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San Martín-González N, Moya-Higueras J, Eixarch E, Castro-Quintas Á, Marques-Feixa L, Crispi F, Daura-Corral M, de la Fuente-Tomás L, Monteserín-García JL, García-Portilla MP, Fañanás L. Intergenerational effects of maternal childhood maltreatment on newborns' stress regulation: The role of maternal depressive symptoms. CHILD ABUSE & NEGLECT 2024; 155:106968. [PMID: 39116554 DOI: 10.1016/j.chiabu.2024.106968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 07/19/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND Maternal childhood maltreatment (CM) has been repeatedly associated with negative offspring's emotional outcomes. The dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis has emerged as the main underlying physiological mechanism. OBJECTIVE To explore the association between maternal CM and newborns' physiological and neurobehavioral stress responses, considering the role of perinatal maternal depression and bonding. PARTICIPANTS AND SETTING 150 healthy women were followed throughout pregnancy. 79 mother-infant dyads were included in the final analyses. Maternal CM was evaluated using the Childhood Trauma Questionnaire and depressive symptoms by the Edinburgh Postnatal Depression Scale (EPDS) at each trimester. At 7 weeks postpartum, the EPDS and the Postpartum Bonding Questionnaire were administered. Newborns' behavioral responses were assessed using "States Organization" (SO) and "States Regulation" (SR) subdomains of the Neonatal Behavioral Assessment Scale (NBAS). Newborns' salivary samples were collected before and after the NBAS to study cortisol reactivity. METHODS A cross-lagged panel model was employed. RESULTS Infants born to mothers with higher CM presented more optimal scores on SO (β (0.635) = 0.216, p 〈001) and SR (ß (0.273) = 0.195, p = .006), and a higher cortisol reactivity after NBAS handling (β(0.019) = 0.217, p = .009). Moreover, newborns of mothers with higher CM and postpartum depressive symptoms exhibited a poorer performance on SR (ß (0.156 = -0.288,p = .002). Analyses revealed non-significant relationships between mother-infant bonding, newborns' cortisol reactivity and SO. CONCLUSIONS Newborns from mothers with greater CM present higher cortisol reactivity and more optimal behavioral responses, which may reflect a prenatal HPA axis sensitization. However, those exposed to maternal postnatal depressive symptoms present poorer stress recovery.
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Affiliation(s)
- Nerea San Martín-González
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER-SAM), Carlos III Health Institute, Madrid, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain
| | - Jorge Moya-Higueras
- Network Centre for Biomedical Research in Mental Health (CIBER-SAM), Carlos III Health Institute, Madrid, Spain; Department of Psychology, Sociology and Social Work, Faculty of Education, Psychology and Social Work, University of Lleida, Spain
| | - Elisenda Eixarch
- BCNatal - Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain; Network Centre for Biomedical Research in Rare Diseases (CIBER-ER), Institute of Health Carlos III, Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Águeda Castro-Quintas
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER-SAM), Carlos III Health Institute, Madrid, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain
| | - Laia Marques-Feixa
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER-SAM), Carlos III Health Institute, Madrid, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain
| | - Fátima Crispi
- BCNatal - Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain; Network Centre for Biomedical Research in Rare Diseases (CIBER-ER), Institute of Health Carlos III, Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Maria Daura-Corral
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | | | - José Luis Monteserín-García
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER-SAM), Carlos III Health Institute, Madrid, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain
| | - María Paz García-Portilla
- Network Centre for Biomedical Research in Mental Health (CIBER-SAM), Carlos III Health Institute, Madrid, Spain; Department of Psychiatry, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain
| | - Lourdes Fañanás
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER-SAM), Carlos III Health Institute, Madrid, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain.
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Pingeton BC, Nieser KJ, Cochran A, Goodman SH, Laurent H, Sbrilli MD, Knight B, Newport DJ, Stowe ZN. Childhood maltreatment exposure is differentially associated with transdiagnostic perinatal depression symptoms. J Affect Disord 2024; 358:183-191. [PMID: 38705531 PMCID: PMC11194995 DOI: 10.1016/j.jad.2024.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/25/2024] [Accepted: 05/02/2024] [Indexed: 05/07/2024]
Abstract
History of childhood maltreatment (CM) is common and robustly associated with prenatal and postpartum (perinatal) depression. Given perinatal depression symptom heterogeneity, a transdiagnostic approach to measurement could enhance understanding of patterns between CM and perinatal depression. METHODS In two independently collected samples of women receiving care at perinatal psychiatry clinics (n = 523 and n = 134), we categorized longitudinal symptoms of perinatal depression, anxiety, stress, and sleep into transdiagnostic factors derived from the Research Domain Criteria and depression literatures. We split the perinatal period into four time points. We conducted a latent profile analysis of transdiagnostic factors in each period. We then used self-reported history of CM (total exposure and subtypes of abuse and neglect) to predict class membership. RESULTS A three-class solution best fit our data. In relation to positive adaptive functioning, one class had relatively more positive symptoms (high adaptive), one class had average values (middle adaptive), and one class had fewer adaptive symptoms (low adaptive). More total CM and specific subtypes associated with threat/abuse increased an individual's likelihood of being in the Low Adaptive class in both samples (ORs: 0.90-0.97, p < .05). LIMITATIONS Generalizability of our results was curtailed by 1) limited racial/ethnic diversity and 2) missing data. CONCLUSIONS Our results support taking a person-centered approach to characterize the relationship between perinatal depression and childhood maltreatment. Given evidence that increased exposure to childhood maltreatment is associated with worse overall symptoms, providers should consider incorporating preventative, transdiagnostic interventions for perinatal distress in individuals with a history of childhood maltreatment.
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Affiliation(s)
- Blaire C Pingeton
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, United States of America.
| | - Kenneth J Nieser
- Department of Population Health Sciences, University of Wisconsin, United States of America
| | - Amy Cochran
- Department of Population Health Sciences, University of Wisconsin, United States of America; Department of Mathematics, University of Wisconsin, United States of America
| | - Sherryl H Goodman
- Department of Psychology, Emory University, United States of America
| | - Heidemarie Laurent
- Department of Psychology, University of Illinois at Urbana-Champaign, United States of America
| | - Marissa D Sbrilli
- Department of Psychology, University of Illinois at Urbana-Champaign, United States of America
| | - Bettina Knight
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, United States of America
| | - D Jeffrey Newport
- Departments of Psychiatry and Behavioral Sciences and Women's Health, University of Texas at Austin Dell Medical School, United States of America
| | - Zachary N Stowe
- Department of Psychiatry, University of Wisconsin at Madison, United States of America
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Lu C, Gao ZW, Xing S, Wang HH, Huang YK, Zhou H, Wu L. Rapid Antidepressant-Like Potential of Chaihu Shugan San Depends on Suppressing Glutamate Neurotransmission and Activating Synaptic Proteins in Hippocampus of Female Mice. Chin J Integr Med 2024; 30:692-700. [PMID: 38733455 DOI: 10.1007/s11655-024-3906-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 05/13/2024]
Abstract
OBJECTIVE To explore the rapid antidepressant potential and the underlying mechanism of Chaihu Shugan San (CSS) in female mice. METHODS Liquid chromatography mass spectrometry (LC-MS)/MS was used to determine the content of main components in CSS to determine its stability. Female C57BL/6J mice were randomly divided into 4 groups, including control (saline), vehicle (saline), CSS (4 g/kg) and ketamine (30 mg/kg) groups. Mice were subjected to irregular stress stimulation for 4 weeks to establish the chronic mild stress (CMS) model, then received a single administration of drugs. Two hours later, the behavioral tests were performed, including open field test, tail suspension test (TST), forced swimming test (FST), novelty suppression feeding test (NSF), and sucrose preference test (SPT). Western blot analysis was used to detect the expression levels of N-methyl-D-aspartate receptor (NMDA) subtypes [N-methyl-D-aspartate receptor 1 (NR1), NR2A, NR2B], synaptic proteins [synapsin1 and post synaptic density protein 95 (PSD95)], and brain-derived neurotrophic factor (BDNF). Moreover, the rapid antidepressant effect of CSS was tested by pharmacological technologies and optogenetic interventions that activated glutamate receptors, NMDA. RESULTS Compared with the vehicle group, a single administration of CSS (4 g/kg) reversed all behavioral defects in TST, FST, SPT and NSF caused by CMS (P<0.05 or P<0.01). CSS also significantly decreased the expressions of NMDA subtypes (NR1, NR2A, NR2B) at 2 h in hippocampus of mice (all P<0.01). In addition, similar to ketamine, CSS increased levels of synaptic proteins and BDNF (P<0.05 or P<0.01). Furthermore, the rapid antidepressant effects of CSS were blocked by transient activation of NMDA receptors in the hippocampus (all P<0.01). CONCLUSION Rapid antidepressant effects of CSS by improving behavioral deficits in female CMS mice depended on rapid suppression of NMDA receptors and activation of synaptic proteins.
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Affiliation(s)
- Chao Lu
- Department of Chinese Medicine Preparations, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Zi-Wei Gao
- Department of Chinese Medicine Preparations, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Shan Xing
- Department of Chinese Medicine Preparations, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
- College of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, 210046, China
| | - Hui-Hui Wang
- Department of Chinese Medicine Preparations, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Yun-Ke Huang
- Department of Chinese Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310000, China
| | - Hang Zhou
- Department of Chinese Medicine Preparations, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Lei Wu
- Department of Chinese Medicine Preparations, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China.
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Liu Y, Li C, Ren H, Han K, Wang X, Zang S, Zhao G. The relationship of peripheral blood cell inflammatory biomarkers and psychological stress in unmedicated major depressive disorder. J Psychiatr Res 2024; 176:155-162. [PMID: 38865865 DOI: 10.1016/j.jpsychires.2024.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/07/2024] [Accepted: 06/08/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Recent research has explored the linkage between major depressive disorder (MDD) and inflammation, especially via altered peripheral blood immune markers. However, the relationship between several novel leukocyte-derived ratios (LDR) and psychological stress in MDD remains uncertain. This study aimed to explore the relationship between LDR, clinical characteristics, recent life events, and childhood maltreatment in MDD patients. METHODS A cross-sectional case-control study was conducted involving 59 healthy controls (HC) and 50 unmedicated MDD patients. Subjects underwent psychological assessments and peripheral blood measurements. LDR assessed in this study included neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), white blood cell-to-mean platelet volume ratio (WMR), systemic immune inflammation index (SII), multiplication of neutrophil and monocyte counts (MNM), and systemic inflammation response index (SIRI). RESULTS MDD patients displayed significant alterations in WMR, PLR, and MNM compared to HC, as well as correlations between several LDR and various clinical features (duration of untreated psychosis and dNLR, the nine-item Patient Health Questionnaire and PLR, the 7-item Generalized Anxiety Disorder Questionnaire and SIRI (NLR and dNLR). There was a significant difference in the comparison of WMR in first-episode patients than in recurrent patients. Analyses further revealed an association between Life Event Scale total scores and NLR (dNLR). No correlation was found between Childhood Trauma Questionnaire total (or subscale) scores and LDR. Additionally, WMR and dNLR presented potential predictive value for distinguishing between MDD and HC. CONCLUSION The study concludes that MDD and some clinical features are associated with alterations in some peripheral blood LDR. These findings emphasize the potential role of peripheral blood LDR in the pathogenesis and clinical heterogeneity of MDD.
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Affiliation(s)
- Yigang Liu
- Department of Clinical Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Cuicui Li
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Honghong Ren
- Department of Psychology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Ke Han
- Department of Rehabilitation, Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan, Shandong, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Shuqi Zang
- Department of Rehabilitation, Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan, Shandong, China
| | - Guoqing Zhao
- Department of Psychology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
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Zagaria A, Fiori V, Vacca M, Lombardo C, Pariante CM, Ballesio A. Inflammation as a mediator between adverse childhood experiences and adult depression: A meta-analytic structural equation model. J Affect Disord 2024; 357:85-96. [PMID: 38677656 DOI: 10.1016/j.jad.2024.04.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 04/05/2024] [Accepted: 04/21/2024] [Indexed: 04/29/2024]
Abstract
Exposure to adverse childhood experiences (ACEs) confers a higher risk of developing depression in adulthood, yet the mediation of inflammation remains under debate. To test this model, we conducted a systematic review and two-stage structural equation modelling meta-analysis of studies reporting correlations between ACEs before age 18, inflammatory markers and depression severity in adulthood. Scopus, Pubmed, Medline, PsycInfo, and CINAHL were searched up to 2 October 2023. Twenty-two studies reporting data on C-reactive protein (CRP, n = 12,935), interleukin-6 (IL-6, n = 4108), tumour necrosis factor-α (TNF-α, n = 2256) and composite measures of inflammation (n = 1674) were included. Unadjusted models revealed that CRP (β = 0.003, 95 % LBCI 0.0002 to 0.0068), IL-6 (β = 0.003, 95 % LBCI 0.001 to 0.006), and composite inflammation (β = 0.009, 95 % LBCI 0.004 to 0.018) significantly mediated the association between ACEs and adult depression. The mediation effects no longer survived after adjusting for BMI; however, a serial mediation model revealed that BMI and IL-6 sequentially mediated the association between ACEs and depression (β = 0.002, 95 % LBCI 0.0005 to 0.0046), accounting for 14.59 % and 9.94 % of the variance of IL-6 and depressive symptoms, respectively. Due to the cross-sectional nature of assessment of inflammation and depression findings should be approached with caution; however, results suggest that complex interactions of psychoneuroimmunological and metabolic factors underlie the association between ACEs and adulthood depression.
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Affiliation(s)
- Andrea Zagaria
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Valeria Fiori
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Mariacarolina Vacca
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Caterina Lombardo
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Andrea Ballesio
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy.
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Lamadé EK, Pedraz-Petrozzi B, Lindner O, Meininger P, Coenen M, Witt SH, Rietschel M, Dukal H, Gilles M, Wudy SA, Hellweg R, Deuschle M. Stress during pregnancy and fetal serum BDNF in cord blood at birth. Psychoneuroendocrinology 2024; 165:107035. [PMID: 38603892 DOI: 10.1016/j.psyneuen.2024.107035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/19/2024] [Accepted: 03/24/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION Adverse environments during pregnancy impact neurodevelopment including cognitive abilities of the developing children. The mediating biological alterations are not fully understood. Maternal stress may impact the neurotrophic regulation of the offspring as early as in utero and at birth. Brain-derived neurotrophic factor (BDNF) is essential for neurodevelopment. Short-term higher levels of BDNF in mice upon stressors associate with lower BDNF later in life, which itself associates with depression in animals and humans. Stress including glucocorticoids may impact BDNF, but there is a lack of data at birth. This study investigated if stress near term associates with fetal BDNF at birth in humans. METHODS Pregnant women near term who underwent primary cesarean sections (at 38.80±0.64 weeks), were included in this study (n=41). Stress at the end of pregnancy was assessed before the cesarean section by determining maternal depressive symptoms (EDPS), maternal state and trait anxiety (STAI-S and STAI-T), maternal prenatal distress (PDQ), stress over the past month (PSS), prenatal attachment to the offspring (PAI), maternal social support (F-Sozu), maternal early life stress (CTQ), socioeconomic status, and the glucocorticoids cortisol and cortisone (n=40) in amniotic fluid at birth. The association with fetal BDNF was analyzed. Cord blood serum of n=34 newborns at birth was analyzed for BDNF and newborn anthropometrics (weight, length and head circumference per gestational age at birth) were assessed. The association of fetal BDNF with anthropometrics at birth was analyzed. RESULTS After a BDNF-outlier (>3 SD) was removed, higher fetal BDNF associated significantly with maternal depressive symptoms (r=0.398, p=0.022), with lower socioeconomic status as assessed by the average number of people per room in the household (r=0.526, p=0.002) and with borderline significance with net income per person in the household (r=-0.313, p=0.087) in the bivariate analyses. In multivariable analysis, BDNF stayed positively associated with maternal depressive symptoms (β=0.404, 95% CI [7.057, 306.041], p=0.041) and lower net income per person in the household (β=-0.562, 95% CI [-914.511, -60.523], p=0.027) when controlling for maternal age, maternal pre-pregnancy BMI, fetal sex and gestational age. Fetal BDNF did not associate with newborn anthropometrics with the outlier removed in bivariate analyses or in multivariable analyses when controlling for maternal BMI and fetal sex. CONCLUSION Maternal depressive symptoms and lower socioeconomic status associated with higher fetal BDNF when controlling for confounders. Fetal BDNF did not associate with newborn anthropometrics with the outlier removed. Further studies should investigate how early altered BDNF associate with the development and possibly psychopathology of the offspring.
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Affiliation(s)
- Eva Kathrin Lamadé
- Department of Psychiatry and Psychotherapy, Research-group Stress-related disorders, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | - Bruno Pedraz-Petrozzi
- Department of Psychiatry and Psychotherapy, Research-group Stress-related disorders, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | - Ole Lindner
- Center for Child and Adolescent Health, Pediatrics, University Hospital of Freiburg, Freiburg 79106, Germany.
| | - Pascal Meininger
- Department of Gynecology and Obstetrics, Westpfalz-Klinikum, Kaiserslautern 67665, Germany.
| | - Michaela Coenen
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, Medical Faculty, LMU Munich, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany.
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | - Helene Dukal
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | - Maria Gilles
- Department of Psychiatry and Psychotherapy, Research-group Stress-related disorders, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | - Stefan A Wudy
- Laboratory for Translational Hormone Analytics, Division of Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University, Giessen, Germany.
| | - Rainer Hellweg
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and the Berlin Institute of Health, Berlin, Germany.
| | - Michael Deuschle
- Department of Psychiatry and Psychotherapy, Research-group Stress-related disorders, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
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Hoffmann S, Schulze S, Löffler A, Becker J, Hufert F, Gremmels HD, Holmberg C, Rapp MA, Entringer S, Spallek J. Did the prevalence of depressive symptoms change during the COVID-19 pandemic? A multilevel analysis on longitudinal data from healthcare workers. Int J Soc Psychiatry 2024; 70:87-98. [PMID: 37671660 PMCID: PMC10860357 DOI: 10.1177/00207640231196737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
BACKGROUND Healthcare workers (HCW) are at high risk to develop mental health problems during the COVID-19 pandemic because of additional work load, perceived stress, and exposure to patients with COVID-19. Currently, there are few studies on change over time in the prevalence of depressive symptoms during pandemic start among HCW. Thus, the aims of the current study were to examine whether depressive symptoms increased during the pandemic and were associated with perceived stress and own COVID-19 infection and workplace exposure to virus-infected patients. METHODS The cohort study used longitudinal data from HCW collected monthly (July 2020 till December 2020) during the first year of the pandemic before vaccination became available. The sample of n = 166 was drawn from a German hospital and included medical (e.g. nurses, therapists, and physicians) and administrative staff. Using multilevel models, we analyzed the change in depressive symptoms [assessed with General Depression Scale (GDS), a validated German version of the Center for Epidemiological Studies Depression Scale (CES-D)] and its association with perceived stress across the study period. Laboratory-confirmed own infection was tested as a potential moderator in this context. Subscales of the GDS were used to examine change over time of depressive symptom modalities (e.g. emotional, somatic, and social interactions (β, 95% confidence interval). RESULTS Depression scores increased significantly during the study period (β = .03, 95% CI [0.02, 0.05]). Perceived stress was associated with depressive symptoms (β = .12, 95% CI [0.10, 0.14]) but did not change over time. Exposure to COVID-19 infection was associated with a higher increase of depressive symptoms (β = .12, 95% CI [0.10, .14]). Somatic symptoms of depression increased among medical HCW with workplace exposure to COVID-19 (β = .25, 95% CI [0.13, 0.38]), but not in administrators (β = .03, 95% CI [-0.04, 0.11]). CONCLUSION Research is needed to identify factors that promote the reduction of depressive symptoms in medical HCW with exposition to COVID-19 patients. Awareness of infection protection measures should be increased.
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Affiliation(s)
- Stephanie Hoffmann
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Germany
- Lausitz Center for Digital Public Health, Institute of Health, Brandenburg University of Technology Cottbus-Senftenberg, Germany
| | - Susanne Schulze
- Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Germany
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit ‘Cognitive Sciences’, Faculty of Human Science, University of Potsdam, Germany
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Germany
| | - Antje Löffler
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Germany
| | - Juliane Becker
- Institute for Clinical Chemistry, Laboratory Diagnostics and Microbiology, Sana Kliniken Niederlausitz gGmbH, Senftenberg, Germany
| | - Frank Hufert
- Department of Microbiology and Virology, Medical University Brandenburg Theodor Fontane, Neuruppin, Germany
| | - Heinz-Detlef Gremmels
- Institute for Clinical Chemistry, Laboratory Diagnostics and Microbiology, Sana Kliniken Niederlausitz gGmbH, Senftenberg, Germany
| | - Christine Holmberg
- Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Germany
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Germany
| | - Michael A Rapp
- Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Germany
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit ‘Cognitive Sciences’, Faculty of Human Science, University of Potsdam, Germany
| | - Sonja Entringer
- Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Psychology, Germany
- Department of Pediatrics, and Development, Health and Disease Research Program University of California, Irvine, USA
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Germany
- Lausitz Center for Digital Public Health, Institute of Health, Brandenburg University of Technology Cottbus-Senftenberg, Germany
- Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Germany
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Suzuki S. Current Strategies for Perinatal Mental Health Care in Japan. JMA J 2024; 7:5-9. [PMID: 38314413 PMCID: PMC10834275 DOI: 10.31662/jmaj.2023-0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/02/2023] [Indexed: 02/06/2024] Open
Abstract
Perinatal mental health care is required to maintain the emotional well-being of pregnant women, as well as their children, partners, and families. The mental and physical support for the pregnant and/or postpartum women with serious mental health problems should be provided with multidisciplinary collaboration in the perinatal area. The adverse outcomes related to impaired perinatal mental health are suicide and child abuse, which are the top reasons why mental health care in pregnant and/or postpartum women is important. Mental health care during the perinatal period should be provided proactively with interventions from medical practitioners. In addition, to promote the provision of information on health management for future pregnancies, "preconception care" through consultation, supported with medical examinations, is also important.
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Affiliation(s)
- Shunji Suzuki
- Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, Tokyo, Japan
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Hitzler M, Matits L, Gumpp AM, Bach AM, Ziegenhain U, Gao W, Kolassa IT, Behnke A. Longitudinal course of endocannabinoids and N-acylethanolamines in hair of mothers and their children in the first year postpartum: investigating the relevance of maternal childhood maltreatment experiences. Psychol Med 2023; 53:7446-7457. [PMID: 37198936 PMCID: PMC10719681 DOI: 10.1017/s0033291723001204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Childhood maltreatment (CM) exerts long-lasting psychological and biological alterations in affected individuals and might also affect the endocannabinoid (eCB) system which modulates inflammation and the endocrine stress response. Here, we investigated the eCB system of women with and without CM and their infants using hair samples representing eCB levels accumulated during the last trimester of pregnancy and 10-12 months postpartum. METHODS CM exposure was assessed with the Childhood Trauma Questionnaire. At both timepoints, 3 cm hair strands were collected from mothers and children (N = 170 resp. 150) to measure anandamide (AEA), 2/1-arachidonoylglycerol (2-AG/1-AG), stearoylethanolamide (SEA), oleoylethanolamide (OEA), and palmitoylethanolamide (PEA). RESULTS Maternal hair levels of 2-AG/1-AG increased and SEA levels decreased from late pregnancy to one year postpartum. Maternal CM was associated with lower SEA levels in late pregnancy, but not one year later. In the children's hair, levels of 2-AG/1-AG increased while levels of SEA, OEA, and PEA decreased from late pregnancy to one year later. Maternal CM was not consistently associated with the eCB levels measured in children's hair. CONCLUSIONS We provide first evidence for longitudinal change in the eCB system of mothers and infants from pregnancy to one year later. While maternal CM influenced the maternal eCB system, we found no consistent intergenerational effects on early regulation of the eCB system in children. Longitudinal research on the importance of the eCB system for the course and immunoregulation of pregnancy as well as for the children's development.
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Affiliation(s)
- Melissa Hitzler
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Lynn Matits
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
- Division of Sports and Rehabilitation Medicine, Department of Medicine, Ulm University Hospital, Ulm, Germany
| | - Anja M. Gumpp
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Alexandra M. Bach
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Ute Ziegenhain
- Department of Child and Adolescent Psychiatry, Ulm University Hospital, Ulm, Germany
| | - Wei Gao
- Department of Biopsychology, Technische Universität Dresden, Dresden, Germany
| | - Iris-Tatjana Kolassa
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Alexander Behnke
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
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Jovanovic T, Roberts A, Huels A. Intergenerational transmission of trauma: A biological perspective. J Trauma Stress 2023; 36:662-664. [PMID: 37218444 DOI: 10.1002/jts.22938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/22/2023] [Accepted: 03/22/2023] [Indexed: 05/24/2023]
Abstract
This commentary is based on an invited panel for the 2022 International Society of Traumatic Stress Studies (ISTSS) annual meeting entitled "Perspective Discourses On…Intergenerational Transmission of Trauma: A Biological Perspective." This was a new format introduced by ISTSS to facilitate discussion around timely topics. This session included scholars from different backgrounds (e.g., epidemiology, neuroscience, environmental health) who shared their approaches to understanding the biological bases of the intergenerational transmission of trauma. Specifically, the panel presented information about putative direct and indirect mechanisms of transmission, including epigenetic and environmental factors, and pointed to behavioral and neurobiological outcomes in offspring. This commentary synthesizes some of the current knowledge gained by these different approaches and identifies key areas to advance in future work.
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Affiliation(s)
- Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA
| | - Andrea Roberts
- Department of Environmental Health, Harvard University, Cambridge, Massachusetts, USA
| | - Anke Huels
- Department of Epidemiology and Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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11
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Keenan-Devlin LS, Borders AEB, Freedman A, Miller GE, Grobman W, Entringer S, Simhan H, Wadhwa P, Buss C. Maternal exposure to childhood maltreatment and adverse birth outcomes. Sci Rep 2023; 13:10380. [PMID: 37369688 DOI: 10.1038/s41598-023-36831-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
Exposure to traumatic events during pregnancy may influence pregnancy and birth outcomes. Growing evidence suggests that exposure to traumatic events well before pregnancy, such as childhood maltreatment (CM), also may influence the course of pregnancy and risk of adverse birth outcomes. We aimed to estimate associations between maternal CM exposure and small-for-gestational-age birth (SGA) and preterm birth (PTB) in a diverse US sample, and to examine whether common CM-associated health and behavioral sequelae either moderate or mediate these associations. The Measurement of Maternal Stress (MOMS) Study was a prospective cohort study that enrolled 744 healthy English-speaking participants ≥ 18 years with a singleton pregnancy, who were < 21 weeks at enrollment, between 2013 and 2015. CM was measured via the Childhood Trauma Questionnaire (CTQ) and participants above the moderate/severe cut-off for any of the five childhood abuse and neglect scales were assigned to the CM-exposed group. Common CM-associated health (obesity, depressive symptoms, hypertensive disorders) and behavioral (substance use) sequelae were obtained from standardized questionnaires and medical records. The main outcomes included PTB (gestational age < 37 weeks at birth) and SGA (birthweight < 10%ile for gestational age) abstracted from the medical record. Multivariable logisitic regression was used to test associations between CM, sequeale, and birth outcomes, and both moderation and mediation by CM-related sequelae were tested. Data were available for 657/744 participants. Any CM exposure was reported by 32% of participants. Risk for SGA birth was 61% higher among those in the CM group compared to the non-CM group (14.1% vs. 7.6%), and each subsequent form of CM that an individual was exposed to corresponded with a 27% increased risk for SGA (aOR 1.27, 95% CI 1.05, 1.53). There was no significant association between CM and PTB (9.3% vs. 13.0%, aOR 1.07, 95% CI 0.58, 1.97). Of these sequelae only hypertensive disorders were associated with both CM and SGA and hypertensive disorders of pregnancy did not mediate the association between CM and SGA. Our findings indicate that maternal CM exposure is associated with increased risk for SGA birth and highlight the importance of investigating the mechanisms whereby childhood adversity sets the trajectory for long-term and intergenerational health issues.
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Affiliation(s)
- Lauren S Keenan-Devlin
- , Evanston, IL, USA
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, USA
- University of Chicago Pritzker School of Medicine, Chicago, USA
| | - Ann E B Borders
- , Evanston, IL, USA
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, USA
- University of Chicago Pritzker School of Medicine, Chicago, USA
- Institute for Public Health and Medicine, Northwestern University Center for Healthcare Studies, Chicago, USA
| | - Alexa Freedman
- , Evanston, IL, USA
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, USA
- Department of Psychology, Northwestern University, Evanston, USA
- Institute for Policy Research, Northwestern University, Evanston, USA
| | - Gregory E Miller
- , Evanston, IL, USA
- Department of Psychology, Northwestern University, Evanston, USA
- Institute for Policy Research, Northwestern University, Evanston, USA
| | - William Grobman
- Institute for Public Health and Medicine, Northwestern University Center for Healthcare Studies, Chicago, USA
- , Chicago, IL, USA
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Evanston, USA
| | - Sonja Entringer
- , Berlin, Germany
- Department of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Development, Health and Disease Research Program, UC University of California Irvine, California, USA
| | - Hyagriv Simhan
- , Pittsburgh, PA, USA
- Division of Maternal-Fetal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, USA
| | - Pathik Wadhwa
- Development, Health and Disease Research Program, UC University of California Irvine, California, USA
- , Irvine, CA, USA
| | - Claudia Buss
- , Berlin, Germany.
- Department of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
- Development, Health and Disease Research Program, UC University of California Irvine, California, USA.
- Department of Pediatrics, Development, Health and Disease Research Program, University of California Irvine, 1001 Health Sciences Road, Irvine, CA, 92697-3950, USA.
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McCormack C, Abuaish S, Monk C. Is There an Inflammatory Profile of Perinatal Depression? Curr Psychiatry Rep 2023; 25:149-164. [PMID: 36947355 DOI: 10.1007/s11920-023-01414-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/24/2023] [Indexed: 03/23/2023]
Abstract
PURPOSE OF REVIEW To synthesize and critically examine recent evidence regarding associations between immune system activity and perinatal depression. RECENT FINDINGS Despite a significant number of studies assessing potential immunological markers of perinatal depression, it does not appear that levels of any individual pro- or anti-inflammatory marker is a useful predictor of perinatal depression. Some recent studies have observed differences in overall immune system functioning and adaptation across this period, taking into account multiple pro- and anti- inflammatory markers. Furthermore, there is evidence for interactions between depression and maternal psychosocial factors. Immune system functioning may be a mechanism through which social determinants of health contribute to risk for perinatal depression. There is substantial evidence implicating dysregulated immune activity in perinatal depression, yet little clarity regarding a consistent immune profile, especially based on analysis of circulating peripheral cytokines.
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Affiliation(s)
- Clare McCormack
- Department of Child and Adolescent Psychiatry, New York University Langone Medical Center, New York, NY, USA.
| | - Sameera Abuaish
- Department of Basic Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Catherine Monk
- Departments of Obstetrics and Gynecology and Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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Liu CH, Koire A, Erdei C, Mittal L. Subjective social status, COVID-19 health worries, and mental health symptoms in perinatal women. SSM Popul Health 2022; 18:101116. [PMID: 35582494 PMCID: PMC9098429 DOI: 10.1016/j.ssmph.2022.101116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 11/13/2022] Open
Abstract
Pregnant women and those who have recently given birth are considered an at-risk population during the COVID-19 pandemic with regards to the impact of both general stress and pandemic-related stressors. The extent to which subjective social status (SSS), one's perception of relative standing compared to others in a social hierarchy, might mitigate the effects of COVID-19-related health worries on mental health has not yet been reported, despite SSS often outperforming socioeconomic status as a predictor of various health outcomes including depression. This cross-sectional survey study tested the moderating effect of SSS on association between COVID-19- related health worries and mental health symptoms (depressive and generalized anxiety) among a sample of 1,637 perinatal women from the United States who took part in the Perinatal Experiences and COVID-19 Effects (PEACE) Study between May 2020 and June 2021. We found that high subjective social status was protective against depressive symptoms when self-reported COVID-19-related worry was low. When COVID-19-related worry was high, subjective social status was no longer influential. Higher levels of COVID-19-related health worries were associated with more anxiety symptoms, and higher subjective social status did not moderate anxiety symptomatology at either level of COVID-19-related worry. Although higher SSS has historically been protective against mental health decline, in the context of the COVID-19 pandemic it may not be sufficiently protective against anxiety, or against depression for those who experience high levels of worry regarding the effects of COVID-19 on health. We assessed perinatal women for mental health symptoms and subjective social status. High subjective social status protected against depression when COVID worry was low. When COVID worry was high, subjective social status didn't protect against depression. COVID-19-related health worries were associated with more anxiety symptoms. High subjective social status was not protective against anxiety symptoms.
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