An epidemiologic study of the autoimmune diseases taken together has not been done heretofore. The National Patient Register of Denmark is used to estimate population prevalence of 31 possible or probable autoimmune diseases. Record linkage is used to estimate 465 pairwise comorbidities in individuals among the 31 diseases, and familial aggregation among sibs, parents and offspring. The prevalence of any of the 31 diseases in the population is more than 5%. Within individuals, there is extensive comorbidity across the 31 diseases. Within families, aggregation is strongest for individual diseases, and weak across diseases. These data confirm the importance of the autoimmune diseases as a group, and suggest that common etiopathologies exist among them.

The purpose of this study was to determine the prevalence, sociodemographic correlates, and comorbidity of recurrent headache in children in the United States. Participants were individuals aged 4 to 18 years (n = 10 198) who participated in the National Health and Nutrition Examination Surveys. Data on recurrent and other health conditions were analyzed. Frequent or severe headaches including migraine in the past 12 months were reported in 17.1% of children. Asthma, hay fever, and frequent ear infections were more common in children with headache, with at least 1 of these occurring in 41.6% of children with headache versus 25.0% of children free of headache. Other medical problems associated with childhood headaches include anemia, overweight, abdominal illnesses, and early menarche. Recurrent headache in childhood is common and has significant medical comorbidity. Further research is needed to understand biologic mechanisms and identify more homogeneous subgroups in clinical and genetic studies. Keywordsheadache; migraine; comorbidity; prevalence Headache is a common complaint in children and adolescents. The most frequent type of recurrent headache in young children is migraine, 1 while the frequency of tension type headache increases in the later years of childhood. Recurrent headaches can negatively impact a child's life in several ways, including school absences, decreased academic performance, social stigma, and impaired ability to establish and maintain peer relationships. The quality of life in children with migraine is impaired to a degree similar to that in children with arthritis or cancer. 2 There has been limited population-based research on headache and migraine in children, particularly in the United States. Most of our knowledge regarding the prevalence and demographic correlates of migraine is derived from school-based questionnaire studies in European countries [3][4][5][6] and some from the United States. 7,8 Prevalence estimates for headache in prepubertal children range from 2.4% to 17% for migraine and 4% to 5% for frequent or severe headache. For the postpubertal ages estimates are considerably higher, ranging from NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript 5% to 18% for migraine and 9% to 29% for other frequent or severe headaches. Despite the impact of headache on pediatric health, only 1 population-based American study to date has examined the frequency of recurrent headache in children. 9 Individuals who suffer from migraine or severe headaches are also diagnosed with certain other medical conditions at a higher than expected frequency. Comorbidity can significantly influence the delivery of medical care as it may confound diagnosis and provide special therapeutic challenges. No population-based study to date has systematically examined the patterns of medical comorbidity of recurrent headache or migraine in childhood. Knowledge of other biologic systems involved would not only help physicians provide better care for their patients but may also ...

Although there is growing evidence of links between the cortisol stress response and personality, the nature of the relationships and the underlying mechanisms require further clarification. The purpose of this study was to examine associations between personality traits and cortisol responses to stress using the Revised NEO Personality Inventory five-factor model of personality. In total, 68 healthy adults, aged 18-30 years, completed the personality assessment and underwent a laboratory psychological stress test that consisted of a 5 min speech and 5-min of mental arithmetic. Findings showed that in the sample as a whole, less Openness was associated with lower cortisol responses to the challenge. Cortisol responses also corresponded to certain personality dimensions in a gender-specific manner. Blunted cortisol responses were associated with higher Neuroticism in women and with lower Extraversion in men. These findings suggest that personality traits that have been traditionally associated with greater psychopathology were also associated with blunted HPA axis responses to stress.

Migraineurs, specifically those with aura, exhibited less decline on cognitive tests over time vs nonmigraineurs. For the Mini-Mental State Examination, these effects were only apparent among those who were older than 50 years.

BACKGROUND-Although much is known about risk factors for the initiation of alcohol use, abuse and dependence, few population-based studies have examined the predictors of transitions across these stages.

Objective-To describe trends in prevalence and incidence of depressive disorder in a cohort from Eastern Baltimore. Results-Older age, lower education, non-White race, and cognitive impairment are independent predictors of attrition due to death and loss of contact, but depressive disorder is not related to attrition. Prevalence rates rise for females between 1981, 1993, and 2004. Incidence rates in the period 1993-2004 are lower than the period 1981-1993, suggesting the rise in prevalence is due to increasing chronicity. MethodConclusion-There has been a rise in the prevalence of depression in the prior quarter century among middle-aged females.

Objective-There are no published nationally representative prevalence estimates of enuresis among children in the United States using standardized diagnostic criteria. This study sets out to describe the prevalence, demographic correlates, comorbidities, and service patterns for enuresis in a representative sample of U.S. children.Method-The diagnosis of enuresis was derived from parent-reported data for "enuresis, nocturnal" collected using the computerized version of the Diagnostic Interview Schedule for Children (C-DISC 4.0) from a nationally representative sample of 8-to 11-year-old children (n = 1,136) who participated in the 2001-2004 National Health and Nutrition Examination Surveys.Results-The overall 12-month prevalence of enuresis was 4.45%. The prevalence in boys (6.21%) was significantly greater than that in girls (2.51%). Enuresis was more common at younger ages and among black youth. Attention-deficit/hyperactivity disorder (ADHD) was strongly associated with enuresis (odds ratio 2.88; 95% confidence interval 1.26-6.57). Only 36% of the enuretic children had received health services for enuresis.Conclusions-Enuresis is a common condition among children in the United States. Few families seek treatment for enuresis despite the potential for adverse effects on emotional health. Child health care professionals should routinely screen for enuresis and its effects on the emotional health of the child and the family. Assessment of ADHD should routinely include evaluation for enuresis and vice versa. Research on the explanations for the association between enuresis and ADHD is indicated. Keywords enuresis; prevalence; health care use; comorbidities; ADHD Enuresis is a distressing condition that involves repeated voiding of urine into clothes or bedclothes that persists beyond the normative age of maturation of urinary control. The prevalence estimates of enuresis are highly variable, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] with a range of 3.8% 19 to 24%. 5 The Correspondence to Srirangam Shreeram, M.D., Genetic Epidemiology, Branch, National Institute of Mental Health, 35 Convent Drive, 1A-202, MSC 3720, Bethesda, MD 20892-3720; s.shreeram@dc.gov. Disclosure: Dr. Shreeram has served on the speakers' bureau of Pfizer and serves as a consultant to Capital Clinical Research Associates, which conducts clinical trials for GlaxoSmithKline, Wyeth, Cephalon, Jazz Pharmaceuticals, Sanofi-Aventis, Takeda, Abbott, Forest, Novartis International AG, Pfizer, Bristol-Myers Squibb, Eli Lilly, Pherin Pharmaceuticals, Avera Pharmaceuticals, BrainCells, and AstraZeneca PLC. The other authors report no conflicts of interest.The National Health and Nutrition Examination Survey data are collected by the National Center for Health Statistics (NCHS). All analyses, interpretations, and conclusions expressed in this article are those of the authors and not the NCHS, which is responsible only for the initial data. 22 The DSM-III 23 and ICD-10 require a bed-wetting frequency of twice per month i...

Background-The 'gateway' pattern of drug initiation describes a normative sequence, beginning with alcohol and tobacco use, followed by cannabis, then other illicit drugs. Previous work has suggested that 'violations' of this sequence may be predictors of later problems but other determinants were not considered. We have examined the role of pre-existing mental disorders and sociodemographics in explaining the predictive effects of violations using data from the US National Comorbidity Survey Replication (NCS-R).