Zurich Cohort Study of Young Adults

在过去的一年里，我们继续分析这项前瞻性队列研究的数据，该研究涵盖了这群从18岁开始接受跟踪的年轻人的总观察期为30年。 我们研究了头痛亚型共病的具体模式，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，头痛各亚型与情绪和焦虑障碍有很大程度的共病。只有社交恐惧症和轻躁狂症与偏头痛有特殊关联，前瞻性分析表明，偏头痛的发病通常先于这些疾病。与单纯偏头痛相比，偏头痛与焦虑或情绪障碍的共病与咨询医生、寻求治疗、药物使用、出现症状的年限、痛苦和损害程度更高相关。 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等人，2012年)。他们采用了两种不同的亚临床精神病测量方法，分别代表分裂型体征和精神分裂症核心症状。使用横断面和纵向分析，他们发现随着时间的推移，亚临床精神病在发病年龄、症状、病程或心理社会结局方面没有显著的性别差异。因此，精神病中的性别差异似乎表现在连续体的高端(全面精神分裂症)，而不是在低于阈值的范围内。可能男性和女性对某些症状有不同的阈值，因为他们的脆弱性或暴露在各种风险因素下的情况不同。使用这一独特的数据，比较了终生躯体抑郁症与单纯抑郁症的性别差异(Silverstein等人，2012年)。 公共卫生影响： 这项研究利用基于人群的样本中的前瞻性数据，对特定头痛亚型和精神疾病之间的联系以及这些亚型对受影响个体的不同影响提供了有价值的见解。了解这些关联的特殊性将有助于我们努力更准确地发现高危个体，为制定更有针对性的预防和治疗努力提供信息，并有助于完善检查这些疾病的病因的研究。 未来计划： 在接下来的一年里，我们计划分析关于以下主题的30年随访数据：1)非恢复性睡眠的纵向病程及其与夜间失眠症状的相关性；2)短睡眠时间、晚睡时间和睡眠障碍作为精神健康不良的预测因子：精神障碍、慢性原因不明的疼痛、自杀、吸烟和酗酒；3)随着时间的推移SCL-90抑郁病程；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.