Migraine, Depression, Chronic Pain , FM, IBS, & Childhood Abuse related - various

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Source: BioMed Central September 28, 2006 More on:

Colitis, Headaches, Pain Control, Headache Research, Fibromyalgia, Depression

High Risk Of Migraine, Depression And Chronic Pain For IBS Sufferers, Large

Study Shows Science Daily — Patients with irritable bowel syndrome are more

likely to suffer from conditions such as migraine or depression than other

individuals.

 

A study published today in BMC Gastroenterology shows that patients with

irritable bowel syndrome (IBS) are 60% more likely to suffer from depression,

migraine or chronic pain than individuals who do not suffer from IBS. A link

between IBS and depression, migraine or chronic pain had been suggested by case

reports but had never been confirmed by such a large, controlled study.

 

In the largest study of its kind, J. Alexander Cole and colleagues from Boston

University, Boston, USA, looked at the occurrence of depression, migraine and

fibromyalgia (chronic, widespread and unexplained pain) in 97,593 individuals

who had consulted a doctor because of IBS, at least once between 1996 and 2002.

A group of 27,402 people who did not suffer from IBS acted as the comparison

group. Cole et al. took into account the many variables and confounding factors

that could have skewed their data in their analysis.

 

Cole et al.'s study shows that individuals who reported symptoms of IBS were

40% more likely to suffer from depression and 60% more likely to suffer from

migraine. The occurrence of fibromyalgia was 1.8 times greater in individuals

with IBS than in control individuals.

 

Article: Migraine, Fibromyalgia, and Depression Among People With IBS: A

Prevalence Study J. Alexander Cole, Kenneth J Rothman, Howard J Cabral, Yuqing

Zhang and Francis A Farraye . BMC Gastroenterology 2006, in press

 

 

Note: This story has been adapted from material provided by BioMed Central.

 

http://www.sciencedaily.com/releases/2006/09/060928095529.htm

 

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Am J Public Health. 2003 July; 93(7): 1065–1067.

 

 

American Journal of Public Health 2003

 

Association Between Childhood Physical Abuse and Gastrointestinal Disorders

and Migraine in Adulthood

 

Renee D. Goodwin, PhD, Christina W. Hoven, DrPH, Robert Murison, PhD, and

Mathew Hotopf, PhD

 

Renee D. Goodwin and Christina W. Hoven are with the Department of

Epidemiology, Columbia University Mailman School of Public Health, and the New

York State Psychiatric Institute, New York, NY. Robert Murison is with the

Department of Biological and Medical Psychology, Division of Physiological

Psychology, University of Bergen, Norway. Mathew Hotopf is with the Department

of Psychological Medicine, Guy’s King’s and St Thomas’ School of Medicine and

Institute of Psychiatry, London, England.

 

 

Requests for reprints should be sent to Renee Goodwin, PhD, Department of

Epidemiology, 1051 Riverside Dr, Unit 43, New York, NY 10032 (e-mail:

rdg66 ' + reverseAndReplaceString('ude.aibmuloc/ta/66gdr',

'/at/','@') + '')}catch(e){} //--> ).

 

 

Accepted September 2, 2002.

 

Previous studies suggest that childhood physical abuse is a strong predictor

of mental disorders during adulthood.1–5 An association between childhood abuse

and increased use of medical services has also been documented,6 suggesting that

childhood physical abuse is associated with poor health. In contrast, relatively

little information is available on the link between childhood physical abuse and

physical illness in adulthood.

 

We examined the association between childhood physical abuse and the odds of

gastrointestinal disorders and migraine headache among adults in the community.

We hypothesized that childhood physical abuse would be associated with increased

odds of gastrointestinal disorders and migraine headache during adulthood, and

that this association would be independent of comorbid mental disorders.

 

Methods

 

Sample

 

The Midlife Development in the United States Survey (MIDUS) is a nationally

representative survey of 3032 persons aged 25 through 74 years in the

noninstitutionalized civilian population of the 48 coterminous United States. It

was carried out between January 1995 and January 1996, with an overall response

rate of 60.8%. The data were weighted to adjust for differential probabilities

of selection and nonresponse. Details on the design, field procedures, and

sampling weights are available elsewhere.7–9

 

 

Diagnostic Assessment

 

MIDUS diagnoses were based on the Composite International Diagnostic Interview

Short Form (CIDI-SF) scales,10 a series of diagnostic-specific scales that were

developed from item-level analyses of a modified version of the World Health

Organization’s Composite International Diagnostic Interview (CIDI-WHO).11 The

CIDI-SF scales were designed to reproduce the full CIDI as exactly as possible

with only a small subset of the original questions. CIDI-SF diagnoses at 12

months included in the MIDUS are major depression, panic attacks, generalized

anxiety disorder, and alcohol and drug abuse disorders. The CIDI-WHO was

designed for use by trained lay interviewers. WHO field trials12 and National

Comorbidity Survey clinical reappraisal studies13–15 documented excellent

reliability and adequate validity for all of these diagnoses.

 

To assess physical health problems, interviewers presented each participant

with a list of physical disorders and asked whether the participant had

experienced, or been diagnosed by a physician with, any of the conditions listed

within the past year. The list included migraine headaches, ulcer, and recurring

stomach problems. Only participants for whom information was available on all

variables (n = 2407) were included in the present analyses.

 

 

Self-Reported Childhood Physical Abuse

 

A history of self-reported childhood abuse was assessed by responses to

questions derived from the Conflict Tactics Scale.16 Subjects were asked whether

their mother or father often, sometimes, or rarely “kicked, bit, or hit [them]

with a fist; hit or tried to hit [them] with something; beat [them] up; choked

[them]; burned [them] or scalded [them].” Affirmative responses to any of the

items were grouped as indicating “any” physical abuse; respondents who answered

“often” were included in analyses as having experienced “frequent” abuse.

 

 

Analytic strategy

 

First, independence-based F tests were used to evaluate differences in

demographic characteristics, mental, and physical disorders between individuals

with no history of physical abuse (reference group), those with any abuse, and

those with frequent abuse. Binary indicator variables were created for use in

multiple logistic regression analyses comparing any abuse with no abuse and

frequent abuse with no abuse. Multiple logistic regression analyses were then

used to investigate the odds of each physical illness’ being associated with

each level of abuse. All analyses were then adjusted for differences in

sociodemographic characteristics and comorbid mental disorders.

 

Results

 

Prevalence and Sociodemographic Characteristics

 

Childhood physical abuse was reported by 381 (15.8%) of the 3032 respondents,

with 74 (3.1%) reporting frequent abuse. Individuals who reported experiencing

childhood abuse were significantly younger, more likely to be of minority racial

status, and more likely to have current mental disorders than those who did not

report abuse (Table 1 ). Frequent abuse was associated with decreased odds of

being married. A higher percentage of men than women reported any abuse, and a

higher percentage of women than men reported frequent abuse.

TABLE 1— Univariate Association Between Self-Reported Physical

Abuse in Childhood, Sociodemographic Characteristics, and Mental and Physical

Disorders Among Adults

 

 

 

 

Childhood Abuse and Physical Illness Among Adults in the Community

Any childhood abuse was associated with a significantly increased odds ratio

(OR) for recurring stomach problems (OR = 1.7; 95% confidence interval [CI] =

1.2, 2.4), and frequent childhood abuse was associated with a significantly

increased likelihood of recurring stomach problems (OR = 3.5; 95% CI = 1.9,

6.4), migraine (OR = 2.7; 95% CI = 1.2, 5.8), and ulcer (OR = 4.2; 95% CI = 1.8,

10.0), which remained statistically significant after adjusting for

sociodemographic characteristics and mental disorders (Table 2 ).

TABLE 2— Association Between Self-Reported Physical Abuse in

Childhood and Odds of Recurring Stomach Problems

 

 

 

Discussion

 

Limitations of this study should be noted. First, since the sample was a

cross-sectional population of adults, recall about events that occurred during

childhood may have suffered from recall bias. Previous evidence suggests that

recall of childhood abuse may have questionable reliability.17–18 Second,

factors not controlled for in this study, such as socioeconomic status during

childhood, may independently influence both odds of exposure to childhood

physical abuse and physical illness, thereby confounding these results.19 Third,

data on physical illnesses were obtained only by self-report; however, previous

data have shown adequate validity of self-reported information on chronic

medical conditions.20

 

These data provide initial evidence of an association between childhood

physical abuse and increased odds of gastrointestinal problems and migraine

headaches among adults in the general population. The mechanism of the observed

association is not known. Experiences of childhood physical abuse may lead to an

increased tendency to somatize emotional distress and to report physical

illnesses.21 It is also possible that the experience of childhood abuse

increases recognition of underlying health problems.22 In other words, physical

abuse may increase awareness or sensitize people to pains or physical discomfort

that others might ignore. Alternatively, childhood abuse may lead to changes in

biological functioning that influence the development of physical illness.23 One

model that could be offered as evidence for this pathway is the increased

gastric scarring among mice exposed to stressful situations.24

 

It is also possible that physical abuse is an indicator of wider psychosocial

adversity in childhood, which might include poverty, parental stress, and poor

parenting.25 These broad risk factors may be more important than abuse per se as

determinants of later physical or mental disorders. The fact that a variable for

neglect, which could be included in poor caretaking and abuse, was not included

in the Conflict Tactics Scale may result in uncontrolled confounding and is

another limitation of this study.

 

Consistent with previous evidence of an association between childhood physical

abuse and poorer mental health in adulthood,1–5 these preliminary data suggest

that childhood physical abuse also increases the likelihood of physical health

problems later in life. Future studies investigating these associations should

use prospective, longitudinal epidemiological samples of youths and adults and

should be able to adjust for a multitude of antecedent common risk factors. Such

studies may help improve our understanding of these links.

 

Notes

 

Contributors

R. D. Goodwin was the principal author and conceptualized the research with

significant input from C. W. Hoven, R. Murison, and M. Hotopf. All authors

participated in the review and revisions of the brief.

 

 

Human Participant Protection

This study was approved by the institutional review board of The University of

Michigan.

 

 

Peer Reviewed

 

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http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1447904

 

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