Zurich Cohort Study of Young Adults

在过去的一年中，我们继续分析了这项前瞻性队列研究的数据，该研究涵盖了从18岁开始随访的年轻人队列的总观察期为30年。 我们通过头痛亚型检查了合并症的具体模式，以及随着时间的推移它们对受影响个体的各自影响。 结果表明，在头痛亚型中，情绪障碍和焦虑障碍存在实质性共病。只有社交恐怖症和轻躁狂症与偏头痛特别相关，前瞻性分析表明，偏头痛的发作通常先于这些疾病。与仅偏头痛相比，偏头痛合并焦虑或情绪障碍与更高水平的咨询医生、寻求治疗、药物使用、症状年数、痛苦和损害相关。 我们在苏黎世的同事领导的分析评估了精神分裂症的性别差异（Rossler et al，2012）。他们采用了两种不同的措施，亚临床精神病代表典型症状和精神分裂症的核心症状。通过横向和纵向分析，他们发现随着时间的推移，亚临床精神病在发病年龄、精神病学、病程或心理社会结局方面没有显著的性别差异。因此，精神病的性别差异似乎表现在连续体的高端（全面爆发的精神分裂症），而不是在阈下范围内。可能男性和女性对某些症状有不同的阈值，因为他们不同地脆弱或暴露于各种风险因素。使用这一独特数据，将终生躯体抑郁症的性别差异与单纯抑郁症的性别差异进行比较（Silverstein et al，2012）。 公共卫生影响： 这项研究提供了有价值的洞察力之间的关联特定的头痛亚型和精神疾病，以及这些亚型的差异影响受影响的个人使用前瞻性数据从人口为基础的样本。了解这些关联的特异性将有助于我们更准确地检测高危人群，为更有针对性的预防和治疗工作的发展提供信息，并有助于完善研究这些疾病的病因。 未来计划： 在接下来的一年中，我们计划分析以下主题的30年随访数据：1）非恢复性睡眠的纵向过程及其与夜间失眠症状的相关性; 2）睡眠时间短，就寝时间晚，睡眠障碍作为心理健康状况差的预测因素：精神障碍，慢性不明原因疼痛，自杀，吸烟和酗酒; 3）SCL-90抑郁症随时间的变化过程; 4）抑郁亚型和持续性疲劳/神经衰弱。

During the past year, we have continued to analyze the data from this prospective cohort study that covers a total observation period of 30 years for this cohort of young adults who have been followed since the age of 18. We examined the specific patterns of comorbidity by headache subtype, and their respective impact on the affected individual over time. Results show that there was substantial comorbidity with mood and anxiety disorders across headache subtypes. Only social phobia and hypomania were specifically associated with migraine, and prospective analysis shows that the onset of migraine generally precedes that of these disorders. As compared to migraine only, migraine comorbidity with anxiety or mood disorders was associated with greater levels of consulting a physician, treatment seeking, medication use, years symptomatic, distress and impairment. Analyses led by our colleagues in Zurich assessed sex differences in schizophrenia (Rossler et al, 2012). They applied two different measures of sub-clinical psychosis representing schizotypal signs and schizophrenia nuclear symptoms. Using cross-sectional and longitudinal analyses, they found no significant sex differences in sub-clinical psychosis over time with respect to age of onset, symptomatology, course, or psycho-social outcome. Thus it appears that sex differences in psychosis manifest themselves at the high end of the continuum (full-blown schizophrenia) rather than within the sub-threshold range. Possibly males and females have separate thresholds for certain symptoms because they are differently vulnerable or exposed to various risk factors. The gender difference in lifetime somatic depression was compared to that of pure depression using this unique data (Silverstein et al, 2012). Public Health Impact: This study provides valuable insight on the association between specific headache subtypes and psychiatric conditions, as well as the differential impact of these subtypes on the affected individual using prospective data from a population-based sample. Understanding the specificity of these associations will aid in our efforts to more accurately detect at-risk individuals, inform the development of more targeted prevention and treatment efforts and help refine studies examining the etiology of these conditions. Future Plans: During the next year, we plan to analyze the 30 year follow up data on the following topics: 1) longitudinal course of nonrestorative sleep and its correlation with nighttime insomnia symptoms; 2) short sleep duration, late bedtime, and sleep disturbances as predictors of poor mental health: mental disorder, chronic unexplained pain, suicidality, smoking, and alcoholism; 3) the SCL-90 depression course over time; 4) depression subtypes and persistent fatigue/neurasthenia.