Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

doi:10.1016/S0140-6736(17)32154-2

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Journal Article•DOI•

Headache, depression and anxiety: associations in the Eurolight project

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Christian Lampl, Hallie Thomas¹, Cristina Tassorelli², Zaza Katsarava, Jose Miguel Lainez³, Michel Lanteri-Minet⁴, Daiva Rastenyte⁵, Elena Ruiz de la Torre, Lars Jacob Stovner¹, Colette Andrée⁶, Timothy J. Steiner¹, Timothy J. Steiner⁷ - Show less +8 more•Institutions (7)

Norwegian University of Science and Technology¹, University of Pavia², University of Valencia³, French Institute of Health and Medical Research⁴, Lithuanian University of Health Sciences⁵, University of Basel⁶, Imperial College London⁷

01 Jun 2016-Journal of Headache and Pain

TL;DR: It is confirmed that depression and especially anxiety are comorbid more than by chance with migraine, and showed the same is true, but more strongly, with MOH, and patients and, more certainly, MOH patients should be screened with HADS in pursuit of best outcomes.

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Abstract: Headache disorders and psychiatric disorders are both common, while evidence, mostly pertaining to migraine, suggests they are comorbid more often than might be expected by chance. There are good reasons for establishing whether they are: symptoms of comorbid illnesses may summate synergistically; comorbidities hinder management, negatively influencing outcomes; high-level comorbidity indicates that, where one disease occurs, the other should be looked for. The Eurolight project gathered population-based data on these disorders from 6624 participants. Eurolight was a cross-sectional survey sampling from the adult populations (18–65 years) of 10 EU countries. We used data from six. The questionnaire included headache-diagnostic questions based on ICHD-II, the Headache-Attributed Lost Time (HALT) questionnaire, and HADS for depression and anxiety. We estimated odds ratios (ORs) to show associations between migraine, tension-type headache (TTH) or probable medication-overuse headache (pMOH) and depression or anxiety. pMOH was most strongly associated with both psychiatric disorders: for depression, ORs (vs no headache) were 5.5 [2.2–13.5] (p < 0.0001) in males, 5.5 [2.9–10.5] (p < 0.0001) in females; for anxiety, ORs were 10.4 [4.9–21.8] (p < 0.0001) and 7.1 [4.5–11.2] (p < 0.0001). Migraine was also associated with both: for depression, ORs were 2.1 [1.3–3.4] (p = 0.002) and 1.8 [1.1–3.1] (p = 0.030); for anxiety 4.2 [2.8–6.3] (p < 0.0001) and 2.4 [1.7–3.4] (p < 0.0001). TTH showed associations only with anxiety: ORs 2.5 [1.7–3.7] (p < 0.0001) for males, 1.5 [1.1–2.1] (p = 0.021) for females. Participants with migraine carried 19.1 % probability of comorbid anxiety, 6.9 % of depression and 5.1 % of both, higher than the representative general-population sample (14.3, 5.6 and 3.8 %). Probabilities in those with MOH were 38.8, 16.9 and 14.4 %; in TTH, they did not exceed those of the whole sample. Comorbid psychiatric disorder did not add to headache-attributed productive time losses, but weak associations existed (R 2 = 0.020–0.082) for all headache types between lost productive time and probabilities of depression and, less so, anxiety. In this large study we confirmed that depression and especially anxiety are comorbid more than by chance with migraine, and showed the same is true, but more strongly, with MOH. Arguably, migraine patients and, more certainly, MOH patients should be screened with HADS in pursuit of best outcomes.

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142 citations

Journal Article•DOI•

Reducing major risk factors for chronic kidney disease

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Valerie A. Luyckx¹, Katherine R. Tuttle², Guillermo Garcia-Garcia³, Mohammed Benghanem Gharbi⁴, Hiddo J.L. Heerspink⁵, David W. Johnson⁶, David W. Johnson⁷, Zhihong Liu⁸, Ziad A. Massy⁹, Orson W. Moe¹⁰, Robert G. Nelson¹¹, Laura Sola, David C. Wheeler¹², Sarah L. White¹³ - Show less +10 more•Institutions (13)

University of Zurich¹, University of Washington², University of Guadalajara³, University of Hassan II Casablanca⁴, University Medical Center Groningen⁵, Translational Research Institute⁶, Princess Alexandra Hospital⁷, Nanjing University⁸, Versailles Saint-Quentin-en-Yvelines University⁹, University of Texas Southwestern Medical Center¹⁰, National Institutes of Health¹¹, University College London¹², University of Sydney¹³

01 Oct 2017-Kidney International

TL;DR: A comprehensive, informed approach to prevention that takes into account all of these factors is required to successfully tackle the global CKD epidemic.

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142 citations

Journal Article•DOI•

Telehealth for musculoskeletal physiotherapy

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Michelle A. Cottrell¹, Trevor Russell²•Institutions (2)

Royal Brisbane and Women's Hospital¹, University of Queensland²

01 Aug 2020-Musculoskeletal science and practice

TL;DR: This masterclass offers a structured approach to the implementation of a musculoskeletal physiotherapy telehealth service, and highlights practical considerations required by both clinicians and healthcare organisations throughout all stages of the implementation process.

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Abstract: Introduction Musculoskeletal conditions are a leading cause of global morbidity. Access to traditional in-person healthcare can be difficult for some under usual conditions and has become a ubiquitous barrier throughout the COVID-19 pandemic. Telehealth, defined as the ‘delivery of healthcare at a distance using information and communication technology’ is a solution to many access barriers and has been rapidly adopted by many healthcare professions throughout the crisis. While significant advancements in technology has made the widespread adoption of telehealth feasible, there are many factors to be considered when implementing a telehealth service. Purpose The aims of this masterclass are to (i) introduce telehealth and outline the current research within the context of musculoskeletal physiotherapy; (ii) provide insights into some of the broader challenges in the wide-scale adoption of telehealth; and (iii) to describe a systematic approach to implementing telehealth into existing healthcare settings, along with some practical considerations. Implications Telehealth is a broad concept and should be implemented to meet the specific needs of a healthcare service. This masterclass offers a structured approach to the implementation of a musculoskeletal physiotherapy telehealth service, and highlights practical considerations required by both clinicians and healthcare organisations throughout all stages of the implementation process.

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141 citations

Journal Article•DOI•

Reproducible Genetic Risk Loci for Anxiety: Results From ∼200,000 Participants in the Million Veteran Program.

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Daniel F. Levey¹, Joel Gelernter, Renato Polimanti¹, Hang Zhou², Zhongshan Cheng³, Mihaela Aslan⁴, Rachel Quaden⁵, John Concato⁶, Krishnan Radhakrishnan¹, Julien Bryois¹, Patrick F. Sullivan¹, Murray B. Stein¹ - Show less +8 more•Institutions (6)

Yale University¹, VA Boston Healthcare System², University of Kentucky³, Karolinska Institutet⁴, University of North Carolina at Chapel Hill⁵, University of California, San Diego⁶

07 Jan 2020-American Journal of Psychiatry

TL;DR: The authors identified novel genome-wide significant associations near genes involved with global regulation of gene expression (SATB1) and the estrogen receptor alpha (ESR1), which may have implications for genetic vulnerability across several psychiatric disorders.

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Abstract: Objective:Anxiety disorders are common and often disabling. The goal of this study was to examine the genetic architecture of anxiety disorders and anxiety symptoms, which are also frequently comor...

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141 citations

Journal Article•DOI•

Environmental toxicology: Sensitive periods of development and neurodevelopmental disorders.

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Djai B. Heyer¹, Rhiannon M. Meredith¹•Institutions (1)

VU University Amsterdam¹

01 Jan 2017-Neurotoxicology

TL;DR: It is concluded that preventing early exposure to environmental toxicants, by increasing public awareness and improving government and industry guidelines, may ultimately lead to a significant reduction in the incidence of NDDs.

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Abstract: Development of the mammalian central nervous system is a complex process whose disruption may have severe and long-lasting consequences upon brain structure and function, potentially resulting in a neurodevelopmental disorder (NDD). Many NDDs are known to be genetic in origin, with symptom onset and their underlying mechanisms now known to be regulated during time-dependent windows or 'critical periods' during normal brain development. However, it is increasingly evident that similar disturbances to the developing nervous system may be caused by exposure to non-genetic, environmental factors. Strikingly, at least 200 industrially applied or produced chemicals have been associated with neurotoxicity in humans and exposure to these modifying compounds, through consumer products or environmental pollution, therefore poses serious threats to public health. Through a combination of human epidemiological and animal experimental studies, we identified developmental periods for increased vulnerability to environmentally-modifying compounds and determined whether and how exposure during specific sensitive time-windows could increase the risk for the NDDs of autism, ADHD or schizophrenia in the developing organism. We report that many environmental toxicants have distinct sensitive time-windows during which exposure may disrupt critical developmental events, thereby increasing the risk of developing NDDs. The majority of these time-windows occur prenatally rather than postnatally. We propose four underlying mechanisms that mediate pathogenesis, namely oxidative stress, immune system dysregulation, altered neurotransmission and thyroid hormone disruption. Given the complexity of underlying mechanisms and their prenatal inception, treatment options are currently limited. Thus, we conclude that preventing early exposure to environmental toxicants, by increasing public awareness and improving government and industry guidelines, may ultimately lead to a significant reduction in the incidence of NDDs.

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140 citations