Risk of incident depression in patients with Parkinson disease in the UK.

BACKGROUND: Non-motor symptoms are not widely recognized in patients with Parkinson disease (PD). We sought to assess the incidence rate as well as the risk of depression in newly diagnosed patients with PD and to compare it to PD-free controls. METHODS: We conducted a population-based follow-up study with a nested case-control analysis based on data from the UK-based General Practice Research Database (GPRD). We included PD patients ≥ aged 40 years with a first PD diagnosis between 1994 and 2005, and a matched comparison group free of PD. We assessed incidence rates (IRs) and relative risk estimates (odds ratios [ORs] with 95% confidence intervals [CI]). RESULTS: The IR of depression in newly diagnosed PD in the UK community was 26.0 (95% CI 22.9-29.5) per 1000 person-years. The risk of developing depression was increased almost twofold in patients with PD when compared to patients without PD (adj. OR 1.89; 95% CI 1.49-2.40). The increased relative risk was most pronounced in women and in individuals 40-69 years of age. Long-term users of levodopa had an increased depression risk when compared to short-term users. CONCLUSIONS: Patients with PD are at an approximately twofold increased risk of being diagnosed with depression compared to the PD-free population.

Migraine incidence, comorbidity and health resource utilization in the UK.

Population-based data on migraine incidence and comorbidity are scarce. We therefore aimed to quantify incidence rates and comorbidity of diagnosed migraine and health resource utilization (HRU) in migraineurs in the UK primary care setting. We conducted a follow-up study with a nested case-control analysis on the General Practice Research Database. The study encompassed 51,688 patients with a first-time diagnosis of migraine between 1994 and 2001, and the same number of matched controls. The migraine incidence rate was 3.69 (95% confidence interval 3.66, 3.73) cases per 1000 person-years. It was around 2.5 times higher in women. Most chronic diseases were slightly more prevalent in migraineurs than in controls. Triptan users had higher health resource utilization than other migraineurs. This study shows that migraine is a common diagnosis in general practice and associated with a high prevalence of comorbidity. The increased HRU in triptan users suggests greater migraine severity.

Height and body mass index in young adulthood and risk of schizophrenia: a longitudinal study of 1 347 520 Swedish men.

OBJECTIVE: Measures of body size reflect genetic and environmental influences on growth and energy balance. Associations between such measures and risk of schizophrenia have been inconsistent. METHOD: This is a population-based cohort study of 1 347 520 men born in Sweden from 1952 to 1982, with height and body mass index (BMI) data available from conscription records. The Swedish National Hospital Discharge Register was used to identify subjects diagnosed with schizophrenia from 1970 to 2000. RESULTS: Subjects with lower BMI and shorter height had an increased risk of developing schizophrenia. Underweight subjects had an approximately 30% increase in risk compared with normal BMI subjects (adjusted HR = 1.30, 95% CI: 1.20-1.42). Tall subjects had an approximately 15% reduction in risk compared with short subjects (adjusted HR = 0.85, 95% CI: 0.80-0.92). CONCLUSION: Both height and BMI in early adulthood are strongly and inversely associated with risk of schizophrenia. We discuss these findings in relation to possible genetic and nutritional causal mechanisms.

Acute mortality during long-distance ski races (Vasaloppet).

OBJECTIVE: We studied mortality during long-distance ski races in Sweden. DESIGN: The cohort comprised all subjects who participated in ski races during the Vasaloppet week from 1970 through 2005. All deaths during the races were identified and compared with the corresponding expected numbers based on national death rates. RESULTS: In total, 698 102 starters generated altogether 581 person-years of skiing. Overall, 13 deaths occurred compared with 1.68 expected during the skiing time, yielding a standardized mortality ratio (SMR) of 7.7 [95% confidence interval (CI) 4.1-13.2]. Twelve of the deaths were caused by cardiovascular disease (SMR=22.1, 95% CI 11.4-38.6). Interviews of relatives revealed that two to four victims had medical conditions of the sort that they probably would have been recommended to avoid participation for medical reasons had they consulted a physician. CONCLUSION: Our study showed a clearly increased risk of acute mortality during long-distance skiing. However, as physically active people spend only a minority of their time in races, in that population the short-term excess mortality during these periods is by far outweighed by the long-term protective effects of exercise on mortality.