Biomedical subjects

Jack Goldberg

Publications and source records attributed to Jack Goldberg.

41 records · Page 3Linked to original sources

PubMed2002

The Vietnam Era Twin Registry.

The Vietnam Era Twin (VET) Registry is composed of 7369 middle-aged male-male twin pairs both of whom served in the military during the time of the Vietnam conflict (1965-1975). The Registry is a United States Department of Veterans Affairs resource that was originally constructed from military records; the Registry has been in existence for more than 15 years. It is one of the largest national twin registries in the US and currently has subjects living in all 50 states. Initially formed to address questions about the long-term health effects of service in Vietnam the Registry has evolved into a resource for genetic epidemiologic studies of mental and physical health conditions. The management and administration of the VET Registry is described with particular attention given to the processes involved with database maintenance and study coordination. Several waves of mail and telephone surveys have collected a wealth of health-related information on Registry twins. More recent data collection efforts have focused on specific sets of twin pairs and conducted detailed clinical or laboratory testing. New Registry initiatives for the future include the construction of a web site and the development of a DNA repository.

Data Collection↗

PubMed2002

Health and functional status of twins with chronic regional and widespread pain.

OBJECTIVE: To examine the independent effects of chronic regional and widespread pain syndromes on health and functional status after accounting for comorbid chronic fatigue using a co-twin control design. METHODS: We identified 95 twin pairs discordant for pain in which one twin had chronic regional or widespread pain and the other denied chronic pain. Demographic data, functional and psychological status, health behaviors, and symptoms based on the 1994 criteria for chronic fatigue syndrome (CFS) were assessed by questionnaire. Psychiatric diagnoses were based on structured interview. Random effects regression modeling estimated associations between chronic regional and widespread pain and each health measure with and without adjustment for CFS. RESULTS: Significant differences (p </= 0.05) were found within twin pairs discordant for chronic regional and widespread pain, for general health perception, and physical and mental health functioning as measured by summary scores from the Short Form-36. In addition, differences were observed within pain discordant pairs in psychological distress as measured by the General Health Questionnaire as well as the number of psychiatric diagnoses. Adjustment for CFS eliminated the association between chronic pain and mental health, but the association between chronic pain and poor general health, physical functioning, and sleep quality persisted (p </= 0.01). Only the intra-pair difference in physical functioning distinguished twins with regional vs widespread pain (p </= 0.05). CONCLUSION: Both chronic regional and widespread pain exact debilitating effects on perceived general health, physical functioning, and sleep quality independent of CFS. However, the psychological and psychiatric influence of chronic pain appears closely tied to CFS. Research should examine the additive role of CFS-like illnesses in patients with chronic pain, and its influence on treatment and outcome.

Activities of Daily Living↗

PubMedDate not supplied

Is the association between posttraumatic stress disorder symptoms and poor health due to a common familial or genetic factor?

OBJECTIVE: The objective of this study was to identify genetic, familial and environmental contributions to the association between posttraumatic stress disorder (PTSD) symptoms and poor health. METHODS: A community sample of 1852 twin pairs was assessed for symptoms of PTSD [with the Impact of Events Scale (IES)] and self-reported global health status using a single five-level question. An ordinal logistic regression model estimated odds ratio/s (OR) for the association between PTSD and health status. Within-pair analysis assessed confounding by familial and genetic factors and adjusted for the possible confounding influence of age, sex, race, education and self-reported physician diagnosis of depression. RESULTS: The IES was strongly and significantly associated with self-reported health [OR=1.8; 95% confidence interval (95% CI)=1.5-2.2; highest quartile vs. lowest quartile]. This association remained significant in within-pair analysis (OR=1.3; 95% CI=1.0-1.7), but after further adjustment for sociodemographics and depression, it was no longer significant (P(trend)=.17). Separate analysis by zygosity did not show differential effect in monozygotic or dizygotic pairs. CONCLUSION: These findings suggest that the association between PTSD symptoms and poor health is, in part, due to familial confounding and sociodemographic factors. Little evidence of confounding by genetic factors was found. These findings suggest that early prevention efforts would have the greatest potential for improving poor health in PTSD-prone patients, whereas later intervention efforts directed at treating PTSD may have a more limited impact on improving poor health.

Adult↗

PubMedDate not supplied

A twin study of depression symptoms, hypertension, and heart disease in middle-aged men.

OBJECTIVE: Epidemiological and clinical studies have established an association between major depression and cardiovascular disease. We utilized a twin design to test whether there are common genetic and environmental risk factors underlying depression symptoms, hypertension and heart disease. METHODS: Association studies were conducted with 6,903 male-male twins from the Vietnam Era Twin Registry who responded to both a 1990 health questionnaire and a 1992 telephone administration of a structured psychiatric interview. Data from 2,731 complete twin pairs were used to fit genetic models which determined the extent to which lifetime depression symptoms, heart disease and hypertension shared genetic and/or environmental factors. RESULTS: Heart disease was significantly associated with 1-4 symptoms and 5 or more symptoms of depression (odds ratio [OR] = 2.62; 95% confidence interval [CI]: 1.54-4.46 and OR = 4.02; 95% CI: 2.16-7.46). Hypertension was significantly associated with 1 to 4 symptoms and 5 or more symptoms of depression (OR = 1.29; 95% CI: 1.11-1.50 and OR = 1.49; 95% CI: 1.21-1.83). The genetic correlations were significant between depression symptoms and hypertension (r =.19), and between depression symptoms and heart disease (r =.42). Of the total variance in depression, 8% was common to hypertension and heart disease, 7% of the variance in hypertension was common with depression symptoms and heart disease, and 64% of the variance in heart disease was common with depression symptoms and hypertension. CONCLUSIONS: Men who reported cardiovascular disease were significantly more likely to have depression symptoms. The lifetime co-occurrence of these phenotypes is partly explained by common genetic risk factors.

Comorbidity↗

PubMedDate not supplied

Relationship between post-traumatic stress disorder and pain in two American Indian tribes.

OBJECTIVES: To estimate the association of lifetime post-traumatic stress disorder (PTSD) and pain in American Indians, and determine if tribe, sex, cultural and psychosocial factors, or major depression influence the magnitude of this association. DESIGN: A cross-sectional probability sample survey completed between 1997 and 2000. A structured interview was conducted by trained, tribal members to gather information on demographic and cultural features, physical health status, psychiatric disorders, and functional status. SETTING: General community. PARTICIPANTS: A total of 3,084 individuals randomly selected from the tribal rolls of a Southwestern (N = 1,446) and a Northern Plains (N = 1,638) tribal group who were 15-54 years of age and lived on or within 20 miles of their reservations. OUTCOME MEASURES: Bodily pain subscale of the Short Form-36. Linear regression models were fit to examine the association between lifetime PTSD and pain, adjusting for demographic, cultural, psychosocial features, painful medical conditions, and major depression. RESULTS: The prevalence of lifetime PTSD was 16% in the Southwestern and 14% in the Northern Plains; women were nearly twice as likely as men to have lifetime PTSD in both tribes. The final adjusted model demonstrated that mean Short Form-36 bodily pain subscale scores were lower (indicating more pain) among individuals with lifetime PTSD than those without lifetime PTSD. Effect modification by tribe, sex, and depression was not observed. CONCLUSIONS: Lifetime PTSD was strongly associated with bodily pain in this rural sample of American Indians. Clinicians should be aware of, and address, the link between physical pain syndromes and PTSD.

Adolescent↗