Depression and anxiety disorders associated with headache frequency. The Nord‐Trøndelag Health Study

The aim of this large cross‐sectional population‐based study was to examine the association between migraine, non‐migrainous headache and headache frequency with depression, and anxiety disorders. From 1995 to 1997, all 92 566 inhabitants aged 20 years and above in Nord‐Trøndelag County in Norway were invited to participate in the Nord‐Trøndelag Health Study (‘Helseundersøkelsen i Nord‐Trøndelag’ = HUNT‐2). A total of 64 560 participated, whereof 51 383 subjects (80%) completed a headache questionnaire that was included. Of these 51 383 individuals, 47 257 (92%) completed the depression subscale items and 43 478 (85%), the anxiety subscale items of the Hospital Anxiety and Depression Scale (HADS). Associations were assessed in multivariate analyses, estimating prevalence odds ratios (OR) with 95% confidence intervals (CI). Depression and anxiety disorders as measured by HADS, were significantly associated with migraine (OR = 2.7, 95% CI 2.3–3.2; OR = 3.2, 95% CI 2.8–3.6) and non‐migrainous headache (OR = 2.2, 95% CI 2.0–2.5; OR = 2.7, 95% CI 2.4–3.0) when compared with headache‐free individuals. The association was stronger for anxiety disorders than for depression. The ORs for depression and anxiety disorders amongst both migraine and non‐migrainous sufferers increased with increasing headache frequency. Depression and anxiety disorders are associated with both migraine and non‐migrainous headache, and this association seems more dependent on headache frequency than diagnostic category.     

Smoking in Pregnancy and Parenthood: What is the Role of Depression, Anxiety and Nicotine Addiction?

This paper presents some of the findings from the Smoking in Pregnancy study of attitudes towards smoking among pregnant women, mothers of young children and their partners in East Surrey. As part of the study, respondents completed a General Health Questionnaire to identify mental health difficulties and, if they were smoking at the time of the study, they also completed the Fagerstrom nicotine addiction test. Eleven female respondents had high scores on the General Health Questionnaire, suggesting symptoms of depression, anxiety and/or social dysfunction for these women. There was no evidence that smokers were suffering from greater mental health difficulties than ex-smokers or non-smokers. However, the General Health Questionnaire scores of smokers were positively associated with their level of nicotine dependence. Furthermore, when General Health Questionnaire scores of all respondents were compared with self-reported health status there was a marked discrepancy suggesting under-reporting of symptoms by women.     

Factors impacting on quality of life in Parkinson's disease: Results from an international survey

Current management guidelines for the treatment of patients with Parkinson's disease (PD) are limited due to the lack of knowledge of factors that influence health‐related quality of life (HRQL). To assess the HRQL of people with PD, and to systematically identify and evaluate those factors (other than disease severity and medication, which could have an impact), we undertook a cross‐sectional, randomized selection, multicenter international survey of patients with PD, caregivers, and clinicians. Face‐to‐face interviews were conducted with subjects in six countries. Disease severity, medication, and other factors hypothesized to influence HRQL were assessed using a combination of specially developed questionnaires and validated instruments including the Parkinson's Disease Questionnaire‐39 (HRQL), Hoehn and Yahr Stage (disease severity), and Beck's Depression Inventory (BDI; depression). Multiple linear regression models were used to demonstrate whether the factors investigated contribute significantly to HRQL. The results obtained indicated that Hoehn and Yahr stage and medication explained only 17.3% of the variability in HRQL of patients with PD, although both were significant (R² = 0.173, P < 0.05). Other factors increased the explanatory power to adjusted R² = 0.597, with BDI being the most significant predictor of variability in HRQL (adjusted R² = 0.582; P < 0.001), followed by “Satisfaction with the explanation of the condition at diagnosis” and “Current feelings of optimism” (both P < 0.05). These factors, in addition to disease severity and medication, explain 59.7% of the variability in HRQL across the population. In conclusion, depression (as measured by the BDI) in PD, “satisfaction with the explanation of the condition at diagnosis” and “current feelings of optimism” have a significant impact on HRQL. The completion of this initial analysis is the first step towards developing management guidelines that truly influence the HRQL of patients with PD. © 2001 Movement Disorder Society.     

抑郁症的睡眠脑电图与人脑兴奋守恒假说

目的　探索抑郁症状与睡眠脑电图参数的相关性。方法　对 18例抑郁症和 10例正常人评定汉密尔顿抑郁评定量表 (HAMD)和检测睡眠脑电图。结果　HAMD总分与觉醒次数及REM密度分别呈显著正相关 (r分别等于 0 .4 0 8和 0 .4 4 5 ,P均 <0 .0 5 )。结论　抑郁症和正常人的白天中枢抑制与夜间中枢兴奋相关 ,从而支持人脑兴奋守恒假说。     

广泛性焦虑症与抑郁症患者免疫、内分泌及单胺递质的对照研究

目的探讨广泛性焦虑症(GAD)与抑郁症(MD)患者在免疫、内分泌和单胺递质方面的差异。方法 对30例GAD患者(焦虑症组)、38例MD患者(抑郁症组)在治疗(5-羟色胺再摄取抑制剂治疗6~8周)前后分别检测血清白细胞介素2(IL-2)、白细胞介素6(IL-6)、白细胞介素1β(IL-1β)、白细胞介素8(IL-8)、可溶性白细胞介素6受体(SIL-6R)、肿瘤坏死因子α(TNF-α)、皮质醇(CS)、促肾上腺皮质激素(ACTH)、肾上腺素(EPH)和去甲肾上腺素(NE)水平。选择30名年龄和性别与患者组相匹配的健康人为对照组。结果 (1)焦虑症组治疗前IL-8[(122±76)ng／L]、SIL-6R[(2 065±790)ng／L]水平均高于对照组(99±68)ng／L]、[(294±48)ng／L,IL-6水平为(1.6±0.7)ng／L,低于对照组[(5.3±2.7)ng／L],差异均有显著性意义(P<0.05);抑郁症组治疗前IL-2[(7.7±6.7)ng／L]、IL-8[(119±67)ng／L]、SIL-6R[(1308±371)ng／L]水平均高于对照组,差异均有显著性意义(均P<0.05)。经治疗后,焦虑症组IL-6[(4.3±1.2)ng／L]水平较治疗前升高,IL-8[(39±9)ng／L]水平较治疗前降低(P<0.05);抑郁症组IL-2[(2.4±1.2)ng／L]、IL-8[(47±15)ng／L]水平较治疗前降低(P<0.05);均接近于对照组水平(均P>0.05)。(2)焦虑症组治疗前ACIH[(49±28)ng／L]、EPH[(67±45)ng／     

Depressive symptoms during buprenorphine vs. methadone maintenance: findings from a randomised, controlled trial in opioid dependence

Research suggests that buprenorphine may possess antidepressant activity. The Beck Depression Inventory was completed at baseline and 3 months by heroin dependent subjects receiving either buprenorphine or methadone maintenance as part of a larger, pre-existing, double blind trial conducted by NDARC (Australia). Depressive symptoms improved in all subjects, with no difference between methadone and buprenorphine groups, suggesting no differential benefit on depressive symptoms for buprenorphine compared to methadone.     

Predictors of mortality in an aging community-based cohort in Korea

Background: Multiple factors related to specific dimensions of health – general, physical and mental – contribute to mortality in the elderly, but their relative contributions to mortality risk is not well‐known. The objectives of this prospective population‐based cohort study were to measure mortality rates and to identify predictors of mortality in community‐dwelling men and women aged 65 years or older in Korea by examining self assessments of general health, objective medical burden, and measurement of cognition, mood and function. Methods: A total of 1245 elderly (529 men; 716 women) were followed up longitudinally for 3.5 years. Fixed predictor variables observed at baseline examined in Cox proportional hazards models were age, sex, education, chronic medical illnesses, self‐rated health, basic activities of daily living, depression measured by the Geriatric Depression Scale, and cognition measured by the Mini‐Mental State Examination. Results: Mortality rates were similar to those of the 2001 Korean population. Older age, male sex, poor self‐rated health and presence of cerebrovascular disease were significant predictors of mortality. Presence of ischemic heart disease and cerebrovascular disease at baseline predicted mortality in men, but not in women. Depression predicted mortality only when chronic medical illnesses were excluded from the model. Conclusions: Subjective self‐rated health and objective medical burden are strong independent predictors of mortality in this elderly community population, in addition to age and sex.     

Depression and immune function

Clinical studies have demonstrated that measures of cell-mediated immune function are altered in bereaved persons and depressed patients. This review article focuses on our recent observations of changes in T cell subpopulations and natural killer cytotoxicity in women undergoing adverse life events including conjugal bereavement. A reduction in natural cytotoxicity has also been found in depressed patients. The mechanism by which psychologic states might influence immune function is discussed.     

地段医院中抑郁性疾病的诊断和预后

为了解在地段医院中就诊的抑郁性疾病患者的诊断稳定性和预后，进行了一次随访研究。９０例患者，按当年的精神科诊断，３８例为抑郁性疾病（抑郁症１６例和抑郁性神经症２２例），５２例为非抑郁作神经症。８年后，应用和当年同样的评定工具和诊断标准进行再诊断。结果发现抑郁性疾病的诊断稳定性良好，Ｋａｐｐａ检验显示抑郁症的诊断预测效度为０．７３，抑郁性神经症为０．８４。比较抑郁症和抑郁性神经症的临床特征、预后和结局，两者大同小异。