During the past year, we have continued to analyze the data from this prospective cohort study that covers a total observation period of 30 years for this cohort of young adults who have been followed since the age of 18. We examined the specific patterns of comorbidity by headache subtype, and their respective impact on the affected individual over time. Results show that there was substantial comorbidity with mood and anxiety disorders across headache subtypes. Only social phobia and hypomania were specifically associated with migraine, and prospective analysis shows that the onset of migraine generally precedes that of these disorders. As compared to migraine only, migraine comorbidity with anxiety or mood disorders was associated with greater levels of consulting a physician, treatment seeking, medication use, years symptomatic, distress and impairment. Analyses led by our colleagues in Zurich assessed sex differences in schizophrenia (Rossler et al, 2012). They applied two different measures of sub-clinical psychosis representing schizotypal signs and schizophrenia nuclear symptoms. Using cross-sectional and longitudinal analyses, they found no significant sex differences in sub-clinical psychosis over time with respect to age of onset, symptomatology, course, or psycho-social outcome. Thus it appears that sex differences in psychosis manifest themselves at the high end of the continuum (full-blown schizophrenia) rather than within the sub-threshold range. Possibly males and females have separate thresholds for certain symptoms because they are differently vulnerable or exposed to various risk factors. The gender difference in lifetime somatic depression was compared to that of pure depression using this unique data (Silverstein et al, 2012). Public Health Impact: This study provides valuable insight on the association between specific headache subtypes and psychiatric conditions, as well as the differential impact of these subtypes on the affected individual using prospective data from a population-based sample. Understanding the specificity of these associations will aid in our efforts to more accurately detect at-risk individuals, inform the development of more targeted prevention and treatment efforts and help refine studies examining the etiology of these conditions. Future Plans: During the next year, we plan to analyze the 30 year follow up data on the following topics: 1) longitudinal course of nonrestorative sleep and its correlation with nighttime insomnia symptoms;2) short sleep duration, late bedtime, and sleep disturbances as predictors of poor mental health: mental disorder, chronic unexplained pain, suicidality, smoking, and alcoholism;3) the SCL-90 depression course over time;4) depression subtypes and persistent fatigue/neurasthenia.
