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Biomedical subjects

K R Merikangas

Publications and source records attributed to K R Merikangas.

At least 55 records · Page 3Linked to original sources
PubMed1996

Bulimia nervosa and substance dependence: association and family transmission.

Alcohol and drug use disorders are common among women with bulimia nervosa (BN) and their family members. However, it is not known whether there is a familial relationship between BN and substance use disorders. We compared 47 women with BN and 44 non-eating-disordered community control women, and their first-degree relatives (177 and 190, respectively). BN probands were stratified by the presence (43%) or absence (57%) of lifetime alcohol and/or drug dependence. The first-degree relatives of substance-dependent BN probands had significantly higher lifetime rates of alcohol/drug dependence (38%), compared with relatives of nonsubstance-dependent BN probands (10%) or relatives of community controls (18%). These data suggest that BN and substance dependence are transmitted independently in families.

Adult↗
PubMed1996

Comorbidity and boundaries of affective disorders with anxiety disorders and substance misuse: results of an international task force.

Associations between affective disorders, anxiety disorders, and substance use disorders were examined in epidemiological studies conducted in Germany, Switzerland, Puerto Rico, and the mainland US. There was a remarkable degree of similarity across studies in the magnitude and type of specific disorders associated with the affective disorders. Comorbidity with affective disorders was greater for the anxiety disorders than for substance misuse. Panic disorder was the subtype of anxiety that was most highly comorbid with depression. Social phobia was the specific phobic type with the strongest association with the affective disorders. The magnitude of associations between substance misuse and affective disorders generally was quite low and less consistent across sites. No major differences were found in the patterns of comorbidity by gender or age group, affective subtype or prevalence period. The onset of anxiety disorders generally preceded that of depression, whereas alcohol misuse was equally likely to pre-or post-date the onset of affective disorders. Finally, comorbidity was associated with an elevation in treatment rates across all sites, confirming Berkson's paradox on an international level.

Adolescent↗
PubMed1995

Tyramine conjugation deficit in migraine, tension-type headache, and depression.

This study was designed to investigate tyramine sulfate conjugation in patients with migraine or tension-type headache, as defined by the newly introduced International Headache Society (IHS) criteria and to examine whether this relationship is mediated by major depression. A total of 62 subjects completed the study: 38 with migraine (22 with aura and 16 without aura), 12 with tension-type headache, and 12 controls. Patients with migraine had significantly lower urinary tyramine sulfate excretion following oral tyramine challenge than normal control. Tension-type headache was also associated with low tyramine conjugation, but only when comorbid with depression. Although mean tyramine sulfate output was lower among subjects with major depression within each of the subtypes of headache, no significant main effect emerged for depression or major subtype thereof. The lower tyramine sulfate excretion values among patients with both migraine and depression compared to those of migraine alone or depression alone in our data and those of others suggests that comorbid migraine with depression may represent a more severe form of migraine than migraine alone. The findings underscore the importance of comorbidity in clinical and epidemiological studies of migraine.

Adult↗
PubMed1995

Combination monoamine oxidase inhibitor and beta-blocker treatment of migraine, with anxiety and depression.

This paper presents the results of a study comparing the effectiveness of a beta-adrenergic blocking agent, atenolol, a monoamine oxidase inhibitor (MAO-I), phenelzine, and the combination in treatment of 61 adults with migraine headache. The goals of the study are (1) to investigate the safety of concomitant treatment of migraine with beta-blockers and phenelzine, (2) to assess whether orthostatic hypertension and other side effects would be relieved, and (3) to compare the results of this open trial of phenelzine to those of a previous study using similar methods. Phenelzine was associated with a large decrease in the frequency and severity of migraine attacks. Anxiety and depression were also reduced by phenelzine both alone, and in combination with a beta-blocker. The results show that the combination of MAO-I's and beta-blockers can be administered safely, and can lead to the reduction in the side effects with either drug alone.

Adrenergic beta-Antagonists↗
PubMed1995

Comorbidity and social phobia: evidence from clinical, epidemiologic, and genetic studies.

This paper reviews evidence from clinical, epidemiologic, and family studies regarding the association between social phobia and other syndromes. Social phobia is strongly associated with other anxiety disorders, substance abuse, and affective disorders in both clinical and community samples. An average of 80% of social phobics identified in community samples meet diagnostic criteria for another lifetime condition. Social phobia is most strongly associated with other subtypes of anxiety disorders, with an average of 50% of social phobics in the community reporting a concomitant anxiety disorder including another phobic disorder, generalized anxiety, or panic disorder. Approximately 20% of subjects in the community meet lifetime criteria for a major depressive disorder. The onset of social phobia generally precedes that of all other disorders, with the exception of simple phobia. Both clinical severity and treated prevalence are consistently greater among social phobics with comorbid disorders. The results of family and twin studies reveal that shared etiologic factors explain a substantial proportion of the comorbidity between social phobia and depression, whereas the association between social phobia and alcoholism derives from a nonfamilial causal relationship between the two conditions. Clinical and phenomenologic implications of these findings are discussed.

Adult↗
PubMed1995

Association between psychopathology and headache syndromes.

During the past year, several important papers have confirmed the association between psychological factors and headache. Recent studies are beginning to identify the specificity of the general association of headache subtypes with subtypes of psychiatric disorders and psychological traits. Studies of this topic have increasingly moved from the clinical arena to the community at large. Finally, much of the research on this topic is now driven by the goal of understanding the possible mechanisms for the concurrence of psychopathology and headache.

Headache↗
PubMed1994

Feasibility of half-sibling designs for detecting a genetic component to a disease.

In genetic epidemiology, adoption and twin study designs are the most commonly used designs to identify genetic and common environmental components underlying familial aggregation. Other fixed family set designs such as a half-sibling design can also be applied to test the same hypothesis. The feasibility of half-sibling designs for detecting a genetic (single-locus or multifactorial) source of familial aggregation of a disease is studied and is compared to both adoption and twin study designs. Results are presented for two types of design when the sampling units are relative pairs reared apart (I) or reared together (II). Although they generally require more observations to achieve the same power, designs involving half-siblings may be more feasible in situations where there is greater availability of these relatives.

Adoption↗
PubMed1994

The Zurich Study: XXIII. Epidemiology of headache syndromes in the Zurich cohort study of young adults.

This study examines the 1 year prevalence rates of headache syndromes in an epidemiologic cohort study of young adults ages 29-30 in Zurich, Switzerland. The 1 year prevalence rates of headache subtypes were 3.3% for migraine with aura and 21.3% of migraine without aura as defined by the International Headache Society (IHS) criteria. The demographic distribution, clinical features, sequelae, and treatment patterns of subjects with specific headache subtypes are described. The rates of migraine are compared to those of other community samples that have employed the IHS criteria for headache subtypes. Subjects with migraine reported pervasive impairment in nearly every life role including occupation, leisure, and social relationships. Despite the substantial degree of impairment in occupational and social functioning that was associated with migraine, an extremely low proportion of subjects had received professional treatment for headache. These results suggest that a concerted effort should be directed towards education regarding the classification of headache and the availability of efficacious treatment for migraine.

Absenteeism↗
PubMed1994

Comorbidity and co-transmission of alcoholism, anxiety and depression.

This paper applies data from a family study of depression to assess patterns of comorbidity and co-transmission of alcoholism, anxiety disorder, and major depression. We found that all three disorders were strongly transmissible; however, alcoholism demonstrated the greatest degree of familial aggregation. The pairwise associations among depression, anxiety and alcoholism indicated that the traits are co-transmitted in families, especially depression and anxiety. Individual associations between traits (or comorbidity) were entirely explained by transmitted (perhaps genetic) agents, because the correlations between traits due to random environment were not significant. These findings have important implications for treatment, psychiatric nosology, and aetiological investigations of these conditions.

Alcoholism↗
PubMed1994

Psychopathology and headache syndromes in the community.

The present study investigated the association between psychopathology and headache in a prospective longitudinal epidemiologic study of a cohort of 19- and 20-year-olds in Zurich, Switzerland. Prevalence rates of psychopathology by headache subtype were examined both cross-sectionally and longitudinally. Psychiatric disorders were evaluated using a direct interview administered by experienced clinicians. Personality was assessed using the Freiburg Personality Inventory and the Symptom Checklist 90. In general, subjects with migraine had more affective and anxiety disorders and exhibited elevated rates of neuroticism and somatization compared to nonmigraine subjects. When examined by headache subtype, migraineurs with aura exhibited greater rates of psychopathology and more personality abnormalities than any of the other headache subtypes or controls. In contrast to clinical wisdom, subjects with tension-type headache did not differ from controls in rates of psychopathology or on any of the personality or symptom factors.

Adolescent↗
PubMed1994

Heterogeneity of depression. Classification of depressive subtypes by longitudinal course.

This paper describes the application of prospective longitudinal data from an epidemiological sample of young adults to define subtypes of major depression. Depression was classified on a spectrum from subthreshold manifestation of symptoms and duration at one end, to cases with recurrent episodes of depression meeting duration criteria for major depressive episodes at the other. There was a direct relationship between the severity of depression over the longitudinal course and both duration and recurrence of depressive episodes. The subgroup of depression with recurrence of both brief and longer duration episodes could be discriminated on most of the indicators of validity including symptoms, impairment, family history, and suicide attempts. In light of the young age of this cohort, the strong history of suicide attempts and other complications of depression among the subjects with recurrent depression was striking. These findings underscore the importance of employing course as a classification criterion of depression, and the inclusion of subthreshold episodes of depression in the characterization of course.

Adult↗
PubMed1994

Diagnostic and treatment implications of psychiatric comorbidity with migraine.

Although an association between migraine and psychiatric disorders has been recognized for over 100 years, this association has been investigated systematically only recently in clinical and community samples. Mechanisms for comorbidity between migraine and psychopathology have also been examined in recent family, pharmacologic treatment, and challenge studies. We review the evidence of an association between migraine and mood, anxiety, and eating disorders and discuss the implications of this association in the diagnosis and pharmacologic treatment of patients with psychiatric disorders and comorbid migraine.

Adult↗
PubMed1994

Diagnostic criteria for migraine. A validity study.

To identify the optimum combination of symptoms for the International Headache Society (IHS) diagnostic criteria for migraine, the criteria were systematically assessed for validity using an epidemiologic sample from Zurich, Switzerland. The indicators of validity used included subjective distress, occupational impairment, family history of migraine, and treatment. The symptoms that provided the best discrimination between migraine and other headache subtypes were photophobia, phonophobia, and osmophobia, in combination with gastrointestinal symptoms. The evaluation of the validity of the IHS classification of migraine is impeded by several factors, including: the presence of multiple headache syndromes within an individual, the tendency for headache characteristics to change over a lifetime, the effects of headache treatments in obscuring syndromes, and the lack of generalizability of findings based on clinical samples. The methods used in this study serve as a model for applying statistical techniques for evaluating the validity of diagnostic criteria. The findings, however, should be replicated in additional studies to determine their generalizability to specific demographic and clinical subgroups.

Adult↗
PubMed1993

Genetic epidemiologic studies of affective disorders in childhood and adolescence.

The application of the methods of genetic epidemiology appears to be one of the most promising avenues to unravel the complex mechanisms through which genes may exert their influence. The approaches of genetic epidemiology are particularly important for those diseases which are characterized by moderate degrees of heritability and lack of direct correspondence between the underlying vulnerability factors and the ultimate expression of the disease, as is the case for affective disorders. The application of the methods of genetic epidemiology to children of affected parents may also elucidate environmental risk factors and early signs of the disorder. Perhaps the most important implication of the identification of genetic markers for affective disorders is the opportunity for prevention of the disorders. Early identification of youngsters who do manifest early signs of the disorders would facilitate secondary and tertiary prevention of the consequences of those conditions.

Adolescent↗
PubMed1993

Linkage studies of psychiatric disorders.

Linkage analysis has been successful in identifying the genetic basis of numerous Mendelian diseases. These successes were due in part to the rapid developments in molecular biology, which have yielded a plethora of informative genetic markers. Although there is strong evidence that the manifestation of schizophrenia and bipolar affective disorders is controlled by genes, no evidence for linkage has been established. For psychiatric disorders, the most important limiting factor is likely to be the lack of single loci with very large effects that occur with any relevant frequency. The difficulties of linkage studies in psychiatric disorders are discussed with reference to non-psychiatric genetic diseases for which linkage to genetic markers has been successful. Recommendations for collecting information to clarify the patterns of transmission of the psychiatric disorders are described.

Genetic Linkage↗
PubMed1993

The Zurich Study. XIX. Patterns of menstrual disturbances in the community: results of the Zurich Cohort Study.

This paper reports on the prevalence of emotional and somatic symptoms of the pre- and peri-menstrual phases of the female reproductive cycle among women who participated in a 10-year prospective epidemiologic cohort study of young adults in Zurich, Switzerland. The association between menstrual syndrome and sociodemographic features, personal habits, and psychopathology is investigated. The findings confirm those of previous studies, which have shown that symptoms of menstrual syndrome are quite common in non-clinical samples in the community, and increase with age. Women with menstrual problems could be distinguished from other women in a number of domains, including demographic characteristics such as nulliparity, higher educational level, distressing life events, lack of oral contraceptive use, psychiatric disorders, and personality traits. The combined evidence for a strong association between menstrual syndrome and anxiety, both in the subjects and their relatives, suggests that menstrual problems may represent a manifestation of underlying anxiety disorders rather than strictly affective disorders as traditionally believed.

Adult↗