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Kai-Dih Juang

Publications and source records attributed to Kai-Dih Juang.

12 recordsLinked to original sources
PubMed2006

Outcomes and predictors of chronic daily headache in adolescents: a 2-year longitudinal study.

OBJECTIVES: To assess the outcomes and predictors of chronic daily headache (CDH) in a community-based cohort of adolescents. METHODS: We established a field sample of 122 adolescents (32 M/90 F, ages 12 to 14) with CDH in 2000. These adolescents received annual follow-up by neurologists for 2 years via a semistructured telephone interview. CDH was defined as > or =15 headache days/month, average > or =2 h/day for >3 months; subtypes were classified based on the original and appendix criteria of the International Classification of Headache Disorders (2nd ed.; ICHD-2). Poor outcome was defined as persistence of CDH at 2 years. RESULTS: Follow-up response rates were 92% in 2001 and 84% in 2002. Average monthly headache frequency was 11.0 +/- 9.7 days in 2001 and 7.7 +/- 6.5 days in 2002. CDH persistence rates were 40% in 2001 and 25% in 2002. Medication overuse declined from 20% (baseline) to 6% at 2 years. The prevalence of migraine did not change throughout the follow-up (67 to 60%), whereas that of tension-type headache deceased from 86 to 46% (p < 0.001). Chronic migraine prevalence increased markedly at baseline and became the most common CDH subtype at follow-up when using the ICHD-2 appendix criteria. During follow-up, seven subjects (6%) dropped out of school. Independent predictors for CDH persistence were medication overuse and major depression. CONCLUSIONS: Most adolescents with chronic daily headache (CDH) continued to have frequent headaches, although the incidence of CDH declined at follow-up. Migraine diagnosis gained prominence as headache frequency decreased. The percentages of chronic migraine in adolescents with CDH increased obviously if the appendix criteria were applied.

Adolescent↗
PubMed2006

Chronic daily headache in adolescents: prevalence, impact, and medication overuse.

OBJECTIVES: To examine the prevalence, impact, and related medication use or overuse of primary chronic daily headache (CDH) among adolescents in a field sample. METHODS: The authors conducted a two-phase CDH survey of all students from ages 12 to 14 years in five selected middle schools in Taiwan. Subjects with CDH in the past year were identified and interviewed by neurologists. CDH was defined as headache occurring at a frequency of 15 days/month or more, average of 2 hours/day or more, for more than 3 months, and its subtypes were classified on the basis of the International Classification of Headache Disorders, 2nd edition. RESULTS: Of the 7,900 participants, 122 (1.5%) fulfilled the criteria for primary CDH in the past year. Girls had a higher prevalence (2.4%) than boys (0.8%) (p < 0.001). Of the CDH subjects, 88 (72%) could be classified into either chronic tension-type headache (65.6%) or chronic migraine (6.6%). None of them fulfilled the criteria of new daily-persistent headache or hemicrania continua. Twenty-four subjects (20%) overused medications. Eighty-two (67%) of all CDH subjects had migraine or probable migraine. In the past semester, most CDH subjects (65%) did not take any sick leave for headaches. Only 6 subjects consulted neurologists in the past year, and only 1 subject took headache prophylactic agents. CONCLUSIONS: Chronic daily headache (CDH) was common in a large nonreferred adolescent sample. Based on the International Classification of Headache Disorders, 2nd edition, criteria, chronic tension-type headache was the most common subtype; however, a majority of adolescents with CDH had headaches with features of migraine.

Adolescent↗
PubMed2006

Postpartum mood disorders may be related to a decreased insulin level after delivery.

Postpartum mood disorders are very frequent complications of delivery. The prevalence of postpartum blue syndrome is around 25% and that of postpartum depression is around 10%. These disorders greatly affect the well-being of these newly delivering mothers. Currently, the etiology of postpartum mood disorders is still unknown. Although many hormones have been investigated for their possible roles in postpartum mood disorders, the results are still inconclusive. Several studies have shown that insulin increases gradually during pregnancy. The level of insulin secretion may double by the third trimester. Insulin level reaches a maximum before delivery and returns to the level before pregnancy after delivery. The drop in the insulin level during the postpartum period appears to be more sudden and abrupt than the rise of insulin level during pregnancy. Recent studies have showed that insulin affects the secretion of serotonin in the brain. While serotonergic nervous system is well known for its important role in the development of mood disorders, decreased insulin level may induce mood disorders through the mechanism of affecting serotonin secretion in the brain. In the current paper, we propose that the rapid decrease in insulin level during the postpartum period may be one of the causes of postpartum mood disorders. If the hypothesis is valid, clinicians may be able to prevent postpartum mood disorders by carbohydrate-rich food during the postpartum period to stimulate the secretion of insulin. A carbohydrate-rich diet may also become an adjunctive therapy in the treatment of postpartum mood disorders according to the present hypothesis.

Female↗
PubMed2005

Does medication overuse headache represent a behavior of dependence?

Medication overuse is relatively common in patients with frequent headache. To explore the prevalence of patients who meet the criteria for substance dependence in Diagnostic and Statistical Manual of Mental Disorders, Edition IV (DSM-IV), and to identify variables of substance dependence among patients with chronic daily headache, we recruited consecutive patients with chronic daily headache at a headache clinic from November 1999 to June 2004. Each patient completed a headache intake form, a dependence questionnaire modified from DSM-IV, and the Hospital Anxiety and Depression Scale (HADS). The presence of probable medication overuse headache (pMOH) was defined on the basis of the International Classification of Headache Disorders, 2nd edition, 2004. A total of 1,861 patients with chronic daily headache (1,369 women, 492 men; mean age, 49.6+/-15.4 years) were recruited. Almost half (895/1,861, 48%) met criteria of pMOH, and 606 of these patients (606/895, 68%) met three of five DSM-IV substance dependence criteria. In contrast, only 191 of 968 patients without pMOH (20%) met the DSM-IV criteria (OR=8.6, [7.0-10.6], chi-square test, P<0.001). Patients who fulfilled DSM-IV criteria of dependence had higher numbers of physician appointments in the past year. Multivariate logistic regression analyses revealed that migraine headache, frequent physician consultation, intensity of headache, and presence of a higher anxiety score were significant independent variables for substance dependence. Among patients with chronic daily headache, pMOH was associated with behaviors of substance dependence.

Analgesics↗
PubMed2005

Hot flashes are associated with psychological symptoms of anxiety and depression in peri- and post- but not premenopausal women.

OBJECTIVE: To explore the relationship between anxiety, depression, vasomotor symptoms, and menopausal status among middle-aged women. DESIGN: A population-based study involving a rural Taiwanese population. Participants received a structured questionnaire, which included the hospital anxiety and depression scale (HADS), gynecological history and a checklist of menopausal symptoms in the most recent 2 weeks. RESULTS: A total of 1273 women with no history of surgical menopause and hormonal therapy history participated. The mean anxiety, depression, and total HADS scores were 4.3 +/- 3.3, 3.3 +/- 2.8 and 7.6 +/- 5.3, respectively, and did not differ according to menopausal status. A total of 10.5% participants reported hot flashes within the previous 2 weeks. After controlling for educational status and insomnia, anxiety (6.0 +/- 3.8 versus 4.1 +/- 3.1) and depression scores (4.0 +/- 3.3 versus 3.2 +/- 2.7) were significantly higher (p < 0.001) compared with those without hot flashes. These differences were attributed to peri- and postmenopausal subjects. CONCLUSIONS: Hot flashes in peri- and postmenopausal women were associated with anxious and depressive symptoms in East Asian population with low prevalence of vasomotor symptoms.

Adult↗
PubMed2005

A longitudinal study of cognition change during early menopausal transition in a rural community.

OBJECTIVE: To characterize changes in cognition that occur during the hormonal transitions of menopause. METHOD: We conducted a longitudinal population-based study in Kinmen, Taiwan, recruiting all women age 40-54 years who were premenopausal and without a history of hormone replacement therapy (HRT) or hysterectomy. The cognitive measures used to assess function included the Auditory-Verbal Learning Test, visual memory, verbal fluency, Trail Making Test and digit span. RESULTS: A total of 694 eligible women participated in the baseline study, and 573 women (83%) completed follow-up 18 months later. After excluding 78 women who received hysterectomy or HRT, the final sample was composed of 495 subjects, of whom 114 (23%) progressed to perimenopause during follow-up. Women who remained premenopausal were younger than those who became perimenopausal (44.7 +/- 2.3 years versus 47.1 +/- 3.0 years, p < 0.01). All follow-up cognitive scores in women who entered perimenopause were slightly better than baseline measures except for Rey Auditory-Verbal Learning Test, which decreased by 0.23 (S.D. = 2.9, p = 0.3). At follow-up, cognitive function except for verbal fluency did not differ significantly between women who stayed premenopausal and those became perimenopausal after controlling for age, education, and baseline cognitive scores. Women who entered perimenopause have an average of 1.3 items (S.D. = 0.4) less in verbal fluency measures as compared with their premenopausal peers at the follow-up period. CONCLUSIONS: The menopausal transition might not accompany significant cognitive decline except for verbal fluency.

Adult↗
PubMed2005

Assessing quality of life for adolescents in Taiwan.

This study was to evaluate the psychometric properties of the Taiwanese quality of life questionnaire for adolescents and the factors affecting the quality of life of Taiwanese adolescents. The survey involved 5538 junior high school students, aged 13-15 years. An initial 90-item questionnaire was shortened to 38 items by means of principal component analyses. Quality of life assessment involved seven factors: family, residential environment, personal competence, social relationships, physical appearance, psychological well-being, and pain. The rate of missing data was low. The Cronbach alpha coefficient remained above the 0.75 threshold criterion for the global scale and seven subdomain scales. A lower quality of life score was evident for female adolescents in higher grades in school, those living with a single parent or other relatives, and those living in rural areas. This 38-item questionnaire should serve as a reliable tool for future studies.

Adolescent↗
PubMed2004

Prevalence of depressive and anxiety disorders in an assisted reproductive technique clinic.

BACKGROUND: Little is known about the prevalence of specific depressive and anxiety disorders in women before a new course of assisted reproductive technology treatment. Few studies have adopted the proper psychiatric diagnostic procedures. METHODS: All consecutive women visiting the assisted reproduction clinic of a university-affiliated medical centre, with the intention of starting a new assisted reproduction treatment course, were recruited. A psychiatrist made a diagnosis of psychiatric disorders using a structured interview, the Mini-International Neuropsychiatric Interview (MINI). RESULTS: Of a total of 112 participants, 40.2% had a psychiatric disorder. The most common diagnosis was generalized anxiety disorder (23.2%), followed by major depressive disorder (17.0%), and dysthymic disorder (9.8%). Participants with a psychiatric morbidity did not differ from those without in terms of age, education, income, or years of infertility. Women with a history of previous assisted reproduction treatment did not differ from those without in depression or anxiety. CONCLUSIONS: Depressive and anxiety disorders were highly prevalent among women who visited an assisted reproduction clinic for a new course of the treatment. Demographic features and a history of previous assisted reproduction treatment were not risk factors for these psychiatric morbidities in the assisted reproduction clinic.

Academic Medical Centers↗
PubMed2003

Ice-cream headache--a large survey of 8359 adolescents.

We conducted a self-administered questionnaire to investigate ice-cream headache in school adolescents aged 13-15 in Taiwan. The target population was 8789 students in 6 public junior high schools. A total of 8359 students completed the questionnaire (response rate 95.1%). The prevalence of ice-cream headache was 40.6%. It was significantly higher in boys than in girls, and increased with grade. Students with migraine had a higher frequency of ice-cream headache compared with the students without migraine (55.2% vs. 39.6%, P < 0.0001). The prevalence of ice-cream headache increased among students with more migrainous features. Approximately one third of students decreased their intake of ice cream, or abstained completely, especially the younger students. Our study suggests ice-cream headache is very common in Taiwanese adolescents, and it is more common in students who experienced migraine.

Adolescent↗
PubMed2003

Migraine prevalence during menopausal transition.

BACKGROUND: The effect of menopausal transition on the frequency of migraine has never been the focus of a community-based study. METHODS: A cross-sectional community-based survey was undertaken among Chinese women aged 40 to 54 years in Kinmen, Taiwan. Neurologists diagnosed migraine based on the 1988 International Headache Society classification criteria. Menstrual history including a past or current history of premenstrual syndrome was obtained. Serum levels of estradiol and follicle-stimulating hormone were measured. RESULTS: The 1-year prevalence of migraine was 16.5% in the 1436 participants. Among the women who had not had hysterectomies and did not report symptoms of premenstrual syndrome, migraine prevalence did not vary according to menopausal status. In contrast, in women with self-reported premenstrual syndrome, menopausal status was a factor in migraine prevalence: the late perimenopausal group had the highest prevalence (31%) and the spontaneous menopausal group had the lowest (7%). Among all menopausal groups, women who had had hysterectomies reported the highest migraine prevalence (27%), with the highest occurring in those with premenstrual syndrome (44%). The presence of low estrogen (<50 pg/mL) and high follicle-stimulating hormone levels (>30 mIU/mL) was associated with lower migraine prevalence, even in the premenopausal and early perimenopausal women. CONCLUSIONS: Our data supported the clinical impression that migraine prevalence increases before menopause and declines after spontaneous menopause. However, in this study, this trend occurred only in women with increased vulnerability to hormonal change, such as those with premenstrual syndrome. The presence of low estrogen and high follicle-stimulating hormone levels predicted lower migraine prevalence, whereas a history of hysterectomy was related to higher prevalence.

Adult↗
PubMed2002

Psychiatric comorbidity of chronic daily headache: impact, treatment, outcome, and future studies.

Patients with chronic daily headache have high frequencies of psychiatric comorbidity or psychologic distress in clinic-based studies. The presence of psychologic distress contributes to poor quality of life in patients with chronic daily headache. Antidepressants are effective in the treatment of chronic daily headache and its comorbid depression symptoms, although there is a discrepancy in the treatment response between chronic daily headache and comorbid depression. Comorbid major depression was a poor outcome predictor for chronic daily headache in clinic-based studies; however, the presence of psychologic distress did not predict the prognosis in population-based studies.A systematic investigation of psychiatric comorbidity is emphasized in patients with chronic daily headache and aims at a more comprehensive clinical management. Large-scale, longitudinal surveys and clinical trials specifically for psychiatric comorbidity of chronic daily headache are warranted to answer whether a syndromic relationship exists between different chronic daily headache subtypes and different psychiatric disorders, and to provide evidence-based treatment options for this large group of patients.

Chronic Disease↗