Migraine: incorrect self-management for a disabling disease.

Migraine is an economically and socially relevant pathology but patients' consciousness and consequently a proper management is often unsatisfactory. In this study, we aimed to evaluate the disease awareness, the general approach and the impact on working activity in a population of headache-affected hospital workers. During an 18-month period, hospital workers responded to a questionnaire investigating headache presence, characteristics and awareness. Specific attention was paid to define headache impact on working activities. 1774 consecutive subjects were enrolled. Headache was documented in 45.7% of the sample, migraine in 16.6%. 40.6% of the patients with headache and 50.7% of the migraneous subjects had a specialist medical evaluation. Triptans use was significantly lower than non-steroidal anti-inflammatory drugs use. 39.5% of migraneous complained of attacks during working time, 60.2% acknowledged a negative influence on work quality. 25.5% of migraneous patients reported a loss of working days attributable to the disease. Migraine is disabling for workers with negative consequences on job capacity and quality. Efforts should be made to improve disease awareness to stimulate a better diagnostic and therapeutic approach.

Attachment style and immunity: a 1-year longitudinal study.

Previous cross-sectional studies suggested an association between attachment-related avoidance and altered immune function. We aimed at testing this hypothesis with longitudinal data. A random sample of 65 female nurses provided a blood sample and completed measures of perceived stress, social support, alexithymia, and attachment style. Immune assays included lymphocyte proliferative response (LPR) to Phytohemagglutinin and NK cell cytotoxicity (NKCC). State measures (perceived stress and support) and immune measures were collected again after 4, 8, and 12 months. Linear mixed effects models were used to examine the relationship between attachment and immunity. While low to moderate levels of attachment-related avoidance were not associated with NKCC, there was a significant negative association (beta -.35; p=.005) between high levels of avoidance and NKCC. No association was observed between NKCC and attachment-related anxiety, and between LPR and both attachment dimensions. While our findings should be interpreted with caution due to study limitations such as the relatively small sample size and the inclusion of only female participants, they corroborate the notion that attachment is linked to physiology and health.

Influence of shift-work on selected immune variables in nurses.

Shift-work, particularly night-work, interferes with the physiological circadian rhythm and has the potential to induce psycho-physiological disturbances. A nurse population was investigated to establish whether shift-work can induce changes in a number of immune variables. Lymphocyte immunophenotype and proliferative response, NK cytotoxicity, cytokines and cortisol were determined in 68 shift-working and 28 daytime nurses at baseline and at 12 months. None of the variables studied differed significantly between shift and daytime workers, either at baseline or at 12 months, except IL-1ß and TNF-α, which were significantly higher among daytime nurses at baseline, but not at follow-up. No effect of shift-work on immune variable and cortisol levels was seen at 12 months after adjustment for baseline values and job seniority. The specific work schedule as well as job type likely influenced our results, suggesting that rotational shift-work does not necessarily affect the immune system adversely. The immune changes reported by other studies in shift-workers should not be generalized.

Relationship of job satisfaction, psychological distress and stress-related biological parameters among healthy nurses: a longitudinal study.

OBJECTIVE: To examine the relationship between job satisfaction, psychological distress, psychosocial processes and stress-related biological factors, and to evaluate whether over time changes of work satisfaction could affect the immunological-inflammatory status of workers. METHODS: One hundred and one nurses were enrolled at the Clinic of Occupational Medicine, Polytechnic University of Marche, Ancona, Italy. Perceived job satisfaction, psychological distress, and social support were assessed every 4 mo over a 1-yr period using 4 self-reported questionnaires. T lymphocytes CD3, CD4(+), CD8(+), CD8(+)-CD57(+), B lymphocyte CD19(+), NK cells CD56(+), and NK cell activity were determined. RESULTS: Job satisfaction was associated with reduced psychological distress and was characterized by low cell numbers of CD8(+) suppressor T cells, CD8(+)-CD57(+) activated T cells, CD56(+) NK cells and low IL-6 levels. Over time changes in psychological parameters were related to changes in the immunological-inflammatory variables. Subjects who increased their job satisfaction showed a reduced psychological stress associated with reduced number of CD8(+)-CD57(+) activated T cells and inflammatory cytokines. CONCLUSIONS: Job (dis)satisfaction is related with psychological mechanisms in stress affecting cellular immune function.

Attachment security and immunity in healthy women.

BACKGROUND: Attachment security is associated with health and possibly autonomic and endocrine reactivity to stress, however the relationship between attachment style and immune function has not yet been investigated. METHODS: A random sample of 61 female nurses provided a blood sample and completed the Perceived Stress Scale, the Multidimensional Scale of Perceived Social Support, the 20-item Toronto Alexithymia Scale, and the Experiences in Close Relationships questionnaire. Immune measures included immunophenotypic analysis, lymphocyte proliferative response to Phytohemagglutinin, and NK cell cytotoxicity (NKCC). Statistical analysis focused on the relationship between attachment-related anxiety or avoidance and immune measures. Multiple regression was used to control for perceived stress and support, alexithymia, health-related behaviors possibly influencing immunity, and use of anti-inflammatory drugs, tobacco or alcohol. RESULTS: Attachment-related anxiety was not associated with any immune parameter. Attachment-related avoidance was associated with lower NKCC. This association was independent from the number of circulating NK cells, which suggests a change in cell functionality. Perceived stress was also associated with lower NKCC. CONCLUSIONS: This study suggests a link between attachment security and immunity. While our findings should be interpreted with great caution and need replication, they are consistent with previous work suggesting that insecure attachment may be a risk factor for health and may relate to biological processes relevant to health.