Neurology Commons^™

Impact Of Insurance Status On Migraine Care In The United States, Andrew Wilper, Steffie Woolhandler, David U. Himmelstein, Rachel Nardin

Publications and Research

Objective
To determine whether insurance status is associated with differential outpatient treatment of migraine in the United States.

Methods
We analyzed 11 years of data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey (1997–2007), which survey patient visits to doctors’ offices, hospital outpatient departments, and emergency departments (EDs) in the United States. We used logistic regression to determine whether insurance status was associated with the prescription of standard migraine therapy, defined as 1) a triptan or dihydroergotamine and 2) a prophylactic agent.

Results
We identified 6,814 individual patient visits for migraine, representing 68.6 million …

Psychiatric Outcomes In Low Birthweight Children At Age Six: Relation To Neonatal Cranial Ultrasound Abnormalities, Agnes H. Whitaker, Ronan Van Rossem, Judy F. Feldman, Irvin Sam Schonfeld, Jennifer A. Pinto-Martin, Carolyn Torre, David Shaffer, Nigel Paneth

Publications and Research

Examined the relation of neonatal cranial ultrasonography abnormalities to later psychiatric disorder in 564 low birth weight children (aged 5.2–8.7 yrs). Psychiatric diagnoses were assessed by means of the Diagnostic Interview Schedule for Children–Parent version, and detailed information was collected on other predictors and outcomes. Results show that 454 Ss had no cranial abnormalities, 78 had germinal matrix hemorrhage (GMH) and/or intraventricular hemorrhage (IVH), and 32 had a parenchymal lesion (PL) or ventricular enlargement (VE). 22% of the Ss had at least 1 psychiatric disorder, the most common being attention deficit hyperactivity disorder (ADHD). Isolated GMH/IVH did not increase …

Persistent Emotional Disorder In Children With Neurological Soft Signs, Daniel Pine, David Shaffer, Irvin Sam Schonfeld

Publications and Research

Provides clinical details in the form of 11 case vignettes from a prospective epidemiological study that found the combination of childhood 'soft' signs and anxious behavior to be a strong risk factor for adolescent emotional disorders. The original study conducted a neuropsychiatric assessment of 180 African-American adolescents (aged 16–18 yrs) who had been followed through childhood. The at-risk Ss exhibited a persistent and specific pattern of both motor abnormalities and anxiety, obsessional compulsive, or depressive symptoms over time. The form of at-risk Ss' neurological and psychiatric abnormalities is consistent with a link between motor system abnormalities and …

Early Soft Signs And Later Psychopathology, David Shaffer, Cornelius Stokman, Patricia A. O'Connor, Stephen Shafer, Joseph E. Barmack, Suzanne Hess, D. Spalten, Irvin Sam Schonfeld

Publications and Research

At age 17 two motor signs, mirror movements and dysdiadochokinesis, were found in more than half the subjects known to have had the respective signs at age 7. These rates were significantly higher than rates found within the group of subjects who were sign free at age 7.

Ten-Year Consistency In Neurological Test Performance Of Children Without Focal Neurological Deficit, Stephen Q. Shafer, Cornelius Stokman, David Shaffer, Stephen K-C Ng, Patricia A. O'Connor, Irvin Sam Schonfeld

Publications and Research

To assess 'soft-sign' persistence and its correlates outside a referred sample, 159 members of a local birth cohort of the United National Collaborative Perinatal Project were traced and their performance on six neurological test scales was measured at age 17 by examiners blind to their status at age seven. A comparison group was also formed, who had been 'sign-free' at age seven. On four of the six tests (dysdiadochokinesis, mirror movements, dysgraphesthesia and motor slowness) index boys did significantly worse than the comparison boys; by contrast, index girls scored significantly worse than comparisons only on motor slowness.