scholarly journals Transient Visual Disturbance is Associated with Disability and Suicidal Risk in Patients with Migraine Without Aura

2021 ◽  
Author(s):  
Yu Chien Tsao ◽  
Yen-Feng Wang ◽  
Jong-Ling Fuh ◽  
Wei-Ta Chen ◽  
Kuan-Lin Lai ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Migraine Without Aura ◽  
Rating Scale ◽  
Depression Scale ◽  
Visual Disturbance ◽  
Visual Aura ◽  
Visual Phenomenon ◽  
Headache Clinic ◽  
Headache Impact ◽  
Visual Disturbances

Abstract Background: Patients with migraine without aura frequently report transient visual disturbances (TVD) other than typical visual aura, but the clinical correlates are not determined. Method: Patients with migraine without aura (MO) that attended the headache clinic were enrolled. Structured questionnaires were self-administered by the patients including headache profiles, comorbidities, lifetime suicidal ideation and attempts, six-item Headache Impact Test, Migraine Photophobia Score, Migraine Disability Assessment, Hospital Anxiety and Depression Scale, Beck Depression Inventory, and Pittsburgh Sleep Quality Index. A semi-structured visual phenomenon questionnaire was also used to assess the characteristics of TVDs. TVD is defined as any zigzag flashes, flickering dots/lines, or blurred/foggy vision associated with headache and with a Visual Aura Rating Scale < 4. Headache specialists interviewed with the participants for the ascertainment of diagnosis and verified of the questionnaires.Result: MO patients (n = 7,200, female/male = 3.56, mean age: 40.1 ± 13.4 years) were divided into 2 subgroups based on the presence (n=2,488) or absence of TVDs (n= 4,712). Patients with TVD had higher headache-related disability, more psychiatric comorbidities and were more likely to be photophobic. Suicidal ideation and attempts were more common in patients with TVD than in those without (ideation: 31.9% vs. 18.1%, OR = 1.92 [95% CI: 1.71−2.15], p < 0.001; attempt: 8.2% vs. 3.5%, OR = 2.23 [95% CI: 1.80−2.75], p < 0.001). The associations remained after adjustment of confounding factors.Conclusion: Presence of transient visual disturbance may suggest a higher migraine-related disability, higher level of photophobia and higher suicidal ideation/attempts in MO patients.

Prevalence and risk factors of restless legs syndrome in patients of migraine without aura

2019 ◽  
Vol 6 (6) ◽  
pp. 1706
Author(s):  
Karthik Nagaraj ◽  
Ramesh Patil
Keyword(s):  
Sleep Quality ◽  
Restless Legs Syndrome ◽  
Migraine Without Aura ◽  
Rating Scale ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Restless Legs ◽  
Midas Questionnaire

Background: An association between migraine and Restless Legs Syndrome (RLS) has been proposed due to shared dopaminergic dysfunction. Both have substantial effects on the quality of life. Identifying co morbidities of migraine helps in optimizing patient management. Objectives To study the prevalence of RLS in patients of migraine without aura, and associated co morbidities of RLS.Methods: This was a hospital based prospective observational study. All patients diagnosed as Migraine without aura as per ICHD-3 criteria completed the questions regarding migraine headache, Migraine Disability Assessment (MIDAS) questionnaire, Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI) and International RLS Study Group (IRLSSG) Rating Scale. RLS was diagnosed using the IRLSSG criteria. Serological investigations were done to look for secondary causes of RLS.Results: Out of 200 consecutive patients of migraine without aura were included in the study over a period of 18 months. Frequency of RLS was 13.5% (n=27). All patients had primary RLS. Mean PSQI score was higher in the patients of migraine without aura with RLS than in non RLS patients of migraine without aura (3.30±2.66 vs 2.24±2.03 p≤0.0168). Poor sleep quality, anxiety, depression was found in 9%, 8% and 2.5% respectively in patients of migraine without aura.Conclusions: An association between migraine without aura and RLS was demonstrated. Migraine without aura was associated with increased frequency of poor sleep quality, anxiety and depression.

scholarly journals Demoralization predicts suicidality in patients with cluster headache

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Brian B. Koo ◽  
Ahmed Bayoumi ◽  
Abdalla Albanna ◽  
Mohammed Abusuliman ◽  
Laura Burrone ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Cluster Headache ◽  
Diagnostic Criteria ◽  
Suicide Risk ◽  
Rating Scale ◽  
Depression Scale ◽  
Stepwise Logistic Regression ◽  
Psychological Phenomena ◽  
Severity Rating ◽  
Demoralization Scale

Abstract Objective To determine the frequency of suicidal ideation and assess suicide risk in cluster headache (CH) patients compared to matched controls without CH in this observational case-control study. Background CH is characterized by recurrent intolerable attacks of unilateral retro-orbital pain, which can cause disability, depression, and desperation. CH has been linked to suicide since its early descriptions by B.T. Horton; however, there is relatively little empiric data showing the association between suicidality and CH, especially in the context of other psychological phenomena, such as depression and demoralization. Methods CH and control participants were recruited through community and CH patient group advertisements. CH diagnosis was confirmed using the International Classification of Headache Disorders, 3rd edition diagnostic criteria for CH. Lifetime suicidal ideation and suicide risk were assessed using the Suicidal Behavior Questionnaire-revised and the Columbia Suicide Severity Rating Scale. The Brief Lifetime Depression Scale evaluated lifetime depression. Demoralization was assessed using the Diagnostic Criteria for use in Psychosomatic Research – Demoralization and the Kissane Demoralization Scale. Forward stepwise logistic regression determined the odds of suicidal ideation. Results One hundred CH and 135 control participants were comparable for age, sex, race, income, and marital status. Significantly more CH than control participants had lifetime active suicidal ideation (47.0% vs. 26.7%; p = 0.001), high suicide risk (38.0% vs. 18.5%; p = 0.0009), lifetime depression history (67.0%% vs. 32.6%; p < 0.00001), and demoralization (28.0% vs. 15.6%; p = 0.02). The odds of lifetime suicidal ideation were higher in those with CH (odds [95% confidence interval]; 2.04 [1.08,3.85]), even after accounting for depression and demoralization. In CH, suicidal ideation was associated with demoralization (6.66 [1.56,28.49]) but not depression (1.89 [0.66,5.46]). Conclusions Lifetime suicidal ideation and high suicide risk are prevalent in CH sufferers, and its likelihood is dependent on the presence of demoralization.

The Visual Aura Rating Scale as an Outcome Predictor for Persistent Visual Aura Without Infarction

Cephalalgia ◽  
2008 ◽  
Vol 28 (12) ◽  
pp. 1298-1304 ◽  
Author(s):  
Y-F Wang ◽  
J-L Fuh ◽  
W-T Chen ◽  
S-J Wang
Keyword(s):  
Complete Resolution ◽  
Rating Scale ◽  
Present Report ◽  
Visual Aura ◽  
Systematic Analysis ◽  
Treatment Regimens ◽  
Symptom Profiles ◽  
Duration Of Illness ◽  
Specific Agent ◽  
Visual Disturbances

Persistent visual aura without infarction is rare. Its pathogenic mechanism is unknown, and the response to migraine prophylactic agents varies. A systematic analysis of 29 patients (23 from the literature and six in the present report; 6M/23F, mean age 37.6 years) was carried out in terms of demographics, headache and visual symptom profiles, treatment regimens and outcomes. Patterns of visual disturbances (VDs) were re-assessed with the Visual Aura Rating Scale (VARS, score 0-10). Even though the majority of patients had headache improvement, only eight (27.6±) had complete resolution of persistent VD, without definite relevance to any specific agent. Patients with complete resolution of VD tended to have scotoma (50.0± vs. 0±; P = 0.003), unilateral/homonymous involvement (62.5± vs. 9.5±; P = 0.008), higher VARS scores (1.88 ± 1.73 vs. 0.10 ± 0.30; P< 0.001) and shorter duration of illness (10.0 ± 12.9 vs. 60.2 ± 90.9 months, P = 0.008) compared with those without. These findings remained even when the six current patients were not included for analyses. In conclusion, the prognosis of persistent VD was poor, and higher VARS scores, i.e. more typical of migraine visual aura, predicted a better outcome. For those with a potential for complete resolution, improvement would occur early in the course.

The Visual Aura Rating Scale (VARS) for Migraine Aura Diagnosis

Cephalalgia ◽  
2005 ◽  
Vol 25 (10) ◽  
pp. 801-810 ◽  
Author(s):  
MK Eriksen ◽  
LL Thomsen ◽  
J Olesen
Keyword(s):  
Rating Scale ◽  
Evidence Based ◽  
Validation Sample ◽  
Semistructured Interview ◽  
Migraine Aura ◽  
Visual Symptom ◽  
Visual Aura ◽  
Maximum Score ◽  
Cardinal Characteristics ◽  
Visual Disturbances

To supplement the traditional ICHD-2 diagnosis for migraine with aura (MA) we developed a diagnostic scale for migraine aura that quantifies the importance of the cardinal characteristics of MA. Since more than 99% of MA patients have visual aura, we developed for simplicity a Visual Aura Rating Scale (VARS). In total 427 patients with MA (ICHD-2) or nonaura visual disturbances were diagnosed in a validated semistructured interview by a trained physician. The patients were separated into a derivation sample and a validation sample. By regression analysis we identified the visual aura characteristics associated with MA in the derivation sample. Based on the identified characteristics we developed VARS and derived a predictive VARS score which was tested in the validation sample. The VARS score is the weighted sum of the presence of five visual symptom characteristics: duration 5-60 min (3 points), develops gradually ≤5 min (2 points), scotoma (2 points), zig-zag lines (2 points), and unilateral (1 point). The maximum score is 10 points. A VARS score of 5 or more diagnosed MA with a sensitivity of 96% (95% CI 92-99%) and a specificity of 98%(95% CI 95-100%) in the derivation sample, and a sensitivity of 91% (95% CI 86-95%) and a specificity of 96% (95% CI 91-100%) in the validation sample. VARS adds evidence based weights to a number of clearly specified characteristics; it is easy to learn, apply and teach and may therefore be a valuable addition to traditional ICHD-2 diagnosis.

Suicide in depressed patients: Identifying a clinical risk profile

2017 ◽  
Vol 41 (S1) ◽  
pp. s891-s892 ◽  
Author(s):  
A. Sarzetto ◽  
D. Delmonte ◽  
F. Seghi ◽  
S. Brioschi ◽  
C. Locatelli ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Suicide Rate ◽  
Suicide Ideation ◽  
Rating Scale ◽  
Psychiatric Hospitalization ◽  
Depression Scale ◽  
Risk Profile ◽  
Major Depressive ◽  
Depressed Patients ◽  
Clinical Risk

IntroductionSuicides that occur during psychiatric hospitalization are tragic events causing immense distress to relatives, peers, and physicians. Suicide risk is particularly high in patients with mood disorders.ObjectivesTo identify a clinical risk profile which can be predictive of suicide in patients undergoing a major depressive episode, hospitalized and within three months after discharge.MethodsWe are going to include consecutively admitted depressed patients in San Raffaele Turro hospital (Milan), with a diagnosis of major depressive disorder or bipolar disorder, for a longitudinal prospective study. Demographical and clinical characteristics will be assessed. Barratt impulsiveness scale, aggression questionnaire, Hamilton psychiatric rating scale for depression, scale for suicide ideation, Columbia suicide severity rating scale will be administered to evaluate, respectively, traits of impulsiveness and aggression, severity of psychopathology and suicidal ideation. A follow-up program has been established to evaluate suicidal ideation one month and three months after discharge.ResultsConsidering suicide rates in other psychiatric wards, we retrospectively analyzed in our mood disorder unit the inpatient suicide rate of the last 3 years. In this period, we admitted 1794 patients. The suicide rate has been cumulatively of 0.17% (4 patients): 0.16% in 2014, 0.16% in 2015, and 0.19% in 2016. In the same period, outpatient suicide rate has been of 0.39%; 57.14% of outpatient suicides happened within three months after discharge.ConclusionsHospitalization and discharge are critical circumstances for psychiatric patients. Evaluation of risk factors will contribute to explain our ward suicide rate and hopefully to reduce it in the future.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals 132 Effects of Valbenazine on Depression and Suicidality in Adults With Tardive Dyskinesia: Pooled Results of 3 Double-Blind, Placebo-Controlled Trials

CNS Spectrums ◽  
2018 ◽  
Vol 23 (1) ◽  
pp. 82-83
Author(s):  
Gary Remington ◽  
Dao Thai-Cuarto ◽  
Joshua Burke ◽  
Scott Siegert ◽  
Grace S. Liang
Keyword(s):  
Suicidal Ideation ◽  
Mood Disorder ◽  
Schizoaffective Disorder ◽  
Rating Scale ◽  
Depression Scale ◽  
Controlled Trials ◽  
Double Blind ◽  
Once Daily ◽  
Double Blind Placebo ◽  
Safety Population

AbstractStudy ObjectivesValbenazine (INGREZZA; VBZ) is a novel and highly selective vesicular monoamine transporter 2 (VMAT2) inhibitor that is approved for the treatment of tardive dyskinesia (TD) in adults. The randomized, double-blind, placebo (PBO)-controlled trials of VBZ evaluated the treatment of TD in patients with a primary psychiatric diagnosis (schizophrenia/schizoaffective disorder or mood disorder) while on concomitant psychiatric medications to manage these disorders. Since treatment-emergent depression and suicidal ideation/behavior are important clinical concerns in psychiatric patient populations, data from these trials were analyzed to assess the effectsof once-daily VBZ on depression and suicidality.MethodsData were pooled from three 6-week trials: KINECT (NCT01688037), KINECT 2 (NCT01733121), KINECT 3 (NCT02274558). Outcome data were analyzed in the safety population by pooled VBZ doses (40 mg, 80 mg) and PBO. Outcomes of interest included: treatment-emergent adverse events (TEAEs) related to depression or suicidality; mean score change from baseline to Week 6 in the Calgary Depression Scale for Schizophrenia (CDSS, for participants with schizophrenia/schizoaffective disorder) or the Montgomery-Åsberg Depression Rating Scale (MADRS, for participants with mood disorder); and, worsening from baseline in Columbia-Suicide Severity Rating Scale (C-SSRS) suicidal ideation scores. All outcomes were analyzed descriptively.ResultsThere were 400 total participants in the pooled safety population; 286 participants had schizophrenia/schizoaffective disorder (40 mg, n=82; 80 mg, n=70; PBO, n=134) and 114 had a mood disorder (40 mg, n=28; 80 mg, n=42; PBO, n=44). Over one-third of participants had a lifetime history of suicidal ideation or behavior (40 mg, 45%; 80 mg, 39%; PBO, 37%). Few participants had a depression- or suicide-related TEAE, with no apparent differences between VBZ and PBO: suicidal ideation (40 mg, 3.6%; 80 mg, 0.9%; PBO, 2.2%); depression (40 mg, 0%; 80 mg, 1.8%; PBO, 1.1%); depressive symptom (40 mg, 0.9%; 80 mg, 0%; PBO, 0.6%); suicide attempt (40 mg, 0%; 80 mg, 0.9%; PBO, 0%). Mean changes from baseline to Week 6 in depression scale scores were generally small and similar across treatment groups: CDSS total score (40 mg, -0.5; 80 mg, -0.6; PBO, -0.3); MADRS total score (40 mg, -0.2; 80 mg, -1.7; PBO, 0.6). Few participants had a shift from no suicidal ideation at baseline (C-SSRS score=0) to any suicidal ideation during treatment (C-SSRS score=1-5): 40 mg, 3.9% (4/103); 80 mg, 0.9% (1/111); PBO, 2.9% (5/174).ConclusionData from 3 double-blind, placebo-controlled trials indicate that once-daily VBZ treatment was not associated with a worsening in depression-related symptoms or an increased risk of suicidal ideation or behavior.Funding AcknowledgementsThis study was funded by Neurocrine Biosciences, Inc.

scholarly journals Addressing Psychosocial Vulnerabilities Through Antenatal Care—Depression, Suicidal Ideation, and Behavior: A Study Among Urban Sri Lankan Women

2021 ◽  
Vol 12 ◽  
Author(s):  
Alexis Palfreyman
Keyword(s):  
Risk Factors ◽  
Suicidal Ideation ◽  
Sri Lanka ◽  
Partner Violence ◽  
Rating Scale ◽  
Depression Scale ◽  
Middle Income ◽  
Depressive Symptomology ◽  
Middle Income Countries ◽  
Low And Middle Income

An absence of data persists for common perinatal mental disorders and suicidal ideation and/or behaviors (SIB), particularly from low- and middle-income countries and from the antenatal period. Capitalizing on Sri Lanka's strong antenatal platform, we identify the prevalence of antenatal depressive symptomology, lifetime- and current-pregnancy SIB and their risk factors in women in urbanizing Sri Lanka, and present opportunities for improved antenatal detection of psychosocial vulnerabilities. One thousand antenatal women in Gampaha District from all trimesters of pregnancy were screened in 2016 using a novel three-part instrument, including the validated Edinburgh Postnatal Depression Scale, a modified Columbia-Suicide Severity Rating Scale for first ever use among a perinatal and South Asian population, and an original Life Circumstances questionnaire (with validated subscales). Prevalence and risk factors associated with depressive symptomology and SIB were explored using univariate, bivariate and logistic regression analyses. Women ranged from 16 to 42 years; 46% were nulliparous. Past-week prevalence of antenatal depressive symptomology was high (29.6%). One in four women reported a lifetime history of SIB, while SIB during the current pregnancy was reported at 7.4%. Exposure to intimate partner violence and lifetime SIB emerged as the strongest correlates of both depressive and current-pregnancy SIB outcomes (p &lt; 0.05). This study evidences the high prevalence of multiple psychosocial vulnerabilities in pregnant women in Sri Lanka and underscores the need for their improved comprehensive assessment. Given antenatal care's high rates of use in Sri Lanka and in low- and middle-income countries in general, this study presents it as a promising mechanism through which to effectively screen for multiple psychosocial vulnerabilities, supporting early identification and intervention for at-risk women and their families.

Characteristics and treatment outcome of suicidal depression: Two large naturalistic cohorts of depressed outpatients

2021 ◽  
pp. 000486742110256
Author(s):  
Bénédicte Nobile ◽  
Emilie Olié ◽  
Jonathan Dubois ◽  
Sebastien Guillaume ◽  
Philip Gorwood ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Suicide Attempt ◽  
Clinical Characteristics ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Depression Scale ◽  
Severe Depression ◽  
New Drugs ◽  
Anxiety And Depression ◽  
Hospital Anxiety

Objective: The emergence of new drugs for managing suicidal ideation (e.g. ketamine) raises the question of whether suicidal depression (i.e. moderate to severe depression with concomitant suicidal ideation) is a specific depression phenotype. Therefore, this study characterized patients with suicidal depression (baseline clinical characteristics, suicidal ideation and depression evolutions, suicide risk) in two large cohorts of outpatients with depression. Methods: LUEUR and GENESE are two large, prospective, naturalistic cohorts of French adult outpatients with depression (Diagnostic and Statistical Manual of Mental Disorders, fourth edition, criteria), treated and followed up for 6 weeks. Depression severity was assessed with the Hospital Anxiety and Depression Scale, and suicidal ideation with the suicidal item of the Montgomery–Åsberg Depression Rating Scale. Patients with moderate or severe depression (Hospital Anxiety and Depression Scale–Depression subscale score >11) were selected and classified as without suicidal ideation (suicidal item of the Montgomery–Åsberg Depression Rating Scale <2), with moderate suicidal ideation (suicidal item of the Montgomery–Åsberg Depression Rating Scale [2; 3]) and with severe suicidal ideation (suicidal item of the Montgomery–Åsberg Depression Rating Scale ⩾4). Results: Baseline clinical features were more severe (e.g. higher anxiety and depression scores) in depressed patients with moderate/severe suicidal ideation. Depression remission after treatment was less frequent among patients with severe suicidal ideation. The risk of suicide attempt during the follow-up was threefold higher in patients with suicidal ideation among those 10% had persistent suicidal ideation. Conclusion: Suicidal depression could be a specific depression phenotype with more severe clinical characteristics, less frequent depression remission, suicidal ideation persistence and higher suicide attempt risk, despite antidepressant treatment. It seems that novel therapeutic strategies could be needed.

scholarly journals Post-Stroke Depression and Its Effect on Functional Outcomes during Inpatient Rehabilitation

2021 ◽  
Author(s):  
Gurumayum Sonachand Sharma ◽  
Anupam Gupta ◽  
Meeka Khanna ◽  
Naveen Bangarpet Prakash
Keyword(s):  
Outcome Measures ◽  
Functional Outcomes ◽  
Rating Scale ◽  
Tertiary Care ◽  
Depression Scale ◽  
Inpatient Rehabilitation ◽  
University Hospital ◽  
Post Stroke ◽  
Significant Difference ◽  
Post Stroke Depression

Abstract Objective The aim of the study is to observe the effect of post-stroke depression on functional outcomes during inpatient rehabilitation. Patients and Methods The design involved is prospective observational study. The location involved is Neurological Rehabilitation unit in a tertiary care university hospital. The study period ranges from October 2019 to April 2020. The participants involved are the patients with first ever stroke, male and female with age ≥18 years and duration less than 1 year. All participants were assessed at admission and after 14 sessions of inpatient rehabilitation by depression subscale of Hospital Anxiety and Depression Scale (HADS-D) and Hamilton Depression Rating Scale (HDRS). The stroke outcomes measures used were: Barthel Index (BI), Scandinavian Stroke Scale (SSS), and Modified Rankin Scale (MRS). Results There are a total of 30 participants (18 males) with median stroke duration of 90 days. The median age of the patients was 58 years. Sixteen patients had ischemic and 14 had hemorrhagic stroke. Out of these, 57% (n = 17) had symptoms of depression (HADS-D >7). Participants in both groups (with and without depression) showed improvement in all the functional outcome measures (BI, SSS, MRS) at the time of discharge as compared with admission scores. The changes in the outcome measures were statistically significant within groups (p < 0.05) but not significant between the groups (p > 0.05). Conclusion The post-stroke depression is common among stroke survivors of less than 1 year duration. There was no significant difference in the functional outcomes between stroke patients with depression and those without depression with inpatient rehabilitation program.

Sign in / Sign up

Export Citation Format

Share Document