super Speciality Hospital, GMC, Jammu, Jammu and Kashmir, India
| | | | - Parvinder Kumar
- Institute of Human Genetics, University of Jammu, Jammu, Jammu and Kashmir, India,Department of Zoology, University of Jammu, Jammu, Jammu and Kashmir, India,*Correspondence: Parvinder Kumar ✉
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Effectiveness of Tai Chi on Blood Pressure, Stress, Fatigue, and Sleep Quality among Chinese Women with Episodic Migraine: A Randomised Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2089139. [PMCID: PMC9605843 DOI: 10.1155/2022/2089139] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/19/2022] [Accepted: 09/27/2022] [Indexed: 11/18/2022]
Abstract
The beneficial effects of Tai Chi on the cardiovascular risk profile and the migraine trigger factors among female migraineurs remain unknown. This study aimed to evaluate the effectiveness of a 12-week Tai Chi training on blood pressure (BP) and migraine-related trigger factors, including stress, fatigue, and sleep quality among Chinese women with episodic migraine. In this study, eligible Hong Kong Chinese women aged 18–65 years were randomly assigned to the Tai Chi group adopting a modified 33-short form of Yang style Tai Chi training for 12 weeks, followed by additional 12 weeks of self-practice or the waiting list control group that maintained the usual lifestyle for 24 weeks. The primary outcome was the changes in BP from the baseline to 12 and 24 weeks. The secondary outcomes included the stress level, fatigue, and sleep quality measured by the perceived stress scale (PSS), the numeric rating scale-fatigue (NRS-fatigue), and the Pittsburgh sleep quality index (PSQI), respectively. Significant between-group differences were found in systolic BP (−6.8 mmHg at 24 weeks, P=0.02), and a decreasing trend was significant across baseline, 12 weeks, and 24 weeks between groups (P < 0.05). The 12-week Tai Chi training significantly reduced the BP level and moderately improved stress level, fatigue status, and sleep quality among Chinese women with episodic migraine. Therefore, Tai Chi could be considered a promising mind-body exercise with good feasibility for migraineurs in the future. This trial is registered with registration number NCT03015753.
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Rossi MF, Tumminello A, Marconi M, Gualano MR, Santoro PE, Malorni W, Moscato U. Sex and gender differences in migraines: a narrative review. Neurol Sci 2022; 43:5729-5734. [PMID: 35676560 PMCID: PMC9176156 DOI: 10.1007/s10072-022-06178-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 05/26/2022] [Indexed: 11/29/2022]
Abstract
Introduction Gender medicine is a new medical approach aimed at the study of the differences between women and men in terms of prevention, diagnosis, and the outcome of all diseases. Migraines are among these. They represent the most common neurological illness; they are most prevalent in adults between 20 and 50 years of age and are three to four times more frequent in woman than in men. Affecting people in working age, migraines are a problem that strongly impacts the psychophysical health and productivity of workers, regardless of the specific job task they have. Methods A narrative review was performed, searching for the most relevant articles describing gender differences in people suffering from migraines, and particularly in workers. Results Migraine global prevalence is 20.7% in women and 9.7% in men whereas prevalence in Italy is 32.9% for women and only 13.0% for men. This difference is partly explained by hormonal differences, as well as by differences in brain structure, genetic polymorphisms and neuronal pathways. Sex differences may also play a role in the progression from episodic to chronic migraine. In workers, migraines are mostly associated with strenuous physical work in men, whilst migraines triggered by night shifts, lack of sleep, or irregular sleep patterns are more common in women. Conclusions To this day, the reasons of sex/gender disparity for migraine are still obscure. However, migraines, chronic migraine in particular, have a negative impact on the lives of all individuals affected by this disease, but particularly in women in which family cares and working activity are often superimposed. Migraine prevention strategies should be planned in workers through the occupational health physician.
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Affiliation(s)
- Maria Francesca Rossi
- Department of Life Sciences and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Antonio Tumminello
- Department of Life Sciences and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Matteo Marconi
- Center for Gender-Specific Medicine, Istituto Superiore Di Sanità, Rome, Italy
| | - Maria Rosaria Gualano
- Department of Public Health Sciences and Paediatrics, University of Torino, 10124, Torino, Italy
| | - Paolo Emilio Santoro
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
- Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Walter Malorni
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy.
- Gemelli Woman Health Center for Digital Health and Personalized Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Umberto Moscato
- Department of Life Sciences and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
- Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy
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Kim SJ, Park SM, Cho HJ, Park JW. Primary headaches increase the risk of dementias: An 8-year nationwide cohort study. PLoS One 2022; 17:e0273220. [PMID: 35980951 PMCID: PMC9387842 DOI: 10.1371/journal.pone.0273220] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/04/2022] [Indexed: 11/20/2022] Open
Abstract
Background Headache, a highly prevalent neurological disorder, has consistently been linked with an elevated risk of dementia. However, most studies are focused on the relationship with migraine in limited age groups. Therefore, the objective of this research was to look at the link between various type of headaches and dementias based on longitudinal population-based data. Methods and results Participants diagnosed with headache from 2002 to 2005 were selected and major covariates were collected. The diagnoses of Alzheimer’s disease, vascular dementia, and other dementias were observed from 2006 until 2013. The adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of dementias according to headache type were calculated by Cox proportional hazards regression. A number of 470,652 participants were observed for a mean of 7.6 years (standard deviation: 1.2), for approximately 3.6 million person-years. Both tension type headache (TTH) and migraine elevated the risk of all-cause dementias (TTH, aHR 1.18, 95% CI 1.13–2.24; migraine, aHR 1.18, 95% CI 1.13–2.24). Headaches had a greater influence in females and non-smokers as a risk factor of dementias. Patients with migraine who consumed alcohol had a higher risk of dementia, however this was not true with TTH patients. Among participants without comorbidities, TTH patients were more susceptible to dementia than migraine patients. Headache patients had a higher proportion of females regardless of headache type and approximately 1.5 times more individuals had three or more comorbidities compared to those without headache. Conclusions Headache could be an independent predictor for subsequent dementia risk. Future studies should focus on clarifying pathogenic pathways and possible dementia-related preventive measures in headache populations.
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Affiliation(s)
- Seon-Jip Kim
- Department of Preventive Dentistry and Public Oral Health, School of Dentistry, Seoul National University, Seoul, Republic of Korea
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Sang Min Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Hyun-Jae Cho
- Department of Preventive Dentistry and Public Oral Health, School of Dentistry, Seoul National University, Seoul, Republic of Korea
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- * E-mail: (JWP); (HJC)
| | - Ji Woon Park
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry, Seoul National University, Seoul, Republic of Korea
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Republic of Korea
- * E-mail: (JWP); (HJC)
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Ljubisavljevic M, Ignjatovic A, Djordjevic V, Pesic MH, Ljubisavljevic S. Depression, Anxiety, Stress, and Health-Related Quality of Life Among Patients With Medication Overuse Headache in a Tertiary Headache Center: A Cross-Sectional Study. J Neuropsychiatry Clin Neurosci 2022; 33:132-143. [PMID: 33626886 DOI: 10.1176/appi.neuropsych.20070189] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The investigators examined the association of patient-related and headache-related parameters and the effect of medication overuse headache (MOH); the occurrence of depression, anxiety, and stress; and the importance of different domains of health-related quality of life in these associations. METHODS Eighty-three patients (women, N=72, men, N=11; mean age, 40.54 years, SD=11.58), who were first diagnosed with MOH during the study period were included in the analyses. The Headache Impact Test-6 (HIT-6), the 36-item Short-Form Survey (SF-36) Questionnaire for quality of life, and the Depression Anxiety Stress Scales were used. RESULTS The findings revealed mild depression, moderate anxiety, and stress, as well as changes in all examined health domains, in the study patients (p<0.05). Risk factors were identified for higher HIT-6 scores (role functioning/physical functioning [odds ratio=0.977, p=0.024] and social functioning [odds ratio=0.963, p=0.032]); for depression (emotional well-being [odds ratio=0.928, p=0.007], social functioning [odds ratio=0.950, p=0.009], and the presence of comorbidity [odds ratio=5.417, p=0.013]); for anxiety (age [odds ratio=1.091, p=0.007], MOH duration [odds ratio=1.422, p=0.047], emotional well-being [odds ratio=0.933, p=0.012], and social functioning [odds ratio=0.943, p=0.001]); and for stress (emotional well-being [odds ratio=0.902, p<0.001]). CONCLUSIONS MOH has a significant negative impact on the personal, family, and social life of patients and is associated with depression, anxiety, and stress. Patients' age, duration of MOH, presence of comorbidities, and adverse effects of physical, emotional, and social dysfunction are particularly important contributors to the negative effects of MOH.
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Affiliation(s)
- Marina Ljubisavljevic
- Center for Mental Health Protection, Clinical Center of Niš, Niš, Serbia (M. Ljubisavljevic, Djordjevic); Faculty of Medicine, University of Niš, Niš, Serbia (Ignjatovic, Djordjevic, S. Ljubisavljevic); Institute for Public Health, Niš, Serbia (Ignjatovic); Faculty of Phylosophy, University of Niš, Niš, Serbia (Hadzi Pesic); and Clinic for Neurology, Clinical Center of Niš, Niš, Serbia (S. Ljubisavljevic)
| | - Aleksandra Ignjatovic
- Center for Mental Health Protection, Clinical Center of Niš, Niš, Serbia (M. Ljubisavljevic, Djordjevic); Faculty of Medicine, University of Niš, Niš, Serbia (Ignjatovic, Djordjevic, S. Ljubisavljevic); Institute for Public Health, Niš, Serbia (Ignjatovic); Faculty of Phylosophy, University of Niš, Niš, Serbia (Hadzi Pesic); and Clinic for Neurology, Clinical Center of Niš, Niš, Serbia (S. Ljubisavljevic)
| | - Vladimir Djordjevic
- Center for Mental Health Protection, Clinical Center of Niš, Niš, Serbia (M. Ljubisavljevic, Djordjevic); Faculty of Medicine, University of Niš, Niš, Serbia (Ignjatovic, Djordjevic, S. Ljubisavljevic); Institute for Public Health, Niš, Serbia (Ignjatovic); Faculty of Phylosophy, University of Niš, Niš, Serbia (Hadzi Pesic); and Clinic for Neurology, Clinical Center of Niš, Niš, Serbia (S. Ljubisavljevic)
| | - Marina Hadzi Pesic
- Center for Mental Health Protection, Clinical Center of Niš, Niš, Serbia (M. Ljubisavljevic, Djordjevic); Faculty of Medicine, University of Niš, Niš, Serbia (Ignjatovic, Djordjevic, S. Ljubisavljevic); Institute for Public Health, Niš, Serbia (Ignjatovic); Faculty of Phylosophy, University of Niš, Niš, Serbia (Hadzi Pesic); and Clinic for Neurology, Clinical Center of Niš, Niš, Serbia (S. Ljubisavljevic)
| | - Srdjan Ljubisavljevic
- Center for Mental Health Protection, Clinical Center of Niš, Niš, Serbia (M. Ljubisavljevic, Djordjevic); Faculty of Medicine, University of Niš, Niš, Serbia (Ignjatovic, Djordjevic, S. Ljubisavljevic); Institute for Public Health, Niš, Serbia (Ignjatovic); Faculty of Phylosophy, University of Niš, Niš, Serbia (Hadzi Pesic); and Clinic for Neurology, Clinical Center of Niš, Niš, Serbia (S. Ljubisavljevic)
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Xie YJ, Lin M, Wong YT, Yan L, Zhang D, Gao Y. Migraine Attacks and Relevant Trigger Factors in Undergraduate Nursing Students in Hong Kong: A Cross-Sectional Study. J Pain Res 2022; 15:701-713. [PMID: 35300404 PMCID: PMC8922458 DOI: 10.2147/jpr.s337465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 02/27/2022] [Indexed: 12/30/2022] Open
Abstract
Objective This study aimed to examine the prevalence and features of migraine and explore the possible migraine triggers in a sample of university nursing students in Hong Kong. Methods A cross-sectional study using self-administered questionnaires was conducted in the Hong Kong Polytechnic University in 2016. The questionnaire included ID Migraine™ for migraine screening and items measuring the frequency, duration, severity, associated symptoms, and trigger factors of migraine. Years 2–5 undergraduate nursing students from the university completed the questionnaires. Binary logistic regression was conducted to examine the migraine-associated factors. Results A total of 702 nursing students, including 168 males and 534 females, were successfully screened. Their mean age was 20.8 ± 1.4 years. The overall prevalence of migraine reached 11.8%. Over half (67.5%) of the students with migraine experienced attacks at least once per month. Each attack had a median duration of 3 h (interquartile range: 1–4 h) and the mean pain intensity score of 6.4 ± 1.6. Students with a family history of migraine (adjusted odds ratio [OR]: 1.89; 95% confidence interval [CI]: 1.10, 3.25; p < 0.05) and poor general health status (Adjusted OR: 3.41, 95% CI: 1.05, 11.09; p < 0.05) were more likely to suffer from migraine than those without. The three most common migraine triggers were the lack of sleep (94.0%), change in sleep schedule (83.1%), and noise (81.9%). Female students were more likely to experience fatigue-triggered migraine than male students (85.9% vs 63.2%, p < 0.05). Conclusion Migraine prevalence was relatively high among undergraduate nursing students in Hong Kong. Sleep problem was the most frequent trigger factor. The students’ awareness of migraine attacks should be increased, and migraine management must be improved by avoiding common trigger factors in this population.
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Affiliation(s)
- Yao Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Special Administrative Region
- Correspondence: Yao Jie Xie, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Special Administrative Region, Tel +852 3400-3798, Fax +852 2364-9663, Email
| | - Meijuan Lin
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Special Administrative Region
| | - Yuen Ting Wong
- Faculty of Social Science, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region
| | - Linjia Yan
- Yibin Health School of Sichuan, Yibin City, Sichuan Province, People’s Republic of China
| | - Dexing Zhang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shantin, N.T., Hong Kong Special Administrative Region
| | - Yang Gao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Kowloon, Hong Kong Special Administrative Region
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Viero FT, Rodrigues P, Trevisan G. Cognitive or daily stress association with headache and pain induction in migraine and tension-type headache patients: a systematic review. Expert Rev Neurother 2022; 22:257-268. [PMID: 35143379 DOI: 10.1080/14737175.2022.2041414] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Primary headache disorders, such as migraine and tension-type headache (TTH), represent a significant public health concern. Besides, cognitive/mental stress was suggested to contribute to TTH and migraine physiopathology. Thus, this study aimed to evaluate the existence of a causal relationship between stress (mental/cognitive or daily stress) and headache or pain improvement in migraine and TTH patients. AREAS COVERED We developed a systematic review of the literature, including studies that utilized mental/cognitive stress tasks or daily stress by lifestyle questionnaire in migraine and TTH patients. Necessarily, these studies should have healthy patients and a pain measure (quantitative sensory tests or headache/migraine detection). PubMed, EMBASE, and SCOPUS were searched, using terms about stress and primary headaches. EXPERT OPINION Both mental/cognitive stress and daily stress (perceived) were related to an increase in pain perception and related to the development of headache or enhanced transient pain intensity in migraine and TTH patients. Different factors could enrich the comprehension of the influence of stress on pain/headache induction in migraine and TTH patients, including methodological standardization, consistency of assessing, and isolating the many headache triggers in randomized controlled trial studies.
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Affiliation(s)
- Fernanda Tibolla Viero
- Graduated Program in Pharmacology, Federal University of Santa Maria (UFSM), 97105-900 Santa Maria (RS), Brazil
| | - Patrícia Rodrigues
- Graduated Program in Pharmacology, Federal University of Santa Maria (UFSM), 97105-900 Santa Maria (RS), Brazil
| | - Gabriela Trevisan
- Graduated Program in Pharmacology, Federal University of Santa Maria (UFSM), 97105-900 Santa Maria (RS), Brazil
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Stubberud A, Buse DC, Kristoffersen ES, Linde M, Tronvik E. Is there a causal relationship between stress and migraine? Current evidence and implications for management. J Headache Pain 2021; 22:155. [PMID: 34930118 PMCID: PMC8685490 DOI: 10.1186/s10194-021-01369-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/01/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The purpose of this narrative review is to examine the literature investigating a causal relationship between stress and migraine and evaluate its implications for managing migraine. METHODS PubMed, PsycINFO and CINAHL were searched from 1988 to August 2021, identifying 2223 records evaluating the relationship between stress and migraine. Records were systematically screened. All potentially relevant records were thematically categorized into six mechanistic groups. Within each group the most recent reports providing new insights were cited. RESULTS First, studies have demonstrated an association of uncertain causality between high stress loads from stressful life events, daily hassles or other sources, and the incidence of new-onset migraine. Second, major stressful life events seem to precede the transformation from episodic to chronic migraine. Third, there is some evidence for changes in levels of stress as a risk factor for migraine attacks. Research also suggests there may be a reversed causality or that stress-trigger patterns are too individually heterogeneous for any generalized causality. Fourth, migraine symptom burden seems to increase in a setting of stress, partially driven by psychiatric comorbidity. Fifth, stress may induce sensitization and altered cortical excitability, partially explaining attack triggering, development of chronic migraine, and increased symptom burden including interictal symptom burden such as allodynia, photophobia or anxiety. Finally, behavioral interventions and forecasting models including stress variables seem to be useful in managing migraine. CONCLUSION The exact causal relationships in which stress causes incidence, chronification, migraine attacks, or increased burden of migraine remains unclear. Several individuals benefit from stress-oriented therapies, and such therapies should be offered as an adjuvant to conventional treatment and to those with a preference. Further understanding the relationship between stress, migraine and effective therapeutic options is likely to be improved by characterizing individual patterns of stress and migraine, and may in turn improve therapeutics.
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Affiliation(s)
- Anker Stubberud
- Department of Neuromedicine and Movement Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway.
- National Advisory Unit on Headaches, Department of Neurology, St. Olavs Hospital, Trondheim, Norway.
| | - Dawn C Buse
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Espen Saxhaug Kristoffersen
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
- Department of General Practice, University of Oslo, Oslo, Norway
| | - Mattias Linde
- Department of Neuromedicine and Movement Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- National Advisory Unit on Headaches, Department of Neurology, St. Olavs Hospital, Trondheim, Norway
| | - Erling Tronvik
- Department of Neuromedicine and Movement Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- National Advisory Unit on Headaches, Department of Neurology, St. Olavs Hospital, Trondheim, Norway
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Rastogi RG, Arnold TL, Borrero-Mejias C, Hastriter EV, Hickman C, Karnik KT, Lewis KS, Little RD. Non-pharmacologic and Mindful-Based Approaches for Pediatric Headache Disorders: a Review. Curr Pain Headache Rep 2021; 25:78. [PMID: 34894314 DOI: 10.1007/s11916-021-00993-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW Headache disorders in children and adolescents are common. Among the different headache disorders, migraine and tension headache are highly prevalent and often debilitating. Pharmacological treatments for pediatric patients are often not approved or effective. Practice guidelines for prevention of pediatric headache and migraine are now incorporating information and recommendations regarding non-pharmacologic therapeutic options. Understanding the mechanism of action, safety, and efficacy of the non-pharmacologic as well as mindful-based therapeutic alternatives currently available for the management and treatment of headache and migraine may allow additional treatment alternatives for children with these conditions. RECENT FINDINGS Studies have been published looking at non-pharmacologic treatments, and mindful-based approaches, namely relaxation, mindfulness meditation, yoga, and hypnosis as options for the treatment of headache and migraine, although there are few that examine these in children and adolescents. Several recent studies that have relevance to the care of children with headache and migraine are reviewed. Non-pharmacologic and mindful-based approaches for the prevention and treatment of headache and migraine in children show safety and efficacy data that is promising. Consider incorporating these multi-modal approaches into the therapeutic management strategies for the child or adolescent with headache and migraine. Additional prospective studies and/or randomized-controlled trials are necessary to further assess the efficacy and cost-effectiveness of these methods.
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Affiliation(s)
- Reena Gogia Rastogi
- Department of Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, 1919 E Thomas Rd, Bldg. B, Phoenix, 85016 AZ, USA.
| | - Tava L Arnold
- Department of Psychology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Clarimar Borrero-Mejias
- Department of Neurology, Institute for Brain Protection Sciences, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Eric V Hastriter
- Department of Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, 1919 E Thomas Rd, Bldg. B, Phoenix, 85016 AZ, USA
| | - Carolyn Hickman
- Department of Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, 1919 E Thomas Rd, Bldg. B, Phoenix, 85016 AZ, USA
| | - Kavitha T Karnik
- Department of Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, 1919 E Thomas Rd, Bldg. B, Phoenix, 85016 AZ, USA
| | - Kara Stuart Lewis
- Department of Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, 1919 E Thomas Rd, Bldg. B, Phoenix, 85016 AZ, USA
| | - Robert D Little
- Department of Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, 1919 E Thomas Rd, Bldg. B, Phoenix, 85016 AZ, USA
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Gendolla A, Rauer N, Kraemer S, Schwerdtner I, Straube A. Epidemiology, Demographics, Triptan Contraindications, and Prescription Patterns of Patients with Migraine: A German Claims Database Study. Neurol Ther 2021; 11:167-183. [PMID: 34837636 PMCID: PMC8857336 DOI: 10.1007/s40120-021-00304-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 11/17/2021] [Indexed: 12/11/2022] Open
Abstract
Introduction Migraine is a neurological disease with a considerable economic and societal burden that negatively impacts quality of life and productivity. Triptans are potent serotonin receptor agonists widely used to treat migraine attacks. Little is known about German patients with migraine diagnosed with triptan contraindications or those who discontinue triptans. Methods This retrospective observational study identifies adults with migraine from a German sickness fund database (2010–2018). Migraine prevalence was calculated for the database population and extrapolated to the German Statutory Health Insurance (SHI) population. Medication use, proportion and demographics of patients with triptan contraindications, prevalence of triptan discontinuation and use of triptans by patients with contraindications were analysed. Results In total 120,170 patients with migraine were identified in the database population, of whom 77.7% were female; migraine prevalence was 2.0% (male) and 7.3% (female), leading to an extrapolated 2,923,979 patients with migraine in the entire German SHI population (2019); of these, 14.5% had ≥ 1 triptan contraindication. The most frequent contraindication was a history of stroke/transient ischaemic attack. However, an extrapolated 25.9% of patients who had a triptan contraindication received a triptan prescription following diagnosis. We calculated that 975,698 patients in the entire German SHI population had ever received a triptan, of whom 596,364 did not receive a triptan prescription in the follow-up year. Of these 596,364 individuals, 96.6% continued to receive a migraine diagnosis after their last triptan prescription. These ‘triptan discontinuers’ were predominantly female (82.6%). Most patients utilized only one specific triptan, with a large majority of ongoing triptan users who had used this specific triptan receiving > 4 prescriptions. Conclusion We confirm the existence of German patients with migraine and unmet therapeutic needs. These are patients diagnosed with triptan contraindications or patients who have discontinued triptan use despite continued migraine attacks. More research is needed to ascertain reasons for triptan discontinuation and the risk of triptan use by patients with contraindications.
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Affiliation(s)
| | | | | | | | - Andreas Straube
- Department of Neurology, Klinikum Grosshadern,University Hospital, Ludwig-Maximilian-University, 81377, Munich, Germany.
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22
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Bottiroli S, De Icco R, Vaghi G, Pazzi S, Guaschino E, Allena M, Ghiotto N, Martinelli D, Tassorelli C, Sances G. Psychological predictors of negative treatment outcome with Erenumab in chronic migraine: data from an open label long-term prospective study. J Headache Pain 2021; 22:114. [PMID: 34600468 PMCID: PMC8487575 DOI: 10.1186/s10194-021-01333-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/22/2021] [Indexed: 12/23/2022] Open
Abstract
Background Monoclonal antibodies (mABs) targeting the calcitonin gene-related peptide (CGRP) pathway represent the first disease-specific preventive migraine therapy. Growing evidence suggests that they are effective in the preventive treatment of difficult-to-treat patients. In this study, we evaluated the psychological predictors of the outcome of treatment with the anti-CGRP monoclonal antibody erenumab in patients with chronic migraine (CM). Methods Seventy-five patients with CM who had already failed at least 3 preventive therapies received erenumab every 28 days for a period of 12 months. Before the first administration, patients received a full psychological evaluation using The Structured Clinical Interview for DSM-5 Clinician Version (SCID-5-CV) to assess personality disturbances (primary outcome), mood and anxiety disorders, and as well specific questionnaires to evaluate alexithymia traits, childhood traumas, and current stressors (secondary outcomes). Results After 12 months of treatment, 53 patients reported a reduction of at least 50% in headache days/per month (Responders), whereas 22 did not (Non Responders). When compared to Responders, Non Responders were characterized by a higher prevalence of personality disorders belonging to Cluster C (avoidant, dependent, and obsessive-compulsive) (77% vs 37%, p = .001). Non Responders were also characterized by a higher prevalence of anxiety disorders (90% vs 60%, p = 0.007), showed more alexithymic traits (51.7 ± 13.7 vs 42.9 ± 14.3, p = 0.017), and reported a higher number of 'at least serious' current stressors (3.2 ± 4.0 vs 0.8 ± 1.4, p < .0001) than Responders. At the multivariate analysis, higher prevalence of Cluster C personality disorders (OR 3.697; p = 0.05) and higher number of ‘at least serious’ life events (OR 1.382; p = 0.017) arose as prognostic factors of erenumab failure. Conclusions Erenumab confirmed its effectiveness in a population of difficult-to-treat migraine. The presence of “anxious-fearful” personality together with current stressors and anxiety represent negative predictors of treatment outcome. Trial registration The study protocol was registered at clinicaltrials.gov (NCT04361721).
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Affiliation(s)
- Sara Bottiroli
- Faculty of Law, Giustino Fortunato University, Benevento, Italy. .,Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy.
| | - Roberto De Icco
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Gloria Vaghi
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Stefania Pazzi
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Elena Guaschino
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Marta Allena
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Natascia Ghiotto
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Daniele Martinelli
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Cristina Tassorelli
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Grazia Sances
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
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23
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Westergaard ML, Lau CJ, Allesøe K, Andreasen AH, Jensen RH. Poor social support and loneliness in chronic headache: Prevalence and effect modifiers. Cephalalgia 2021; 41:1318-1331. [PMID: 34162255 DOI: 10.1177/03331024211020392] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To explore the prevalence of poor social support and loneliness among people with chronic headache, and how these might be effect modifiers in the relationships between chronic headache and stress, medication overuse, and self-rated health. BACKGROUND Poor social support and loneliness are consistently linked to worse health outcomes. There are few epidemiologic studies on their effect on headache. METHODS The Danish Capital Region Health Survey, a cross-sectional survey, was conducted in 2017. Participants were asked about headache, pain medication use, social support, loneliness, perceived stress, and self-rated health. Data were accessed from sociodemographic registers. Logistic regression analyses were performed to test for effect modification. RESULTS The response rate was 52.6% (55,185 respondents) and was representative of the target population. People with chronic headache were more likely to report poor social support and loneliness compared to those without chronic headache (p < 0.0001 for both). Odds ratios for the combination of chronic headache and poor social support were very high for stress (odds ratio 8.1), medication overuse (odds ratio 21.9), and poor self-rated health (odds ratio 10.2) compared to those without chronic headache and with good social support. Those who reported both chronic headache and loneliness had a very high odds ratio for stress (odds ratio 14.4), medication overuse (odds ratio 20.1), and poor self-rated health (odds ratio 15.9) compared to those without chronic headache and low loneliness score. When adjusted for sociodemographic factors, poor social support and loneliness were not significant effect modifiers in almost all these associations. Loneliness was a significant effect modifier in the association between chronic headache and medication overuse, but exerted greater effect among those who did not report they were lonely. CONCLUSION Poor social support and loneliness were prevalent among people with chronic headache. The combination of chronic headache and poor social support or loneliness showed higher odds ratios for stress, medication overuse, and poor self-rated health compared to those with good social support and low loneliness scores. The effect of loneliness in the relationship between chronic headache and medication overuse warrants further study.
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Affiliation(s)
| | - Cathrine Juel Lau
- Center for Clinical Research and Prevention, Bispebjerg og Frederiksberg Hospital, Frederiksberg, Denmark
| | - Karen Allesøe
- Center for Clinical Research and Prevention, Bispebjerg og Frederiksberg Hospital, Frederiksberg, Denmark.,Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Holbæk, Denmark
| | - Anne Helms Andreasen
- Center for Clinical Research and Prevention, Bispebjerg og Frederiksberg Hospital, Frederiksberg, Denmark
| | - Rigmor Højland Jensen
- Danish Headache Center, Rigshospitalet‒Glostrup, University of Copenhagen, Glostrup, Denmark
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van Staveren I. Migraine and stress-an exploratory cross-country study of external stress factors. BMC Res Notes 2021; 14:174. [PMID: 33964985 PMCID: PMC8105928 DOI: 10.1186/s13104-021-05587-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/24/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The data collected by the Global Burden of Disease 2016 project indicate that migraine ranks second in high-income countries with very competitive and flexible labour markets, and first in low- and middle-income countries suffering from civic unrest and conflict. This raises the question whether external stress factors may be correlated with migraine years lived with disability per 100,000 inhabitants (YLD). The objective of this exploratory study is to test the hypothesis that external stress factors are correlated with the prevalence and severity of migraine at the country level. The analysis uses two country groups: developed and developing countries. For the first group, the proxy variables for stress are labour productivity and unemployment rate. For the second group, the proxy variables measure conflict-related deaths and share of migrant/refugee population. RESULTS The results show a positive relationship between the stress variables on the one hand and migraine YLD on the other hand for both country groups. Almost all results are statistically significant at p < 0.01. These exploratory findings suggest that societal stress factors may be potential candidates for modifiable factors for the prevalence and/or severity of migraine at the country level.
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Affiliation(s)
- Irene van Staveren
- Institute of Social Studies, Erasmus University Rotterdam, Kortenaerkade 12, 2518 AX, The Hague, The Netherlands.
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25
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Baiden P, Tarbet Z, Chakravarty S, LaBrenz CA, Okumu M. Functional difficulties mediate the association between exposure to adverse childhood experiences and headaches among children: Findings from a population-based study. Headache 2021; 61:673-682. [PMID: 33891349 DOI: 10.1111/head.14098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/15/2021] [Accepted: 02/08/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are commonly observed in the general population and often have lasting neurological and physiological effects. Previous studies have found links between exposure to ACEs, headaches, and functional difficulties in adults. However, little is known about the mechanisms through which exposure to ACEs is associated with headaches among children. OBJECTIVE To examine the association between exposure to ACEs and headaches in children, and whether functional difficulties mediate this association. METHODS Data for this cross-sectional secondary analysis study came from the 2017-2018 National Survey of Children's Health. The sample analyzed in this study was 40,953 children who were between ages 3 and 17 years. We adjusted for the complexity of the sampling design and used structural equation modeling to examine the mediating effect of functional difficulties in the association between exposure to ACEs and headaches. RESULTS Based on parent reports, we found that 4.1% (1697/40,953) of the children reported frequent or severe headaches, and 9.5% (3906/40,953) were exposed to three or more ACEs. About one in four children (23.4%; 9601/40,953) had at least one functional difficulty. The results show that exposure to ACEs was directly positively associated with functional difficulties (β = 0.16, p < 0.001, 95% CI = 0.15-0.17), and functional difficulties were in turn positively associated with headaches (β = 0.17, p < 0.001, 95% CI = 0.12-0.22). The Sobel test of indirect effect showed that functional difficulties partially mediated the association between exposure to ACEs and headaches (β = 0.027, p < 0.001, 95% CI = 0.022-0.029). Also, older children and children with brain injury were more likely to report experiencing headaches. CONCLUSIONS The findings from this study suggest an association between exposure to ACEs and headaches among children, and functional difficulties partially mediate this association.
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Affiliation(s)
- Philip Baiden
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | - Zachary Tarbet
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | | | - Catherine A LaBrenz
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | - Moses Okumu
- University of North Carolina, at Chapel Hill, School of Social Work, Chapel Hill, NC, USA
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Vodonos A, Novack V, Waismel-Manor I, Ezra Y, Guetta A, Ifergane G. Sick of news? Television news exposure, collective stressful events and headache related emergency department visits. PLoS One 2021; 16:e0249749. [PMID: 33831069 PMCID: PMC8031395 DOI: 10.1371/journal.pone.0249749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/24/2021] [Indexed: 11/29/2022] Open
Abstract
Stress is a well-known trigger for primary headache yet its impact is difficult to demonstrate in large epidemiological studies. Israeli national TV news is often referred to as the “tribal fire”, as many Israelis watch national news coverage following terror attacks or military operations. We examined the association between exposure to television news and their content with headache related Emergency Department visits. This retrospective cohort study included data on daily Emergency Department visits with a chief complaint of headache in Soroka University Medical Center, during 2002–2012. Data on daily television news viewership ratings were obtained from the Israeli Audience Research Board and its content from Channel 2 headlines, the highest rated TV news program. To estimate the short-term effects of news rating during the evening news on the number of daily headache visits, we applied generalized linear mixed models. 16,693 Emergency Department visits were included in the analysis. An increase in five units of daily rating percentages was associated with increase in Emergency Department visits the following day, relative risk (RR) = 1.032, (95% CI 1.014–1.050). This association increased with the age of the patients; RR = 1.119, (95% CI 1.075–1.65) for older than 60-year-old, RR = 1.044 (95% CI 1.010–1.078) for ages 40–60 and RR = 1.000 (95% CI 0.977–1.023) for younger than 40-year-old. We did not find a specific content associated with ED visit for headache. Higher television news ratings were associated with increased incidence of Emergency Department headache related visits. We assume that especially among older persons, news viewership ratings provide an indirect estimate of collective stress, which acts as a headache trigger for susceptible subjects.
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Affiliation(s)
- Alina Vodonos
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel
| | - Victor Novack
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel
| | | | - Yacov Ezra
- Neurology Department, Soroka University Medical Center, Beer-Sheva, Israel
| | - Adi Guetta
- Neurology Department, Soroka University Medical Center, Beer-Sheva, Israel
| | - Gal Ifergane
- Neurology Department, Soroka University Medical Center, Beer-Sheva, Israel
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Estrategias de afrontamiento, estrés percibido y bienestar psicológico en individuos con cefalea primaria. ACTA COLOMBIANA DE PSICOLOGIA 2021. [DOI: 10.14718/acp.2021.24.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
El propósito de este estudio fue evaluar la asociación entre las estrategias de afrontamiento, el bienestar subjetivo y el estrés en personas con cefalea primaria - es decir, con dolor de cabeza sin origen orgánico. En total, participaron 150 personas adultas -135 mujeres y 15 hombres-diagnosticadas con cefalea primaria y episodios de cefalea en los últimos seis meses. Los instrumentos de medida utilizados fueron la Escala de satisfacción con la vida de Diener, la escala de estrategias de afrontamiento Brief Cope, la Escala de estrés percibido de Cohen, dos preguntas sobre la intensidad y frecuencia del dolor, y un cuestionario sociodemográfico. En general, se encontró que el bienestar subjetivo se relaciona positivamente con la planificación y negativamente con el uso de sustancias y la frecuencia del dolor; a la vez que el estrés percibido se asocia positivamente con negar la realidad del acontecimiento estresante, culpabilizarse por la situación ocurrida y la frecuencia del dolor, y negativamente con la aceptación de la situación estresante. Además, se observó un mayor estrés percibido en usuarios de atención pública de salud que en aquellos que son atendidos en el sistema privado. Este estudio permite identificar las estrategias que deben ser potenciadas o modificadas con ayuda del personal de salud para mejorar la calidad de vida de las personas con cefalea primaria.
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28
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Personality and Headaches: Findings From Six Prospective Studies. Psychosom Med 2021; 83:118-124. [PMID: 33395215 PMCID: PMC8858382 DOI: 10.1097/psy.0000000000000902] [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] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The present study examined the association between personality traits and concurrent and incident headaches. METHODS Participants (n = 34,989), aged 16 to 107 years were from the Midlife in the United States study, the Midlife in Japan study, the Health and Retirement Study, the Wisconsin Longitudinal Study Graduate and Siblings samples, and the Longitudinal Internet Studies for the Social Sciences. Demographic factors, personality traits, and headaches were assessed at baseline. Headaches were assessed again 4 to almost 20 years later. RESULTS Across the samples, higher neuroticism was related to a higher likelihood of concurrent (combined odd ratio = 1.41, 95% confidence interval [CI] = 1.28-1.55, p < .001) and incident (combined odd ratio = 1.28, 95% CI = 1.12-1.46, p < .001) headaches, whereas higher extraversion was associated with a lower likelihood of concurrent (combined odd ratio = 0.87, 95% CI = 0.84-0.89, p < .001) and incident (combined odd ratio = 0.90, 95% CI = 0.85-0.96, p = .001) headaches. Higher conscientiousness (combined odd ratio = 0.90, 95% CI = 0.86-0.94, p < .001) and openness (combined odd ratio = 0.95, 95% CI = 0.90-0.99, p = .025) were associated with a lower probability of reporting concurrent headaches. Agreeableness was unrelated to headaches. Sex was not a consistent moderator. CONCLUSIONS The present study provides robust evidence that neuroticism and introversion are risk factors for headaches in concurrent and prospective analyses across multiple cohorts.
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Schramm S, Tenhagen I, Schmidt B, Holle-Lee D, Naegel S, Katsarava Z, Jöckel KH, Moebus S. Prevalence and risk factors of migraine and non-migraine headache in older people - results of the Heinz Nixdorf Recall study. Cephalalgia 2020; 41:649-664. [PMID: 33269953 DOI: 10.1177/0333102420977183] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The prevalence of migraine and non-migraine headache declines with age. METHODS Data from the third visit (2011-2015) of the population-based Heinz Nixdorf Recall study were analysed (n = 2038, 51% women, 65-86 years). Possible risk factors for headache activity (obesity, education, smoking, sports, alcohol, partnership status, living alone, having children, sleep quality, depression, hypertension, diabetes mellitus, stroke, coronary heart disease, medication), and headache symptoms were assessed. We estimated the lifetime prevalence and the prevalence of current active headache of migraine with and without aura, and non-migraine headache. The associations between possible risk factors and headache activity (active vs. inactive) were estimated by age and sex-adjusted odds ratios and 95% confidence intervals (OR [95% CI]) using multiple logistic regression. RESULTS The lifetime prevalence of migraine was 28.6% (n = 584). One hundred and ninety-two (9.4%) had still-active migraine, 168 (3.5%) had migraine with aura, and 416 (5.9%) had migraine without aura. One hundred and sixty-eight (8.2%) had "episodic infrequent migraine, 0-8 headache days/month", 10 (0.5%) had "episodic frequent migraine, 9-14 headache days/month", and five (0.2%) had "chronic migraine, ≥15 headache days/month". Overall, 10 (0.5%) had "chronic headache, any headache on ≥15 days/month". Female gender and younger age were the most important associated migraine risk factors. Depression (1.62 [1.06; 2.47]) and poor sleep (1.06 [1.00; 1.12]) were associated with migraine and headache activity in general. Antihypertensives were associated with headache remission (0.80 [0.64; 1.00]). Additionally, undertaking less sports (0.72 [0.51; 1.03]) was associated with higher migraine activity. CONCLUSIONS Headaches and migraines are not rare in the older population. They are related to mood and sleep disturbance, and migraine even to less physical activity. Antihypertensives are related to headache remission.
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Affiliation(s)
- Sara Schramm
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Isabell Tenhagen
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Dagny Holle-Lee
- Department of Neurology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Steffen Naegel
- Department of Neurology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.,Clinic and Polyclinic for Neurology, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Zaza Katsarava
- Department of Neurology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.,Department of Neurology, Evangelical Hospital Unna, Unna, Germany.,EVEX Medical Corporation, Tbilisi, Georgia.,Sechenov University Moscow, Moscow, Russian Federation
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Susanne Moebus
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
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30
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Seddik AH, Branner JC, Ostwald DA, Schramm SH, Bierbaum M, Katsarava Z. The socioeconomic burden of migraine: An evaluation of productivity losses due to migraine headaches based on a population study in Germany. Cephalalgia 2020; 40:1551-1560. [DOI: 10.1177/0333102420944842] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background This study estimates the socioeconomic impact of migraine headaches on paid and unpaid work productivity in the adult German population in 1 year. Methods We used data on headache frequency (days per month) from a longitudinal population-based study. Prevalence estimates of migraine were derived from the Global Burden of Disease Collaborative Network. Demography data were derived from official statistics in 2017. Aggregate headache days in 1 year were translated to losses in paid and unpaid productive hours based on estimates of presenteeism and absenteeism along with other socioeconomic parameters. Paid hours lost were distributed across the industry sectors. In this way, an age-, gender- and industry sector-specific monetary value was calculated for paid hours lost. Unpaid hours lost were valued by assigning the unpaid activities to their nearest market substitute. In a last step, value-added multipliers derived from input-output tables were used to calculate the economic value chain effects. Results A total of 15.5 million persons (20 years or older) suffer from migraine in Germany. Our analysis shows that 60% of those have three or fewer headache days per month, while patients suffering chronic migraine (15+ headache days per month) account for 5.4% of the adult migraine population. Females bear 65% of the total 836 million headache days per year. The socioeconomic losses due to migraine amount to €100.4 billion (€6493 on average per patient) in one year. Conclusion In addition to time losses in paid work, migraine causes substantial socioeconomic losses to unpaid work activities due to its disproportionate prevalence among females. Economic value chain effects provide a novel perspective on losses beyond a patient’s time loss. Overall, the elements of socioeconomic burden provide a strong rationale that innovative migraine therapies could be of high value to society.
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Affiliation(s)
| | | | - Dennis A Ostwald
- WifOR Institute, Darmstadt, Germany
- SIBE, Graduate School of the Faculty for Leadership and Management, Steinbeis University, Berlin, Germany
| | - Sara H Schramm
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | | | - Zaza Katsarava
- Evangelical Hospital Unna, Unna, Germany
- Department of Neurology, University of Duisburg-Essen, Essen, Germany
- EVEX Medical Corporation, Tbilisi, Republic of Georgia
- IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
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Amini-Parikhani M, Ghaffarazad A, Soleimanpour H, Ebrahimi-Bakhtavar H, Rahmani F. Efficacy of adding midazolam to paracetamol in pain control of patients with a primary headache: A randomized, clinical trial study. Turk J Emerg Med 2020; 20:63-68. [PMID: 32587924 PMCID: PMC7305668 DOI: 10.4103/2452-2473.285011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/19/2020] [Accepted: 04/04/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES: This study aimed to determine the effect of adding intravenous midazolam to paracetamol in the treatment of patients with primary headache referring to the emergency department. METHODS: In a randomized clinical trial, 120 patients (18–65 years old) with primary headache referring to the emergency department were enrolled. Patients were divided into two groups (case: paracetamol + midazolam and control: paracetamol + placebo), and the treatment was administered based on the treatment group. The severity of pain (according to the initial Visual Analog Scale) and at different times after the treatment onset (15, 30, and 60 min) and the degree of satisfaction with the treatment were compared in two groups of patients. RESULTS: There were no statistically difference between the two groups about the median of pain severity at the time of 0 min (case: 8 vs. control: 8), 15 min (case: 6 vs. control: 6), and 30 min (case: 4 vs. control: 4) with P > 0.05. Headache severity at 60 min after the treatment onset in the case group (median: 1) was less than that of the control group (median: 3). There was also a statistically significant difference in the median of patient satisfaction in the case group (case: 9 and control: 7 with P < 0.001) and satisfaction in the case group was higher. CONCLUSIONS: Based on our primary and secondary outcomes and the results of the study, we conclude that adding intravenous midazolam to paracetamol do not improve the therapeutic response ratio over time, but the effect of this intervention appeared after 1 h.
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Affiliation(s)
- Mahin Amini-Parikhani
- Student Research Committee, Tabriz University of Medical Sciences, East Azerbaijan, I. R, Tabriz, Iran
| | - Amir Ghaffarazad
- Emergency Medicine Research Team, Tabriz University of Medical Sciences Tabriz, East Azerbaijan, I. R, Tabriz, Iran
| | - Hassan Soleimanpour
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Haniyeh Ebrahimi-Bakhtavar
- Emergency Medicine Research Team, Tabriz University of Medical Sciences Tabriz, East Azerbaijan, I. R, Tabriz, Iran
| | - Farzad Rahmani
- Emergency Medicine Department, Tabriz University of Medical Sciences, Tabriz, Iran
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Shaygan M, Yazdanpanah M. Prevalence and Predicting Factors of Chronic Pain among Workers of Petrochemical and Petroleum Refinery Plants. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2020; 11:3-14. [PMID: 31605473 PMCID: PMC7024591 DOI: 10.15171/ijoem.2020.1632] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 08/14/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND Taking into account the differences in job requirements and conditions, it is expected that workers in some occupations are more susceptible to pain than others. OBJECTIVE To examine the prevalence of chronic pain among workers of several petrochemical and petroleum refinery plants. We also examined the predictive role of psycho-familial variables (depression, work-family conflict and job stress) in causing chronic pain when controlling for demographic and occupational factors. METHODS This cross-sectional study was carried out among 674 workers. Those with chronic pain were identified by affirmative answers to screening questions based on the ICD-11 criteria. RESULTS There were 162 (24.0%; 95% CI 20.8% to 27.3%) workers meeting the ICD- 11 criteria for chronic pain. Headache was the most frequently reported pain (29.9%). We found a significantly (p=0.03) higher prevalence of pain among the middle age than in other age groups. Chronic pain more frequently affected divorced/widowed workers (p<0.001), and those with more work experience (p=0.04). Workers with chronic pain reported significantly higher levels of depression (p<0.001), job stress (p=0.007), and work-family conflict (p<0.001). After controlling for demographic and occupational factors, depression (p<0.001) and work-family conflict (p=0.003) were found to be independent predictors of chronic pain among studied workers. CONCLUSION Workers who experience higher levels of depression, work-family conflict and job stress might be more prone to chronic pain. The majority of these factors are modifiable, and the problem may thus be solved by establishing appropriate screening programs, and availability of proper services and education.
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Affiliation(s)
- Maryam Shaygan
- Community Based Psychiatric Care Research Center, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Maryam Yazdanpanah
- Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Eighty years of Medication-Overuse Headache: what about Medication-Overuse Backpain? J Neurol 2019; 266:3167-3170. [PMID: 31686187 DOI: 10.1007/s00415-019-09611-7] [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: 08/27/2019] [Revised: 10/27/2019] [Accepted: 10/28/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Although chronic low back pain (CLBP) is one of the most common pain syndromes, up to now, clear pathophysiological causes or specific treatment options are missing. Medication-overuse has been associated with chronic headache, but never with CLBP. HYPOTHESIS Based on several similarities between CLBP and Medication-Overuse Headache (MOH), we hypothesized that medication-overuse might contribute to CLBP as well, maybe even as an own entity. Might there be something like Medication-Overuse Backpain (MOB)? METHODS We substantiate our hypothesis with a preliminary case-series analyzing five patients suffering from CLBP with a marked medication-overuse. In these patients, a stepwise analgesic withdrawal was recommended. RESULTS Within 6 months of recruitment, five patients fulfilled the inclusion criteria and successfully completed discontinuation of their medication. All patients reported noticeable pain relief, despite the discontinuation of their analgesics. Withdrawal was well tolerated in all cases. CONCLUSIONS Considering our results, the described withdrawal method seems to be a simple and safe method to achieve pain reduction while simultaneously preventing organ damage. Despite the preliminary character of our results, our hypothesis might stimulate a new understanding of CLBP's pathophysiology.
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Malmberg-Ceder K, Haanpää M, Korhonen PE, Kautiainen H, Veromaa V, Soinila S. The role of psychosocial risk factors in the burden of headache. J Pain Res 2019; 12:1733-1741. [PMID: 31213885 PMCID: PMC6548994 DOI: 10.2147/jpr.s165263] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 04/01/2019] [Indexed: 11/30/2022] Open
Abstract
Purpose: Psychosocial risk factors are common in headache patients and affect the impact of headache in multiple ways. The aim of our study was to assess how psychosocial risk factors correlate with the headache impact test-6 (HIT-6). To our knowledge this is the first study to evaluate the impact of several psychosocial factors on the HIT-6 score. Patients and methods: Our study population consisted of 469 Finnish female employees reporting headache during the past year. Psychosocial risk factors were assessed using validated, self-administered questionnaires: the generalized anxiety disorder 7-item scale (GAD-7) for anxiety, the major depression inventory (MDI) for depressive symptoms, the ENRICHD short social support instrument (ESSI) for social isolation, the cynical distrust scale for hostility and the Bergen burnout indicator (BBI-15) for work stress. Results: Exploratory factor analysis of the HIT-6 scores revealed two factors, one describing psychological and quality of life aspects affected by headache and the other describing severity of pain and functional decline. Internal consistency of the HIT-6 was 0.87 (95%CI: 0.85–0.89). Correlations between the total HIT-6 score and all measured psychosocial risk factors except for hostility were weak, but statistically significant. Conclusion: The HIT-6 questionnaire has good construct validity and it describes reliably and independently the impact of headache without interference of psychosocial factors in general working-aged female population.
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Affiliation(s)
- Kirsi Malmberg-Ceder
- Department of Neurology, Satakunta Central Hospital, Pori, Finland.,Department of Neurology, University of Turku, Turku, Finland
| | - Maija Haanpää
- Mutual Insurance Company Ilmarinen, Helsinki, Finland.,Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Päivi E Korhonen
- Department of General Practice, Turku University Hospital, Turku University, Turku, Finland
| | - Hannu Kautiainen
- Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland.,Folkhälsan Research Centre, Helsinki, University of Helsinki, Helsinki, Finland
| | - Veera Veromaa
- Department of General Practice, Turku University Hospital, Turku University, Turku, Finland.,Central Satakunta Heath Federation of Municipalities, Harjavalta, Finland
| | - Seppo Soinila
- Department of Neurology, University of Turku, Turku, Finland.,Division of Clinical Neurosciences/General Neurology, Turku University Hospital, Turku, Finland
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Bottiroli S, Galli F, Viana M, De Icco R, Bitetto V, Allena M, Pazzi S, Sances G, Tassorelli C. Negative Short-Term Outcome of Detoxification Therapy in Chronic Migraine With Medication Overuse Headache: Role for Early Life Traumatic Experiences and Recent Stressful Events. Front Neurol 2019; 10:173. [PMID: 30899242 PMCID: PMC6416203 DOI: 10.3389/fneur.2019.00173] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/11/2019] [Indexed: 01/03/2023] Open
Abstract
Background: Early traumatic experiences and Stressful episodes appear to be associated to the development and perpetuation of chronic pain disorders and to dependence-related behaviors. Objective: The present study evaluated whether these factors can be predictors, together with psychiatric conditions, of the outcome of a detoxification treatment in patients suffering from chronic migraine and medication-overuse headache in a 2-month follow-up. Methods: Consecutive patients undergoing a detoxification program as therapy for treating chronic migraine and medication overuse headache at the Pavia Headache Center were analyzed. During this program, lasting about 1 week, all patients received the standard CARE in-patient withdrawal protocol, which consisted in discontinuing abruptly the overused drug(s) and receiving daily detoxification therapy. Data on childhood traumatic events and recent stressful ones were analyzed by means of the Childhood Trauma Questionnaire and Stressful life-events Questionnaire. Psychiatric conditions were evaluated using the Structured Clinical Interview for Diagnostic and Statistical Manual of mental disorders. Results: A total of 166 (80% females; mean age 44.7) patients completed the follow-up at 2 months after the detoxification program: of these 118 (71%) (78% females; mean age 44.7) stopped overuse and reverted to an episodic pattern of headache (Group A); 19 (11%) (89% females; mean age 41.3) kept overusing and maintained a chronic pattern of headache (Group B); and 29 (18%) (79% females; mean age 46.9) stopped overuse without any benefit on headache frequency (Group C). At the multivariate analyses, a higher number of early life emotional distress (Odds Ratio 11.096; p = 0.037) arose as a prognostic factor for the outcome in Group B, while major depression during life-time (Odds Ratio 3.703; p = 0.006) and higher number of severe stressful episodes in the past 10 years (Odds Ratio 1.679; p = 0.045) were prognostic factors for the outcome of Group C. Conclusions: Data suggest that early life traumas and stressful events have a negative impact on the outcome of the detoxification program in subjects overusing acute medication for headache. The history of emotional childhood traumas is associated to the failure to cease overuse, whereas recent very serious life events are associated to the persistence of headache chronicity.
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Affiliation(s)
- Sara Bottiroli
- Faculty of Law, Giustino Fortunato University, Benevento, Italy.,Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Federica Galli
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Michele Viana
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy.,Headache Group, Department of Basic and Clinical Neurosciences, King's College London, London, United Kingdom.,Headache Center, Institute of the Neurocenter of Southern Switzerland (NSI), Regional Hospital Lugano, Lugano, Switzerland
| | - Roberto De Icco
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Vito Bitetto
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Marta Allena
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Stefania Pazzi
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Grazia Sances
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Cristina Tassorelli
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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van der Doef MP, Schelvis RMC. Relations Between Psychosocial Job Characteristics and Work Ability in Employees with Chronic Headaches. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:119-127. [PMID: 29637456 DOI: 10.1007/s10926-018-9769-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Purpose The aim of the study was to determine (a) to which extent job demands and job resources predict work ability in employees with chronic headaches, and (b) whether work ability in these employees is more hampered by high demands and more enhanced by resources than in employees without chronic disease. Methods All employees with chronic headaches (n = 593) and without chronic disease (n = 13,742) were selected from The Netherlands Working Conditions Survey conducted in 2013. This survey assessed amongst others job characteristics and various indicators of work ability, i.e. sick leave, employability, work engagement, and emotional exhaustion. Hierarchical regression analyses were conducted for employees with chronic headaches and compared to employees without chronic disease, controlling for age, gender and educational level. Results In employees with chronic headaches higher quantitative and emotional demands contributed to higher emotional exhaustion, and higher emotional demands to higher sick leave. Higher cognitive demands were however associated with higher work engagement. Higher autonomy was related to higher employability and lower emotional exhaustion. Higher supervisor and colleague support was associated with higher employability, higher engagement and lower emotional exhaustion. Higher supervisor support was associated with lower sick leave. Supervisor support emerged as a stronger predictor for emotional exhaustion in the employees with chronic headaches than in the employees without chronic disease. Conclusions Job demands and job resources are important for work ability in employees with chronic headaches. Furthermore, results suggest that these employees benefit more strongly from supervisor support than employees without chronic disease.
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Affiliation(s)
- Margot P van der Doef
- Institute of Psychology, Health, Medical, and Neuropsychology Unit, Leiden University, Leiden, The Netherlands.
| | - Roosmarijn M C Schelvis
- Netherlands Organization for Applied Scientific Research TNO, Work, Health & Technology, Leiden, The Netherlands
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Buse DC, Greisman JD, Baigi K, Lipton RB. Migraine Progression: A Systematic Review. Headache 2018; 59:306-338. [PMID: 30589090 DOI: 10.1111/head.13459] [Citation(s) in RCA: 162] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Migraine is a common and often debilitating neurological disease. It can be divided into episodic and chronic subforms based on the number of monthly headache days. Because only a subset of individuals with episodic migraine (EM) progress to chronic migraine (CM) over any given time period, understanding the factors that predict the new onset of CM or "migraine progression" may provide insights into the mechanisms, pathophysiology, prevention, and treatment of CM. In this review, we identify and summarize studies that report risk factors associated with the new onset of CM or related chronic headache diagnoses, group these risk factors and report the strength of evidence for the identified risk factors. OBJECTIVE To conduct a systematic review of studies that identify risk factors for the new onset of CM or related chronic headache diagnoses such as transformed migraine (TM) and chronic daily headache (CDH). METHODS Herein we summarize the findings of studies of risk factors associated with the new onset of CM/TM, CDH, or related diagnoses from the English language literature published before March 2018. The PubMed database was searched for relevant studies. Longitudinal studies with follow-up data and case-control studies were included in this qualitative synthesis. We report methodology, analytic criteria, and results for each manuscript and for the parent study. Next, we review the strength of evidence for each of the identified risk factors using a modified version of AB Hill's criteria for causation and rank evidence as fair, moderate, or strong. We categorized risk factors as nonmodifiable, modifiable and based on putative mechanisms. We further categorized risk factors into sociodemographics, lifestyle factors and habits, headache features, comorbid and concomitant diseases and conditions and pharmacologic treatment-related. Finally, we review theories of the pathophysiology underlying the development of new onset chronic migraine or increasing attack frequency. RESULTS The PubMed search yielded 1870 records after duplicates were removed. Nine additional records were identified through expert consultation and other methods (eg, citations found as references in manuscripts identified in the literature review and through communication with the authors of manuscripts included in the review). The 1879 manuscripts were screened against the inclusion and exclusion criteria and 109 were found to be potentially eligible. Of 109 full-text articles, 17 studies were identified as meeting the prespecified criteria based on the consensus of all authors. Of the 17 full texts, 13 were longitudinal cohort studies and 4 were case-controlled studies. We found strength of evidence ranging from fair to strong for the identified risk factors. The strongest data were found for increased headache day frequency, depression, and medication overuse/high-frequency use. Risk factors for new onset CM and CDH in children and adolescents were similar to those identified in adults. CONCLUSIONS A range of risk factors for the new onset of CM/TM, CDH, or related chronic headache diseases were identified with the strongest data supporting increased headache day frequency, acute medication overuse/high-frequency use and depression, which are potentially modifiable risk factors. Modifiable risk factors may provide targets for intervention. The lack of strong evidence or any evidence does not imply that there is not a relationship between a particular risk factor and new onset CM or related disease; but may indicate little or no research or that research did not have sufficient methodological rigor. In addition, it is likely that additional risk factors exist which have not yet been identified. Putative factors include pro-inflammatory states and pro-thrombotic states. Development of central sensitization and increased activation of the trigeminal nociceptive pathways may be drivers of the new onset of CM or CDH. Future research may include the systematic testing of interventions targeting modifiable risk factors to determine if progression can be prevented as well as continued exploration of the benefits of treating these risk factors among people with CM in an effort to increase rates of remission. Future work should also consider the natural fluctuations in headache day frequency and examine progression in terms of continuous definitions rather than or in addition to a dichotomous boundary.
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Affiliation(s)
- Dawn C Buse
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jacob D Greisman
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Khosrow Baigi
- Department of Family Medicine, Bronx Care Health System, Bronx, NY, USA
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.,Montefiore Medical Center, Bronx, NY, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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Fernando Prieto Peres M, Prieto Peres Mercante J, Belitardo de Oliveira A. Non-Pharmacological Treatment for Primary Headaches Prevention and Lifestyle Changes in a Low-Income Community of Brazil: A Randomized Clinical Trial. Headache 2018; 59:86-96. [PMID: 30485409 DOI: 10.1111/head.13457] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Primary headaches can be reduced by lifestyle changes, such as stress management and physical activity. However, access to programs focused on behavioral interventions is limited in underserved, poor communities. OBJECTIVES We performed a randomized open-label clinical trial to test the therapeutic and behavioral effects of aerobic exercise, relaxation, or the combination of both, in individuals with primary headaches of a small, low-income community of the Brazilian Amazon. METHODS Participants were screened from the riverine/rural population, and individuals with primary headache were included. We assessed clinical characteristics and physical activity levels. Interventions were delivery 3 times/week for 6 months. The primary outcome variable was changes in days with headache, while changes in duration of attacks, pain intensity, and physical activity levels were secondary outcomes variables. RESULTS Seven hundred and ninety individuals were screened (15.3% of rural/riverine population). Seventy-four participants were randomly assigned to relaxation (n = 25), physical activity orientation program (n = 25), or both (n = 24) interventions. Intention to treat analyses showed all interventions as effective to reduce days with headaches and duration of attacks (both P < .01). Pain intensity was reduced only in relaxation and relaxation + physical activity groups (both P < .01). Physical activity levels increased only in the relaxation + physical activity group (P < .05). CONCLUSIONS Non-pharmacological interventions such as physical activity and relaxation are effective for reducing headaches, while combining such interventions promote health behavior toward higher physical activity levels in low-income populations with primary headaches. CLINICAL TRIAL REGISTRATION NUMBER SGPP 1544.
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Affiliation(s)
- Mario Fernando Prieto Peres
- Instituto do Cérebro, Hospital Israelita Albert Einstein, São Paulo, Brazil.,Faculdade de Medicina, Instituto de Psiquiatria, Universidade de São Paulo, São Paulo, Brazil
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Chang X, Pellegrino R, Garifallou J, March M, Snyder J, Mentch F, Li J, Hou C, Liu Y, Sleiman PMA, Hakonarson H. Common variants at 5q33.1 predispose to migraine in African-American children. J Med Genet 2018; 55:831-836. [PMID: 30266756 DOI: 10.1136/jmedgenet-2018-105359] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 08/16/2018] [Accepted: 08/29/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Genome-wide association studies (GWASs) have identified multiple susceptibility loci for migraine in European adults. However, no large-scale genetic studies have been performed in children or African Americans with migraine. METHODS We conducted a GWAS of 380 African-American children and 2129 ancestry-matched controls to identify variants associated with migraine. We then attempted to replicate our primary analysis in an independent cohort of 233 African-American patients and 4038 non-migraine control subjects. RESULTS The results of this study indicate that common variants at 5q33.1 associated with migraine risk in African-American children (rs72793414, p=1.94×10-9). The association was validated in an independent study (p=3.87×10-3) for an overall meta-analysis p value of 3.81×10-10. eQTL (Expression quantitative trait loci) analysis of the Genotype-Tissue Expression data also shows the genotypes of rs72793414 were strongly correlated with the mRNA expression levels of NMUR2 at 5q33.1. NMUR2 encodes a G protein-coupled receptor of neuromedin-U (NMU). NMU, a highly conserved neuropeptide, participates in diverse physiological processes of the central nervous system. CONCLUSIONS This study provides new insights into the genetic basis of childhood migraine and allow for precision therapeutic development strategies targeting migraine patients of African-American ancestry.
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Affiliation(s)
- Xiao Chang
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Renata Pellegrino
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - James Garifallou
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Michael March
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - James Snyder
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Frank Mentch
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jin Li
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Affiliated Cancer Hospital & Institute, Guangzhou Medical University, Guangzhou, China
| | - Cuiping Hou
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Yichuan Liu
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Patrick M A Sleiman
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Hakon Hakonarson
- The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Cha MJ, Kim BK, Moon HS, Ahn JY, Oh K, Kim JY, Kim BS, Sohn JH, Chung JM, Song TJ, Kim J, Seo JG, Chu MK, Cho SJ. Stress Is Associated with Poor Outcome of Acute Treatment for Chronic Migraine: A Multicenter Study. PAIN MEDICINE 2018; 19:1832-1838. [PMID: 29106663 DOI: 10.1093/pm/pnx269] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background Chronic migraine (CM) is associated with severe psychological symptoms and disabilities. Information on the relationship between stress and the outcomes of acute CM treatment is limited. Methods We evaluated the clinical presentation and stress levels of patients with CM who visited the neurology departments of 14 hospitals between September and December 2015. The patients were divided into stress and reference groups on the basis of the Korean version of the Brief Encounter Psychosocial Instrument (BEPSI-K). Quality of life was evaluated using EuroQol Five Dimension Questionnaire Three-Level. The Migraine Assessment of Current Therapy questionnaire was used to assess the outcomes of acute treatment. Results This study included 186 CM patients. On the basis of the BEPSI-K score, 79 and 107 patients were assigned to the stress and reference groups, respectively. The stress group had more patients with poor outcomes of acute treatment than the reference group (67.1% vs 40.2%, P < 0.001). In a multivariate analysis, female gender (odds ratio [OR] = 3.266, 95% confidence interval [CI] = 1.172-9.103, P = 0.024), the number of headache-free days per month (OR = 0.932, 95% CI = 0.883-0.985, P = 0.012), and BEPSI-K score (OR = 1.667, 95% CI = 1.051-2.643, P = 0.030) predicted poor outcomes of acute treatment. Conclusions High levels of stress were reported by 42.5% of patients with CM. The association between stress and the outcomes of acute treatment suggests that stress is an important clinical variable for improving the management of CM.
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Affiliation(s)
- Myoung-Jin Cha
- Department of Neurology, National Police Hospital, Seoul, Korea
| | - Byung-Kun Kim
- Department of Neurology, Eulji Hospital, Eulji University, Seoul, Korea
| | - Heui-Soo Moon
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin-Young Ahn
- Department of Neurology, Seoul Medical Center, Seoul, Korea
| | - Kyungmi Oh
- Department of Neurology, Korea University Guro Hospital, Korea University School of Medicine, Seoul, Korea
| | - Jee Young Kim
- Department of Neurology, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea
| | - Byung-Su Kim
- Department of Neurology, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
| | - Jong-Hee Sohn
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Jae-Myun Chung
- Department of Neurology, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Tae-Jin Song
- Department of Neurology, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Jiyoung Kim
- Department of Neurology, Bio Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Jong-Geun Seo
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Min Kyung Chu
- Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
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Andreeva VA, Fezeu LK, Hercberg S, Galan P. Obesity and Migraine: Effect Modification by Gender and Perceived Stress. Neuroepidemiology 2018; 51:25-32. [PMID: 29843127 DOI: 10.1159/000489663] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 04/25/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The association between obesity and migraine has been established; however, it is unclear whether it varies by perceived stress within each gender. METHODS This cross-sectional study used data from the ongoing NutriNet-Santé e-cohort with enrollees from the general population. Anthropometric and migraine data were provided via self-report questionnaires (2013-2016). Migraine was defined using established criteria. Perceived stress was assessed with Cohen's Perceived Stress Scale-10. Associations were estimated via gender- and stress-stratified multivariable polytomous logistic regression models. RESULTS Among 32,835 participants with complete data (75% women; mean age = 51.9 ± 13.8 years), 34% reported no headache, 44% non-migraine headache, and 22% migraine with or without aura during one's lifetime. In these groups, obesity was present in 8.6, 9.9, and 11.6%, respectively. Stress was a significant moderator of the obesity-migraine association only among women. The largest significant adjusted odds ratio (aOR) was found between obesity and migraine in women with high stress (aOR 1.61, 95% CI 1.35-1.91). CONCLUSIONS We found support for gender- and stress-dependent associations between obesity and migraine using a large, heterogeneous adult sample. This underscores the need for evidence-based strategies for weight loss and stress reduction for female migraineurs.
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Affiliation(s)
- Valentina A Andreeva
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13/Inserm U1153/Inra U1125/Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Léopold K Fezeu
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13/Inserm U1153/Inra U1125/Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Serge Hercberg
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13/Inserm U1153/Inra U1125/Cnam, COMUE Sorbonne Paris Cité, Bobigny, France.,Département de Santé Publique, Hôpital Avicenne, Bobigny, France
| | - Pilar Galan
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Université Paris 13/Inserm U1153/Inra U1125/Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
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Bottiroli S, Galli F, Viana M, Sances G, Tassorelli C. Traumatic Experiences, Stressful Events, and Alexithymia in Chronic Migraine With Medication Overuse. Front Psychol 2018; 9:704. [PMID: 29867669 PMCID: PMC5960722 DOI: 10.3389/fpsyg.2018.00704] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 04/23/2018] [Indexed: 01/08/2023] Open
Abstract
Background: Many factors are involved in the prognosis and outcome of Chronic Migraine and Medication Overuse Headache (CM+MOH), and their understanding is a topic of interest. It is well known that CM+MOH patients experience increased psychiatric comorbidity, such as anxiety, depression, or personality disorders. Other psychological factors still need to be explored. The present study is aimed to evaluate whether early life traumatic experiences, stressful life events, and alexithymia can be associated with CM+MOH. Methods: Three hundred and thirty-one individuals were recruited for this study. They belonged to one of the two following groups: CM+MOH (N = 179; 79% females, Age: 45.2 ± 9.8) and episodic migraine (EM) (N = 152; 81% females; Age: 40.7 ± 11.0). Diagnosis was operationally defined according to the International Classification of Headache Disorders 3rd edition (ICHD-IIIβ). Data on early life (physical and emotional) traumatic experiences, recent stressful events and alexithymia were collected by means of the Childhood Trauma Questionnaire, the Stressful life-events Questionnaire, and the Toronto Alexithymia Scale (TAS-20), respectively. Results: Data showed a higher prevalence of emotional (χ2 = 6.99; d.f. = 1; p = 0.006) and physical (χ2 = 6.18; d.f. = 1; p = 0.009) childhood trauma and of current stressful events of important impact (χ2 = 4.42; d.f. = 1; p = 0.025) in CM+MOH patients than in EM ones. CM+MOH patients were characterized by higher difficulties in a specific alexithymic trait (Factor 1 subscale of TAS-20) [F(1, 326) = 6.76, p = 0.01, ηp2 = 0.02] when compared to the EM group. The role of these factors was confirmed in a multivariate analysis, which showed an association of CM+MOH with emotional (OR 2.655; 95% CI 1.153–6.115, p = 0.022) or physical trauma (OR 2.763; 95% CI 1.322–5.771, p = 0.007), and a high score at the Factor 1 (OR 1.039; 95% CI 1.002–1.078, p = 0.040). Conclusions: Our findings demonstrated a clear relationship between CM+MOH and life traumas, stressful events, and alexithymia. These observations have a relevant role in multiple fields of related to chronic headache: from the management to the nosographic framing.
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Affiliation(s)
- Sara Bottiroli
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Federica Galli
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Michele Viana
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Grazia Sances
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Cristina Tassorelli
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Johansson AM, Vikingsson H, Varkey E. The physiotherapist, an untapped resource for headaches: a survey of university students. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2018. [DOI: 10.1080/21679169.2017.1352023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Anna-Maria Johansson
- Department of Health and Rehabilitation/Physiotherapy, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hannah Vikingsson
- Department of Health and Rehabilitation/Physiotherapy, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Emma Varkey
- Department of Health and Rehabilitation/Physiotherapy, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Rabiei K, Hellström P, Högfeldt-Johansson M, Tisell M. Does subjective improvement in adults with intracranial arachnoid cysts justify surgical treatment? J Neurosurg 2018; 128:250-257. [DOI: 10.3171/2016.9.jns161139] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVESubjective improvement of patients who have undergone surgery for intracranial arachnoid cysts has justified surgical treatment. The current study aimed to evaluate the outcome of surgical treatment for arachnoid cysts using standardized interviews and assessments of neuropsychological function and balance. The relationship between arachnoid cyst location, postoperative improvement, and arachnoid cyst volume was also examined.METHODSThe authors performed a prospective, population-based study. One hundred nine patients underwent neurological, neuropsychological, and physiotherapeutic examinations. The arachnoid cysts were considered symptomatic in 75 patients, 53 of whom agreed to undergo surgery. In 32 patients, results of the differential diagnosis revealed that the symptoms were due to a different underlying condition and were unrelated to an arachnoid cyst. Neuropsychological testing included target reaction time, Grooved Pegboard, Rey Auditory Verbal Learning, Rey Osterrieth complex figure, and Stroop tests. Balance tests included the extended Falls Efficacy Scale, Romberg, and sharpened Romberg with open and closed eyes. The tests were repeated 5 months postoperatively. Cyst volume was pre- and postoperatively measured using OsiriX software.RESULTSPatients who underwent surgery did not have results on balance and neuropsychological tests that were different from patients who declined or had symptoms unrelated to the arachnoid cyst. Patients with a temporal arachnoid cyst performed within the normal range on the neuropsychological tests. Seventy-seven percent of the patients who underwent surgery reported improvement, yet there were no differences in test results before and after surgery. Arachnoid cysts in the temporal region and posterior fossa did not influence the preoperative results of neuropsychological and motor tests. The arachnoid cyst volume decreased postoperatively (p < 0.0001), but there was no relationship between volume reduction and clinical improvement.CONCLUSIONSThe results of this study speak against objectively verifiable improvement following surgical treatment in adults with intracranial arachnoid cysts.
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Affiliation(s)
- Katrin Rabiei
- 1Institute of Neuroscience and Physiology, Sahlgrenska Academy; and
- 2Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Per Hellström
- 1Institute of Neuroscience and Physiology, Sahlgrenska Academy; and
| | - Mats Högfeldt-Johansson
- 1Institute of Neuroscience and Physiology, Sahlgrenska Academy; and
- 2Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Magnus Tisell
- 1Institute of Neuroscience and Physiology, Sahlgrenska Academy; and
- 2Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
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Affiliation(s)
- Geoffrey L Heyer
- From the Division of Child Neurology (G.L.H.), Nationwide Children's Hospital and The Ohio State University, Columbus; and Division of Child and Adolescent Neurology (K.J.M.), Mayo Clinic, Rochester, MN.
| | - Kenneth J Mack
- From the Division of Child Neurology (G.L.H.), Nationwide Children's Hospital and The Ohio State University, Columbus; and Division of Child and Adolescent Neurology (K.J.M.), Mayo Clinic, Rochester, MN
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Negro A, Curto M, Lionetto L, Guerzoni S, Pini LA, Martelletti P. A Critical Evaluation on MOH Current Treatments. Curr Treat Options Neurol 2017; 19:32. [PMID: 28808924 DOI: 10.1007/s11940-017-0465-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OPINION STATEMENT Migraine is the most frequent neurological disorder observed in clinical practice characterized by moderate to severe pain attacks associated with neurological, gastrointestinal, and dysautonomic symptoms. Each year, 2.5% of patients with episodic migraine develop chronic migraine (CM). CM is characterized by high frequency of the attacks that may result into chronic intake of abortive medications. Nearly, the 70% of CM patients referring to tertiary head centers show acute pain medications overuse that may lead to the development of medication overuse headache (MOH). The management of MOH requires three steps: (1) education, (2) withdrawal of the overuse drug and detoxification, and (3) re-prophylaxis. In the last years, several real-life prospective studies provided further evidence in clinical setting of the onabotulinumtoxinA 155-195 U efficacy for the headache prophylaxis in CM with MOH patients. There is a general agreement on two factors: (1) withdrawal of the overuse drug is condicio sine qua non to reverse the pattern to medium-low-frequency migraine, and (2) the focus of management needs to shift from acute treatment of pain to prevention of headache. CM patients close to developing MOH, patients with high-frequency episodic migraine, and those already abusing of drugs require special attention and should refer to tertiary headache centers. For all of them, a solution could be an "early treatment." Early should be their referral to a tertiary headache center, early should be the withdrawal of the overuse drug and a proper detoxification, and perhaps early should be the start of a preventative therapy.
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Affiliation(s)
- Andrea Negro
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy. .,Regional Referral Headache Centre, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00191, Rome, Italy.
| | - Martina Curto
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Luana Lionetto
- Advanced Molecular Diagnostics Unit, IDI Istituto Dermopatico dell'Immacolata - IRCSS, Rome, Italy
| | - Simona Guerzoni
- Department of Diagnostic and Clinical Medicine and Public Health, Proteomic Lab, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi Alberto Pini
- Department of Diagnostic and Clinical Medicine and Public Health, Proteomic Lab, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.,Regional Referral Headache Centre, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00191, Rome, Italy
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Psychological generators of stress-headaches. J Behav Med 2017; 41:109-121. [DOI: 10.1007/s10865-017-9872-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 07/06/2017] [Indexed: 01/03/2023]
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Krøll LS, Hammarlund CS, Westergaard ML, Nielsen T, Sloth LB, Jensen RH, Gard G. Level of physical activity, well-being, stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain. J Headache Pain 2017; 18:46. [PMID: 28421374 PMCID: PMC5395520 DOI: 10.1186/s10194-017-0753-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 04/06/2017] [Indexed: 01/03/2023] Open
Abstract
Background The prevalence of migraine with co-existing tension-type headache and neck pain is high in the general population. However, there is very little literature on the characteristics of these combined conditions. The aim of this study was to investigate a) the prevalence of migraine with co-existing tension-type headache and neck pain in a clinic-based sample, b) the level of physical activity, psychological well-being, perceived stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain compared to healthy controls, c) the perceived ability of persons with migraine and co-existing tension-type headache and neck pain to perform physical activity, and d) which among the three conditions (migraine, tension-type headache or neck pain) is rated as the most burdensome condition. Methods The study was conducted at a tertiary referral specialised headache centre where questionnaires on physical activity, psychological well-being, perceived stress and self-rated health were completed by 148 persons with migraine and 100 healthy controls matched by sex and average age. Semi-structured interviews were conducted to assess characteristics of migraine, tension-type headache and neck pain. Results Out of 148 persons with migraine, 100 (67%) suffered from co-existing tension-type headache and neck pain. Only 11% suffered from migraine only. Persons with migraine and co-existing tension-type headache and neck pain had lower level of physical activity and psychological well-being, higher level of perceived stress and poorer self-rated health compared to healthy controls. They reported reduced ability to perform physical activity owing to migraine (high degree), tension-type headache (moderate degree) and neck pain (low degree). The most burdensome condition was migraine, followed by tension-type headache and neck pain. Conclusions Migraine with co-existing tension-type headache and neck pain was highly prevalent in a clinic-based sample. Persons with migraine and co-existing tension-type headache and neck pain may require more individually tailored interventions to increase the level of physical activity, and to improve psychological well-being, perceived stress and self-rated health.
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Affiliation(s)
- Lotte Skytte Krøll
- Department of Health Sciences, Lund University, P.O. Box 157, 221 00, Lund, Sweden. .,Danish Headache Centre, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Nordre Ringvej 69, 2600, Glostrup, Denmark.
| | | | - Maria Lurenda Westergaard
- Danish Headache Centre, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Nordre Ringvej 69, 2600, Glostrup, Denmark
| | - Trine Nielsen
- Danish Headache Centre, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Nordre Ringvej 69, 2600, Glostrup, Denmark
| | - Louise Bönsdorff Sloth
- Danish Headache Centre, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Nordre Ringvej 69, 2600, Glostrup, Denmark
| | - Rigmor Højland Jensen
- Danish Headache Centre, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Nordre Ringvej 69, 2600, Glostrup, Denmark
| | - Gunvor Gard
- Department of Health Sciences, Lund University, P.O. Box 157, 221 00, Lund, Sweden
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Kim DY, Lee MJ, Choi HA, Choi H, Chung CS. Clinical patterns of primary stabbing headache: a single clinic-based prospective study. J Headache Pain 2017; 18:44. [PMID: 28401499 PMCID: PMC5388665 DOI: 10.1186/s10194-017-0749-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 03/21/2017] [Indexed: 01/03/2023] Open
Abstract
Background The clinical features and disease courses of primary stabbing headache (PSH) are diverse. We aimed to identify distinct clinical patterns of PSH. Methods We prospectively screened consecutive first-visit patients who presented with stabbing headache at the Samsung Medical Centre Headache Clinic from June 2015 to March 2016. Demographics, headache characteristics, and disease courses were prospectively evaluated. After discerning factors related to the chronicity at the time of presentation, clinical patterns were identified based on the frequency (daily vs. intermittent), clinical course (remitted or not), and total disease duration (<3 or >3 months). Results In the 65 patients with PSH included in this study, monophasic (n = 31), intermittent (n = 17), and chronic daily (n = 12) patterns were identified. The median disease durations were 9 days for monophasic PSH, 9 months for chronic daily PSH, and 2 years for intermittent PSH. The features of monophasic PSH were greater severity, single and side-locked locations, more attacks per day, daily occurrence, and good treatment response. Chronic daily PSH was associated with female predominance, longer-lasting stabs, and multiple or migrating locations on bilateral or alternating sides. The characteristics of intermittent PSH included female predominance and sporadic stabs with less intensity. Conclusions Our study demonstrated distinct clinical patterns of PSH. In addition to help early recognition of disease, our findings suggest different pathophysiologic mechanisms. Future prospective studies are required to reveal the etiologies of these different PSH patterns and their optimal treatment strategies.
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Affiliation(s)
- Dong Yeop Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Ji Lee
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun Ah Choi
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hanna Choi
- Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Chin-Sang Chung
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Griep RH, Toivanen S, Santos IS, Rotenberg L, Juvanhol LL, Goulart AC, Aquino EM, Benseñor I. Work-family conflict, lack of time for personal care and leisure, and job strain in migraine: Results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Am J Ind Med 2016; 59:987-1000. [PMID: 27373788 DOI: 10.1002/ajim.22620] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND Work-family conflict and time scarcity may affect health. We investigated the association between these issues and migraine, taking into account job strain. METHODS Baseline data from ELSA-Brasil (6,183 women; 5,664 men) included four indicators of work-family conflict: time- and strain-based interference of work with family (TB-WFC, SB-WFC), interference of family with work (FWC) and lack of time for personal care and leisure (LOT). Migraine was classified according to International Headache Society criteria. RESULTS Among women, definite migraine was associated with SB-WFC (odds ratio [OR] = 1.28; 95% confidence interval [CI] 1.06-1.55), FWC (OR = 1.32; 1.00-1.75), and LOT (OR = 1.30; 1.08-1.58). Probable migraine was associated with SB-WFC (OR = 1.17; 1.00-1.36). High psychological job demands and low social support interacted with LOT in association with definite migraine. Among men, probable migraine was associated with LOT (OR = 1.34; 1.09-1.64), and there were interactions between job strain and WFC for probable migraine. CONCLUSIONS Balancing the demands of professional and domestic spheres could be highly relevant in the management of migraines. Am. J. Ind. Med. 59:987-1000, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Rosane Härter Griep
- Laboratory of Health and Environment Education; Oswaldo Cruz Institute; Fundação Oswaldo Cruz; Manguinhos; Rio de Janeiro Brazil
- Centre for Health Equity Studies ∣ CHESS; Stockholm University/KarolinskaInstitutet; Stockholm Sweden
| | - Susanna Toivanen
- Centre for Health Equity Studies ∣ CHESS; Stockholm University/KarolinskaInstitutet; Stockholm Sweden
| | - Itamar S. Santos
- Departamento de Clínica Médica; Faculdade de Medicina da Universidade de São Paulo; Brazil
| | - Lucia Rotenberg
- Laboratory of Health and Environment Education; Oswaldo Cruz Institute; Fundação Oswaldo Cruz; Manguinhos; Rio de Janeiro Brazil
| | | | - Alessandra C. Goulart
- Centre for Clinical and Epidemiological Research; Hospital Universitário da Universidade de São Paulo; Brazil
| | - Estela M. Aquino
- Institute of Collective Health; Federal University of Bahia; Salvador Bahia Brazil
| | - Isabela Benseñor
- Centre for Clinical and Epidemiological Research; Hospital Universitário da Universidade de São Paulo; Brazil
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