1
|
Bai Y, Shu C, Hou Y, Wang GH. Adverse childhood experience and depression: the role of gut microbiota. Front Psychiatry 2024; 15:1309022. [PMID: 38628262 PMCID: PMC11019508 DOI: 10.3389/fpsyt.2024.1309022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Depression is the most common psychiatric disorder that burdens modern society heavily. Numerous studies have shown that adverse childhood experiences can increase susceptibility to depression, and depression with adverse childhood experiences has specific clinical-biological features. However, the specific neurobiological mechanisms are not yet precise. Recent studies suggest that the gut microbiota can influence brain function and behavior associated with depression through the "microbe-gut-brain axis" and that the composition and function of the gut microbiota are influenced by early stress. These studies offer a possibility that gut microbiota mediates the relationship between adverse childhood experiences and depression. However, few studies directly link adverse childhood experiences, gut microbiota, and depression. This article reviews recent studies on the relationship among adverse childhood experiences, gut microbiota, and depression, intending to provide insights for new research.
Collapse
Affiliation(s)
- Yu Bai
- Department of Psychiatry, Renmin Hospital of Wuhan University, Institute of Neuropsychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Chang Shu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Institute of Neuropsychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ying Hou
- Peking University China-Japan Friendship School of Clinical Medicine, Department of Neurology, Beijing, China
| | - Gao-Hua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Institute of Neuropsychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| |
Collapse
|
2
|
Cahill S, Chandola T, Hager R. Genetic Variants Associated With Resilience in Human and Animal Studies. Front Psychiatry 2022; 13:840120. [PMID: 35669264 PMCID: PMC9163442 DOI: 10.3389/fpsyt.2022.840120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/19/2022] [Indexed: 11/15/2022] Open
Abstract
Resilience is broadly defined as the ability to maintain or regain functioning in the face of adversity and is influenced by both environmental and genetic factors. The identification of specific genetic factors and their biological pathways underpinning resilient functioning can help in the identification of common key factors, but heterogeneities in the operationalisation of resilience have hampered advances. We conducted a systematic review of genetic variants associated with resilience to enable the identification of general resilience mechanisms. We adopted broad inclusion criteria for the definition of resilience to capture both human and animal model studies, which use a wide range of resilience definitions and measure very different outcomes. Analyzing 158 studies, we found 71 candidate genes associated with resilience. OPRM1 (Opioid receptor mu 1), NPY (neuropeptide Y), CACNA1C (calcium voltage-gated channel subunit alpha1 C), DCC (deleted in colorectal carcinoma), and FKBP5 (FKBP prolyl isomerase 5) had both animal and human variants associated with resilience, supporting the idea of shared biological pathways. Further, for OPRM1, OXTR (oxytocin receptor), CRHR1 (corticotropin-releasing hormone receptor 1), COMT (catechol-O-methyltransferase), BDNF (brain-derived neurotrophic factor), APOE (apolipoprotein E), and SLC6A4 (solute carrier family 6 member 4), the same allele was associated with resilience across divergent resilience definitions, which suggests these genes may therefore provide a starting point for further research examining commonality in resilience pathways.
Collapse
Affiliation(s)
- Stephanie Cahill
- Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom.,Faculty of Humanities, Cathie Marsh Institute for Social Research, The University of Manchester, Manchester, United Kingdom
| | - Tarani Chandola
- Faculty of Humanities, Cathie Marsh Institute for Social Research, The University of Manchester, Manchester, United Kingdom.,Methods Hub, Department of Sociology, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Reinmar Hager
- Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| |
Collapse
|
3
|
Lipsky RK, McDonald CC, Souders MC, Carpio CC, Teitelman AM. Adverse childhood experiences, the serotonergic system, and depressive and anxiety disorders in adulthood: A systematic literature review. Neurosci Biobehav Rev 2021; 134:104495. [PMID: 34919986 DOI: 10.1016/j.neubiorev.2021.12.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/26/2021] [Accepted: 12/09/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Recent studies have examined the role that the serotonergic system plays in moderating the association between adverse childhood experiences (ACEs) and depressive and anxiety disorders in adulthood. The aim of this literature review is to synthesize studies that examined serotonin's impact in relation to ACEs, and depressive and anxiety disorders in this population. METHODS Published studies from 2008 to 2018 were retrieved from PubMed, CINAHL, and PsychINFO databases, and were included if ACEs, the serotonergic system, and depressive and or anxiety disorders were assessed in those with a mean age between nineteen and forty. RESULTS Twenty-eight studies were included. Various genetic polymorphisms in the serotonergic signaling system moderated the association between ACEs and depression. Additionally, selective serotonin reuptake inhibitors with a high affinity for the serotonin transporter, resulted in poor treatment outcomes for those with history of ACEs. CONCLUSION Additional research is needed in order to further define the role that the serotonergic genes play in the association between ACEs and depressive and anxiety disorders in adulthood.
Collapse
Affiliation(s)
- R K Lipsky
- University of Pennsylvania, School of Nursing, Family and Community Health, 418 Curie Blvd., Philadelphia, PA, 19104, United States; National Clinician Scholars Program, Duke University, 40 Duke Medicine Circle, Durham, NC, 27705, United States.
| | - C C McDonald
- University of Pennsylvania, School of Nursing, Family and Community Health, 418 Curie Blvd., Philadelphia, PA, 19104, United States
| | - M C Souders
- University of Pennsylvania, School of Nursing, Family and Community Health, 418 Curie Blvd., Philadelphia, PA, 19104, United States
| | - C C Carpio
- University of Pennsylvania, School of Nursing, Family and Community Health, 418 Curie Blvd., Philadelphia, PA, 19104, United States; National Clinician Scholars Program, Duke University, 40 Duke Medicine Circle, Durham, NC, 27705, United States
| | - A M Teitelman
- University of Pennsylvania, School of Nursing, Family and Community Health, 418 Curie Blvd., Philadelphia, PA, 19104, United States
| |
Collapse
|
4
|
Nishimi K, Choi KW, Cerutti J, Powers A, Bradley B, Dunn EC. Measures of adult psychological resilience following early-life adversity: how congruent are different measures? Psychol Med 2021; 51:2637-2646. [PMID: 32406816 PMCID: PMC7863576 DOI: 10.1017/s0033291720001191] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Psychological resilience - positive psychological adaptation in the context of adversity - is defined and measured in multiple ways across disciplines. However, little is known about whether definitions capture the same underlying construct and/or share similar correlates. This study examined the congruence of different resilience measures and associations with sociodemographic factors and body mass index (BMI), a key health indicator. METHODS In a cross-sectional sample of 1429 African American adults exposed to child maltreatment, we derived four resilience measures: a self-report scale assessing resiliency (perceived trait resilience); a binary variable defining resilience as low depression and posttraumatic stress (absence of distress); a binary variable defining resilience as low distress and high positive affect (absence of distress plus positive functioning); and a continuous variable reflecting individuals' deviation from distress levels predicted by maltreatment severity (relative resilience). Associations between resilience measures, sociodemographic factors, and BMI were assessed using correlations and regressions. RESULTS Resilience measures were weakly-to-moderately correlated (0.27-0.69), though similarly patterned across sociodemographic factors. Women showed higher relative resilience, but lower perceived trait resilience than men. Only measures incorporating positive affect or resiliency perceptions were associated with BMI: individuals classified as resilient by absence of distress plus positive functioning had lower BMI than non-resilient (β = -2.10, p = 0.026), as did those with higher perceived trait resilience (β = -0.63, p = 0.046). CONCLUSION Relatively low congruence between resilience measures suggests studies will yield divergent findings about predictors, prevalence, and consequences of resilience. Efforts to clearly define resilience are needed to better understand resilience and inform intervention and prevention efforts.
Collapse
Affiliation(s)
- Kristen Nishimi
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Karmel W. Choi
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
- Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA
| | - Janine Cerutti
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
- Atlanta VA Medical Center, Atlanta, GA
| | - Erin C. Dunn
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
- Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA
- Center on the Developing Child at Harvard University, Cambridge, MA
| |
Collapse
|
5
|
Yoon S, Howell K, Dillard R, Shockley McCarthy K, Rae Napier T, Pei F. Resilience Following Child Maltreatment: Definitional Considerations and Developmental Variations. TRAUMA, VIOLENCE & ABUSE 2021; 22:541-559. [PMID: 31405362 DOI: 10.1177/1524838019869094] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Resilience following childhood maltreatment has received substantial empirical attention, with the number of studies on this construct growing exponentially in the past decade. While there is ample interest, inconsistencies remain about how to conceptualize and assess resilience. Further, there is a lack of consensus on how developmental stage influences resilience and how protective factors affect its expression. The current systematic review uses a developmental lens to synthesize findings on resilience following child maltreatment. Specifically, this article consolidates the body of empirical literature in a developmentally oriented review, with the intention of inclusively assessing three key areas-the conceptualization of resilience, assessment of resilience, and factors associated with resilience in maltreatment research. A total of 67 peer-reviewed, quantitative empirical articles that examined child maltreatment and resilience were included in this review. Results indicate that some inconsistencies in the literature may be addressed by utilizing a developmental lens and considering the individual's life stage when selecting a definition of resilience and associated measurement tool. The findings also support developmental variations in factors associated with resilience, with different individual, relational, and community protective factors emerging based on life stage. Implications for practice, policy, and research are incorporated throughout this review.
Collapse
Affiliation(s)
- Susan Yoon
- College of Social Work, 2647The Ohio State University, Columbus, OH, USA
| | - Kathryn Howell
- Department of Psychology, 5415The University of Memphis, Memphis, TN, USA
| | - Rebecca Dillard
- College of Social Work, 2647The Ohio State University, Columbus, OH, USA
| | | | - Taylor Rae Napier
- Department of Psychology, 5415The University of Memphis, Memphis, TN, USA
| | - Fei Pei
- College of Social Work, 2647The Ohio State University, Columbus, OH, USA
| |
Collapse
|
6
|
Malik S, Joychan S, Zajac J, Sinisgalli S, Namerow L. Using an Attachment-Informed Framework in the Clinical Care of Children and Adolescents: A Review of Attachment Theory and Its Impact on Developmental Psychopathology. Psychiatr Ann 2021. [DOI: 10.3928/00485713-20210608-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
7
|
Li M, Liu S, D'Arcy C, Gao T, Meng X. Interactions of childhood maltreatment and genetic variations in adult depression: A systematic review. J Affect Disord 2020; 276:119-136. [PMID: 32697690 DOI: 10.1016/j.jad.2020.06.055] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 06/10/2020] [Accepted: 06/23/2020] [Indexed: 12/29/2022]
Abstract
Background Childhood maltreatment (CM) significantly increases the risk of adulthood psychopathology. Interplay between susceptible genetic variations and CM contributes to the occurrence of depression. This review aims to systematically synthesize the relationships between genetic variations and depression among those exposed to CM. Methods Electronic databases and gray literature to March 31st, 2020 were searched for literature on the topic of depression and CM limited to English-language. Data extraction and quality assessment of key study characteristics were conducted. Qualitative approaches were used to synthesize the findings. Results The initial search resulted in 9185 articles. A total of 29 articles that met the eligibility criteria were included in this review. High heterogeneity was identified regarding the study sample ages, candidate genes and SNPs, the categorization of CM and depression. The findings of this review include several frequently studied genes (5-HTTLPR, CRHR1, BDNF, CREB1, FKBP5, IL1B, NTRK2, and OXTR). Both consistent and inconsistent findings were identified. Overall, the interplay of CM with CREB1-rs2253206 significantly increased the risk of depression. In contrast, CRHR1-TCA haplotype (rs7209436, rs4792887, rs110402), CRHR1-rs17689882, and CRHR1-rs110402 showed protective effects on depression and depressive symptoms among individuals with a history of maltreatment. Limitations Due to clinical and methodological diversity of the studies a qualitative approach was used. Conclusion This review firstly provides a comprehensive overview of the interplay between CM and genetic variations in adult depression. Future etiological explorations should focus on the above-identified genes for down-stream exploration and address the issues and challenges of gene by environment studies.
Collapse
Affiliation(s)
- Muzi Li
- Department of Psychiatry, Faculty of Medicine, McGill University, 6875 Boulevard LaSalle, Montreal, QC, Canada; Douglas Research Centre, Montreal, QC, Canada
| | - Sibei Liu
- Mitacs Globalink Internship, Canada; School of Public Health, Jilin University, Changchun, Jilin, China
| | - Carl D'Arcy
- School of Public Health, University of Saskatchewan, Saskatoon, SK Canada; Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK Canada
| | - Tingting Gao
- School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xiangfei Meng
- Department of Psychiatry, Faculty of Medicine, McGill University, 6875 Boulevard LaSalle, Montreal, QC, Canada; Douglas Research Centre, Montreal, QC, Canada.
| |
Collapse
|
8
|
González-Giraldo Y, Forero DA. Association between resilience and a functional polymorphism in the serotonin transporter (SLC6A4) gene: A meta-analysis. EXCLI JOURNAL 2020; 19:1174-1183. [PMID: 33088257 PMCID: PMC7573178 DOI: 10.17179/excli2020-2660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/15/2020] [Indexed: 12/20/2022]
Abstract
Resilience is a mechanism used by humans to adapt to adverse situations. It is a protective factor against mental health problems. This process can be influenced by environmental and genetic factors. Several genes have been associated with interindividual differences in resilience levels, but the results are inconclusive. Therefore, the aim of this meta-analysis was to evaluate the effect of a functional polymorphism (5-HTTLPR) in the SLC6A4 gene on resilience levels. A search in PubMed, HugeNavigator and Google Scholar databases was carried out and 16 studies about the association of 5-HTTLPR polymorphism and resilience in humans were identified. The OpenMeta[Analyst] program was employed to perform statistical analysis using a random-effects model. The final analysis included 9 studies, for a total of 4,080 subjects. Significant results were found when the standardized mean differences (SMD) of LL and SL carriers were compared, (SMD: -0.087 (confidence interval: -0.166 to -0.008; I2: 0 %); P value: 0.031). A significant result was also found in an analysis comparing SS/SL versus LL genotypes (SMD: -0.231; confidence interval: -0.400 to -0.061, P value: 0.008; I2: 0 %). This is the first meta-analysis performed to identify the pooled association of a functional polymorphism in the serotonin transporter gene and resilience. The current results suggest that the L/L genotype is associated with resilience. Further studies are necessary to elucidate the role of genetics on the resilience mechanisms.
Collapse
Affiliation(s)
- Yeimy González-Giraldo
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia.,Center for Psychosocial Studies for Latin America and the Caribbean, Universidad Antonio Nariño, Bogotá, Colombia
| | - Diego A Forero
- School of Health and Sports Sciences, Fundación Universitaria de Área Andina, Bogotá, Colombia
| |
Collapse
|
9
|
Niitsu K, Rice MJ, Houfek JF, Stoltenberg SF, Kupzyk KA, Barron CR. A Systematic Review of Genetic Influence on Psychological Resilience. Biol Res Nurs 2018; 21:61-71. [DOI: 10.1177/1099800418800396] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
When exposed to adversity, some individuals are at an increased risk of posttraumatic stress disorder, experiencing persistent biopsychosocial disturbances, whereas others adapt well, described as resilience. Resilience is a complex biopsychosocial phenomenon conceptualized as adaptation to adversity influenced by an individual’s genetic variants, epistasis, epigenetics, and gene-by-environment interactions. Studies on psychological resilience have focused on behavioral and psychosocial variables with far less examination of the genetic contributions. The purpose of this review is to identify specific genetic variants contributing to the biological capacity for psychological resilience. PubMed and PsycINFO were searched using the following key words: psychological resilience AND genotype(s). Additional articles were identified from the Human Genome Epidemiology Navigator using the term resilience, psychological. Ten studies met the criteria. Six genes were empirically associated with psychological resilience: serotonin-transporter-linked polymorphic region ( 5-HTTLPR), dopamine receptor D4, brain-derived neurotrophic factor ( BDNF), corticotropin-releasing hormone receptor 1, oxytocin receptor and regulator of G-protein signaling 2 . The findings of this systematic review suggest that the L/L or L’/L’ genotype of 5-HTTLPR and rs25531 in children/adolescents and the S/S or S’/S’ genotype in adults are most frequently related to resilience. Additionally, the Val/Val genotype of rs6265 in BDNF in Caucasians was also associated with resilience. There are numerous factors contributing to the complexity of determining the genetic influence on resilience including analysis of rs25531, assumptions of the mode of inheritance, operationalization of resilience, demographic and population characteristics, sample size, and other types of genetic influence including epistasis and epigenetics. While current evidence is supportive, further investigation of the genetic influence on resilience is required.
Collapse
Affiliation(s)
- Kosuke Niitsu
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Michael J. Rice
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Julia F. Houfek
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Kevin A. Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Cecilia R. Barron
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| |
Collapse
|
10
|
Varoglu E, Seytanoglu A, Asilmaz E, Taneri B. Neurotransmitter receptor genotypes associated with mental and behavioral disorders. Per Med 2018; 14:327-338. [PMID: 29749833 DOI: 10.2217/pme-2016-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
AIM Investigation of association studies within the field of mental and behavioral disorders is of value given their complex molecular etiology including epistatic interactions of multiple genes with small effects. MATERIALS & METHODS Utilizing biomedical text mining, associations are uncovered for all mental and behavioral conditions listed in Diagnostic and Statistical Manual of Mental Disorders Text Revision. Specifically, a computational pipeline is designed to retrieve neurotransmitter receptor variations from biomedical literature with a text mining approach, where unique polymorphisms are also mined. RESULTS Analyses of 1337 unique neurotransmitter receptors and 465 distinct conditions yield 1568 unique gene-disease associations. CONCLUSION This study takes an unconventional approach to association studies and generates a novel dataset of associations for disorders such as major depression and schizophrenia, which provides a global perspective for their genetic etiology.
Collapse
Affiliation(s)
- Ekrem Varoglu
- Department of Computer Engineering, Eastern Mediterranean University, Famagusta, North Cyprus 99628, Turkey
| | - Adil Seytanoglu
- Department of Biological Sciences, Eastern Mediterranean University, Famagusta, North Cyprus 99628, Turkey
| | | | - Bahar Taneri
- Department of Biological Sciences, Eastern Mediterranean University, Famagusta, North Cyprus 99628, Turkey.,Institute for Public Health Genomics, Department of Genetics & Cell Biology, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
11
|
Bleys D, Luyten P, Soenens B, Claes S. Gene-environment interactions between stress and 5-HTTLPR in depression: A meta-analytic update. J Affect Disord 2018; 226:339-345. [PMID: 29031184 DOI: 10.1016/j.jad.2017.09.050] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/18/2017] [Accepted: 09/23/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND Meta-analyses have yielded contradictory findings concerning the role of 5-HTTLPR in interaction with stress (GxE) in depression. The current meta-analysis investigates if these contradictory findings are a result of differences between studies in methodological approaches towards the assessment of stress and depression. METHODS After performing a systematic database search (February to December 2016), first, a meta-analysis was used to investigate the total effect size and publication bias. Second, stratified meta-analyses were used to investigate the potential moderating influence of different methodological approaches on heterogeneity of study findings. Third, a meta-regression was used to investigate the combined influence of the methodological approaches on the overall effect size. RESULTS Results showed a small but significant effect of 5-HTTLPR in interaction with stress in the prediction of depression (OR[95%CI] = 1.18[1.09; 1.28], n = 48 effect sizes from 51 studies, totaling 51,449 participants). There was no evidence of publication bias. Heterogeneity of effect sizes was a result of outliers and not due to different methodological approaches towards the assessment of stress and depression. Yet, there was some evidence that studies adopting a categorical and interview approach to the assessment of stress report higher GxE effects, but further replication of this finding is needed. LIMITATIONS A large amount of heterogeneity (i.e., 46%) was not explained by the methodological factors included in the study and there was a low response rate of invited studies. CONCLUSIONS The current meta-analysis provides new evidence for the robustness of the interaction between stress and 5-HTTLPR in depression.
Collapse
Affiliation(s)
- Dries Bleys
- KU Leuven, Faculty of Psychology and Educational Sciences, Tiensestraat 102, 3000 Leuven, Belgium.
| | - Patrick Luyten
- KU Leuven, Faculty of Psychology and Educational Sciences, Tiensestraat 102, 3000 Leuven, Belgium; University College London, Faculty of Brain Sciences, 1-19 Torrington Place, London WC1E7HB, United Kingdom
| | - Bart Soenens
- Ghent University, Department of Developmental, Personality and Social Psychology, H. Dunantlaan 2, 9000 Ghent, Belgium
| | - Stephan Claes
- KU Leuven, Research Group Psychiatry, Herestraat 49, 3000 Leuven, Belgium
| |
Collapse
|
12
|
Culverhouse RC, Saccone NL, Horton AC, Ma Y, Anstey KJ, Banaschewski T, Burmeister M, Cohen-Woods S, Etain B, Fisher HL, Goldman N, Guillaume S, Horwood J, Juhasz G, Lester KJ, Mandelli L, Middeldorp CM, Olié E, Villafuerte S, Air TM, Araya R, Bowes L, Burns R, Byrne EM, Coffey C, Coventry WL, Gawronski KAB, Glei D, Hatzimanolis A, Hottenga JJ, Jaussent I, Jawahar C, Jennen-Steinmetz C, Kramer JR, Lajnef M, Little K, Zu Schwabedissen HM, Nauck M, Nederhof E, Petschner P, Peyrot WJ, Schwahn C, Sinnamon G, Stacey D, Tian Y, Toben C, Van der Auwera S, Wainwright N, Wang JC, Willemsen G, Anderson IM, Arolt V, Åslund C, Bagdy G, Baune BT, Bellivier F, Boomsma DI, Courtet P, Dannlowski U, de Geus EJC, Deakin JFW, Easteal S, Eley T, Fergusson DM, Goate AM, Gonda X, Grabe HJ, Holzman C, Johnson EO, Kennedy M, Laucht M, Martin NG, Munafò MR, Nilsson KW, Oldehinkel AJ, Olsson CA, Ormel J, Otte C, Patton GC, Penninx BWJH, Ritchie K, Sarchiapone M, Scheid JM, Serretti A, Smit JH, Stefanis NC, Surtees PG, Völzke H, Weinstein M, Whooley M, Nurnberger JI, Breslau N, Bierut LJ. Collaborative meta-analysis finds no evidence of a strong interaction between stress and 5-HTTLPR genotype contributing to the development of depression. Mol Psychiatry 2018; 23:133-142. [PMID: 28373689 PMCID: PMC5628077 DOI: 10.1038/mp.2017.44] [Citation(s) in RCA: 194] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 01/23/2017] [Accepted: 02/02/2017] [Indexed: 01/01/2023]
Abstract
The hypothesis that the S allele of the 5-HTTLPR serotonin transporter promoter region is associated with increased risk of depression, but only in individuals exposed to stressful situations, has generated much interest, research and controversy since first proposed in 2003. Multiple meta-analyses combining results from heterogeneous analyses have not settled the issue. To determine the magnitude of the interaction and the conditions under which it might be observed, we performed new analyses on 31 data sets containing 38 802 European ancestry subjects genotyped for 5-HTTLPR and assessed for depression and childhood maltreatment or other stressful life events, and meta-analysed the results. Analyses targeted two stressors (narrow, broad) and two depression outcomes (current, lifetime). All groups that published on this topic prior to the initiation of our study and met the assessment and sample size criteria were invited to participate. Additional groups, identified by consortium members or self-identified in response to our protocol (published prior to the start of analysis) with qualifying unpublished data, were also invited to participate. A uniform data analysis script implementing the protocol was executed by each of the consortium members. Our findings do not support the interaction hypothesis. We found no subgroups or variable definitions for which an interaction between stress and 5-HTTLPR genotype was statistically significant. In contrast, our findings for the main effects of life stressors (strong risk factor) and 5-HTTLPR genotype (no impact on risk) are strikingly consistent across our contributing studies, the original study reporting the interaction and subsequent meta-analyses. Our conclusion is that if an interaction exists in which the S allele of 5-HTTLPR increases risk of depression only in stressed individuals, then it is not broadly generalisable, but must be of modest effect size and only observable in limited situations.
Collapse
Affiliation(s)
- R C Culverhouse
- Department of Medicine and Division of Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - N L Saccone
- Department of Genetics and Division of Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - A C Horton
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Y Ma
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - K J Anstey
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, ACT, Australia
| | - T Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - M Burmeister
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
| | - S Cohen-Woods
- School of Psychology, Faculty of Social and Behavioural Sciences, Flinders University, Adelaide, SA, Australia
| | - B Etain
- Sorbonne Paris Cité, Université Paris Diderot, UMR-S 1144, Paris, France
- AP-HP, Groupe Saint-Louis-Lariboisière-F. Widal, Paris, France
- INSERM, U1144, Paris, France
| | - H L Fisher
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - N Goldman
- Office of Population Research, Princeton University, Princeton, NJ, USA
| | - S Guillaume
- Université Montpellier, Montpellier, France
- INSERM U1061 Neuropsychiatry, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
| | - J Horwood
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - G Juhasz
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- NAP-A-SE New Antidepressant Target Research Group, Semmelweis University, Budapest, Hungary
| | - K J Lester
- School of Psychology, University of Sussex, Brighton, UK
| | - L Mandelli
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - C M Middeldorp
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - E Olié
- Université Montpellier, Montpellier, France
- INSERM U1061 Neuropsychiatry, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
| | - S Villafuerte
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - T M Air
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - R Araya
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
| | - L Bowes
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - R Burns
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, ACT, Australia
| | - E M Byrne
- Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | - C Coffey
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
| | - W L Coventry
- Discipline of Psychology, University of New England, Armidale, NSW, Australia
| | - K A B Gawronski
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - D Glei
- Center for Population and Health, Georgetown University, Washington, DC, USA
| | - A Hatzimanolis
- Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Neurobiology Research Institute, Theodor-Theohari Cozzika Foundation, Athens, Greece
| | - J-J Hottenga
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, VU Medical Center Amsterdam, Amsterdam, The Netherlands
| | - I Jaussent
- INSERM U1061 Neuropsychiatry, Montpellier, France
| | - C Jawahar
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - C Jennen-Steinmetz
- Department of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - J R Kramer
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | | | - K Little
- Murdoch Childrens Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics and School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - H M Zu Schwabedissen
- Biopharmacy, Department Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - M Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - E Nederhof
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen, The Netherlands
| | - P Petschner
- Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
- NAP-A-SE New Antidepressant Target Research Group, Semmelweis University, Budapest, Hungary
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - W J Peyrot
- Department of Psychiatry, VU University Medical Center & GGZ inGeest, Amsterdam, The Netherlands
| | - C Schwahn
- Department of Prosthetic Dentistry, Gerostomatology and Dental Materials, University Medicine Greifswald, Greifswald, Germany
| | - G Sinnamon
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - D Stacey
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - Y Tian
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - C Toben
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - S Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - N Wainwright
- Department of Public Health and Primary Care, School of Clinical Medicine, Cambridge, UK
| | - J-C Wang
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - G Willemsen
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, VU Medical Center Amsterdam, Amsterdam, The Netherlands
| | - I M Anderson
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, Manchester, UK
| | - V Arolt
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - C Åslund
- Centre for Clinical Research, Uppsala University, Uppsala, Sweden
- Västmanland County Hospital Västerås, Västerås, Sweden
| | - G Bagdy
- Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
- NAP-A-SE New Antidepressant Target Research Group, Semmelweis University, Budapest, Hungary
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - B T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - F Bellivier
- Sorbonne Paris Cité, Université Paris Diderot, UMR-S 1144, Paris, France
- AP-HP, Groupe Saint-Louis-Lariboisière-F. Widal, Paris, France
- INSERM, U1144, Paris, France
| | - D I Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, VU Medical Center Amsterdam, Amsterdam, The Netherlands
| | - P Courtet
- Université Montpellier, Montpellier, France
- INSERM U1061 Neuropsychiatry, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
| | - U Dannlowski
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - E J C de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, VU Medical Center Amsterdam, Amsterdam, The Netherlands
| | - J F W Deakin
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, Manchester, UK
| | - S Easteal
- John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia
| | - T Eley
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - D M Fergusson
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - A M Goate
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - X Gonda
- Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
- NAP-A-SE New Antidepressant Target Research Group, Semmelweis University, Budapest, Hungary
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Department of Psychiatry and Psychotherapy, Kutvolgyi Clinical Center, Semmelweis University, Budapest, Hungary
| | - H J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - C Holzman
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - E O Johnson
- Fellow Program and Behavioral Health and Criminal Justice Division, RTI International, Research Triangle Park, NC, USA
| | - M Kennedy
- Department of Pathology, University of Otago Christchurch, Christchurch, New Zealand
| | - M Laucht
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - N G Martin
- Genetic Epidemiology, QIMR Berghofer, Brisbane, QLD, Australia
| | - M R Munafò
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK
| | - K W Nilsson
- Centre for Clinical Research, Uppsala University, Uppsala, Sweden
- Västmanland County Hospital Västerås, Västerås, Sweden
| | - A J Oldehinkel
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen, The Netherlands
| | - C A Olsson
- Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Burwood, VIC, Australia
- Department of Paediatrics and School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
| | - J Ormel
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen, The Netherlands
| | - C Otte
- Charité Universitätsmedizin Berlin, Klinik für Psychiatrie und Psychotherapie Campus Benjamin Franklin, Berlin, Germany
| | - G C Patton
- Department of Paediatrics, Murdoch Childrens Research Institute, University of Melbourne, Melbourne, VIC, Australia
| | - B W J H Penninx
- Department of Psychiatry, VU University Medical Center & GGZ inGeest, Amsterdam, The Netherlands
| | - K Ritchie
- INSERM U1061 Neuropsychiatry, Montpellier, France
| | - M Sarchiapone
- Department of Health Sciences, University of Molise, Campobasso, Italy
| | - J M Scheid
- Department of Psychiatry, Michigan State University, East Lansing, MI, USA
| | - A Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - J H Smit
- Department of Psychiatry, VU University Medical Center & GGZ inGeest, Amsterdam, The Netherlands
| | - N C Stefanis
- Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Neurobiology Research Institute, Theodor-Theohari Cozzika Foundation, Athens, Greece
| | - P G Surtees
- Department of Public Health and Primary Care, School of Clinical Medicine, Cambridge, UK
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - M Weinstein
- Center for Population and Health, Georgetown University, Washington, DC, USA
| | - M Whooley
- Veterans Affairs Health Care System and University of California, San Francisco, CA, USA
| | - J I Nurnberger
- Institute of Psychiatric Research, Departments of Psychiatry and Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - N Breslau
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - L J Bierut
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| |
Collapse
|
13
|
Perry LM, Goldstein-Piekarski AN, Williams LM. Sex differences modulating serotonergic polymorphisms implicated in the mechanistic pathways of risk for depression and related disorders. J Neurosci Res 2017; 95:737-762. [PMID: 27870440 DOI: 10.1002/jnr.23877] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 07/12/2016] [Accepted: 07/14/2016] [Indexed: 12/27/2022]
Abstract
Despite consistent observations of sex differences in depression and related emotional disorders, we do not yet know how these sex differences modulate the effects of genetic polymorphisms implicated in risk for these disorders. This Mini-Review focuses on genetic polymorphisms of the serotonergic system to illustrate how sex differences might modulate the neurobiological pathways involved in the development of depression. We consider the interacting role of environmental factors such as early-life stress. Given limited current knowledge about this topic, we highlight methodological considerations, challenges, and guidelines for future research. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- LeeAnn M Perry
- Neurosciences Program, Stanford University, Stanford, California
| | - Andrea N Goldstein-Piekarski
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.,Sierra-Pacific Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.,Sierra-Pacific Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| |
Collapse
|
14
|
Chronic and remitting trajectories of depressive symptoms in the elderly. Characterisation and risk factors. Epidemiol Psychiatr Sci 2017; 26:146-156. [PMID: 26768574 PMCID: PMC5517623 DOI: 10.1017/s2045796015001122] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND In elderly general population sub-syndromal clinically significant levels of depressive symptoms are highly prevalent and associated with high co-morbidity and increased mortality risk. However changes in depressive symptoms over time and etiologic factors have been difficult to characterise notably due to methodological shortcomings. Our objective was to differentiate trajectories of depressive symptoms over 10 years in community-dwelling elderly men and women using statistical modelling methods which take into account intra-subject correlation and individual differences as well as to examine current and life-time risk factors associated with different trajectories. METHODS Participants aged 65 and over were administered standardised questionnaires and underwent clinical examinations at baseline and after 2, 4, 7 and 10 years. Trajectories over time of the Center for Epidemiologic Studies Depression scores were modelled in 517 men and 736 women separately with latent class mixed models which include both a linear mixed model to describe latent classes of trajectories and a multinomial logistic model to characterise the latent trajectories according to baseline covariates (socio-demographic, lifestyle, clinical, genetic characteristics and stressful life events). RESULTS In both genders two different profiles of symptom changes were observed over the 10-year follow-up. For 9.1% of men and 25% of women a high depressive symptom trajectory was found with a trend toward worsening in men. The majority of the remaining men and women showed decreasing symptomatology over time, falling from clinically significant to very low levels of depressive symptoms. In large multivariate class membership models, mobility limitations [odds ratio (OR) = 4.5, 95% confidence interval (CI) 1.6-12.9 and OR = 4.9, 95% CI 2.3-10.7, in men and women respectively], ischemic pathologies (OR = 2.9, 95% CI 1.0-8.3 and OR = 3.1, 95% CI 1.0-9.9), and recent stressful events (OR = 4.5, 95% CI 1.1-18.5, OR = 3.2, 95% CI 1.6-6.2) were associated with a poor symptom course in both gender as well as diabetes in men (OR = 3.5, 95% CI 1.1-10.9) and childhood traumatic experiences in women (OR = 3.1, 95% CI 1.6-5.8). CONCLUSIONS This prospective study was able to differentiate patterns of chronic and remitting depressive symptoms in elderly people with distinct symptom courses and risk factors for men and women. These findings may inform prevention programmes designed to reduce the chronic course of depressive symptomatology.
Collapse
|
15
|
Agnafors S, Svedin CG, Oreland L, Bladh M, Comasco E, Sydsjö G. A Biopsychosocial Approach to Risk and Resilience on Behavior in Children Followed from Birth to Age 12. Child Psychiatry Hum Dev 2017; 48:584-596. [PMID: 27628896 PMCID: PMC5487709 DOI: 10.1007/s10578-016-0684-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
An increasing prevalence of mental health problems calls for more knowledge into factors associated with resilience. The present study used multiple statistical methodologies to examine a biopsychosocial model of risk and resilience on preadolescence behavior. Data from 889 children and mothers from a birth cohort were used. An adversity score was created by combining maternal symptoms of depression, psychosocial risk and children's experiences of life events. The proposed resilience factors investigated were candidate genetic polymorphisms, child temperament, social functioning, and maternal sense of coherence. The l/l genotype of the serotonin transporter linked polymorphic region was associated with lower internalizing scores, but not mainly related to the level of adversity. An easy temperament was associated with resilience for children exposed to high adversity. Social functioning was found to be promotive independent of the risk level. The results support a multiple-level model of resilience indicating effects, though small, of both biological and psychosocial factors.
Collapse
Affiliation(s)
- Sara Agnafors
- Faculty of Health Sciences, Division of Child and Adolescent Psychiatry, IKE, Department of Clinical and Experimental Medicine, Linköping University, 581 85, Linköping, Sweden.
| | - Carl Göran Svedin
- Faculty of Health Sciences, Division of Child and Adolescent Psychiatry, IKE, Department of Clinical and Experimental Medicine, Linköping University, 581 85 Linköping, Sweden
| | - Lars Oreland
- Department of Neuroscience, Uppsala University, 751 24 Uppsala, Sweden
| | - Marie Bladh
- Faculty of Health Sciences, Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Linköping University, 581 85 Linköping, Sweden
| | - Erika Comasco
- Department of Neuroscience, Uppsala University, 751 24 Uppsala, Sweden
| | - Gunilla Sydsjö
- Faculty of Health Sciences, Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Linköping University, 581 85 Linköping, Sweden
| |
Collapse
|
16
|
Gorodetsky E, Carli V, Sarchiapone M, Roy A, Goldman D, Enoch MA. Predictors for self-directed aggression in Italian prisoners include externalizing behaviors, childhood trauma and the serotonin transporter gene polymorphism 5-HTTLPR. GENES BRAIN AND BEHAVIOR 2016; 15:465-73. [PMID: 27062586 DOI: 10.1111/gbb.12293] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 03/24/2016] [Accepted: 04/04/2016] [Indexed: 12/16/2022]
Abstract
Suicidal behavior and self-mutilation can be regarded as the expression of self-directed aggression and both are common in prison populations. We investigated the influence of externalizing behaviors, depressive symptoms, childhood trauma, 5-HTTLPR variants on self-directed aggression (N = 145) in a group of 702 male Italian prisoners. Participants were comprehensively evaluated, including for psychiatric disorders, impulsive traits, lifetime aggressive behavior [Brown-Goodwin Lifetime History of Aggression (BGHA)], hostility, violent behavior during incarceration, depressive symptomatology [Hamilton Depression Rating Scale (HDRS)], childhood trauma [Childhood Trauma Questionnaire (CTQ)]. Logistic regression analysis showed false discovery rate corrected independent main effects of externalizing behaviors: BGHA (P = 0.001), violent behavior in jail (P = 0.007), extraversion (P = 0.015); HDRS (P = 0.0004), Axis I disorders (P = 0.015), CTQ (P = 0.004) and 5-HTTLPR genotype (P = 0.02). Carriers of 5-HTTLPR high (LA LA ), intermediate (LA LG , SLA ) activity variants were more likely to have exhibited self-directed aggression relative to the low activity (LG LG , SLG , SS) variant: high/low: odds ratio (OR) = 2.3, 95% confidence interval (CI) 1.27-4.68, P = 0.007; intermediate/low: OR = 1.96, 95% CI 1.09-3.68, P = 0.025. The CTQ main effect was driven by physical abuse. There was no interactive effect of 5-HTTLPR and CTQ. Secondary logistic regression analyses in (1) all suicide attempters (N = 88) and (2) all self-mutilators (N = 104), compared with controls showed that in both groups, childhood trauma (P = 0.008-0.01), depression (P = 0.0004-0.001) were strong predictors. BGHA, violent behavior in jail predicted self-mutilation (P = 0.002) but not suicide attempts (P = 0.1). This study was able to distinguish differing influences on self-directed aggression between groups of closely related predictor variables within the externalizing behavioral domain. 5-HTTLPR had an independent, variant dosage effect.
Collapse
Affiliation(s)
- E Gorodetsky
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, NIH, Rockville, MD, USA
| | - V Carli
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.,National Center for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden
| | - M Sarchiapone
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.,National Institute of Health for Migration and Poverty, Rome, Italy
| | - A Roy
- Veterans Affairs Medical Center, Psychiatry Service, East Orange, NJ, USA
| | - D Goldman
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, NIH, Rockville, MD, USA
| | - M-A Enoch
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, NIH, Rockville, MD, USA
| |
Collapse
|
17
|
Schiele MA, Ziegler C, Holitschke K, Schartner C, Schmidt B, Weber H, Reif A, Romanos M, Pauli P, Zwanzger P, Deckert J, Domschke K. Influence of 5-HTT variation, childhood trauma and self-efficacy on anxiety traits: a gene-environment-coping interaction study. J Neural Transm (Vienna) 2016; 123:895-904. [PMID: 27145764 DOI: 10.1007/s00702-016-1564-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 04/27/2016] [Indexed: 11/29/2022]
Abstract
Environmental vulnerability factors such as adverse childhood experiences in interaction with genetic risk variants, e.g., the serotonin transporter gene linked polymorphic region (5-HTTLPR), are assumed to play a role in the development of anxiety and affective disorders. However, positive influences such as general self-efficacy (GSE) may exert a compensatory effect on genetic disposition, environmental adversity, and anxiety traits. We, thus, assessed childhood trauma (Childhood Trauma Questionnaire, CTQ) and GSE in 678 adults genotyped for 5-HTTLPR/rs25531 and their interaction on agoraphobic cognitions (Agoraphobic Cognitions Questionnaire, ACQ), social anxiety (Liebowitz Social Anxiety Scale, LSAS), and trait anxiety (State-Trait Anxiety Inventory, STAI-T). The relationship between anxiety traits and childhood trauma was moderated by self-efficacy in 5-HTTLPR/rs25531 LALA genotype carriers: LALA probands maltreated as children showed high anxiety scores when self-efficacy was low, but low anxiety scores in the presence of high self-efficacy despite childhood maltreatment. Our results extend previous findings regarding anxiety-related traits showing an interactive relationship between 5-HTT genotype and adverse childhood experiences by suggesting coping-related measures to function as an additional dimension buffering the effects of a gene-environment risk constellation. Given that anxiety disorders manifest already early in childhood, this insight could contribute to the improvement of psychotherapeutic interventions by including measures strengthening self-efficacy and inform early targeted preventive interventions in at-risk populations, particularly within the crucial time window of childhood and adolescence.
Collapse
Affiliation(s)
- Miriam A Schiele
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany.,Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Christiane Ziegler
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany
| | - Karoline Holitschke
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Christoph Schartner
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany
| | - Brigitte Schmidt
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany
| | - Heike Weber
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany.,Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University Frankfurt, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University Frankfurt, Frankfurt, Germany
| | - Marcel Romanos
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Peter Zwanzger
- kbo-Inn-Salzach-Hospital, Wasserburg am Inn, Germany.,Department of Psychiatry und Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Jürgen Deckert
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany
| | - Katharina Domschke
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Füchsleinstrasse 15, 97080, Würzburg, Germany.
| |
Collapse
|
18
|
Gressier F, Calati R, Serretti A. 5-HTTLPR and gender differences in affective disorders: A systematic review. J Affect Disord 2016; 190:193-207. [PMID: 26519640 DOI: 10.1016/j.jad.2015.09.027] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 09/12/2015] [Accepted: 09/15/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Serotonin transporter-linked polymorphic region (5-HTTLPR) variants have been extensively studied in psychiatric disorders. Although gender effects have been reported, they have not been comprehensively reviewed. The aim of our study was to summarize literature findings on 5-HTTLPR and gender differences in affective disorders. METHODS A systematic search of PubMed, ISI Web of Knowledge, and PsycINFO databases was performed for dates until January 2015. The included articles (n=78) analyzed the association between 5-HTTLPR and affective spectrum disorders, taking into account gender. The quality of each study was assessed through STROBE and CONSORT. RESULTS 5-HTTLPR modulation of affective disorders varied by gender. The S allele (or SS genotype) seemed to be differently associated with an increased risk of depression, depressive symptoms, anxiety traits and symptoms, and symptoms of internalizing behavior among women and an increased risk of aggressiveness, conduct disorder and symptom counts of externalizing behavior among men. Moreover, the presence of stressful life events reinforced the association. Interestingly, these differences seemed to begin with adolescence and were not consistent among the elderly, suggesting a plausible role of hormonal fluctuations. LIMITATIONS The review is limited by the small number of included papers, due to the paucity of information in the literature regarding 5-HTTLPR and gender. CONCLUSIONS 5-HTTLPR variants may exert a differential modulation on a number of features depending on gender. Further studies are needed to more deeply investigate the effect of 5-HTTLPR×gender on the modulation of affective disorders.
Collapse
Affiliation(s)
- F Gressier
- INSERM UMR 1178, Univ Paris Sud, Department of Psychiatry, Assistance Publique-Hôpitaux de Paris, Bicêtre University Hospital, 78 rue du Général Leclerc, 94275 Le Kremlin Bicêtre, France.
| | - R Calati
- INSERM U1061, University of Montpellier, FondaMental Foundation, Montpellier, France
| | - A Serretti
- Department of Biomedical and Neuromotor Science, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy
| |
Collapse
|
19
|
Arpawong TE, Lee J, Phillips DF, Crimmins EM, Levine ME, Prescott CA. Effects of Recent Stress and Variation in the Serotonin Transporter Polymorphism (5-HTTLPR) on Depressive Symptoms: A Repeated-Measures Study of Adults Age 50 and Older. Behav Genet 2015; 46:72-88. [PMID: 26330209 DOI: 10.1007/s10519-015-9740-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 08/21/2015] [Indexed: 12/16/2022]
Abstract
Depending on genetic sensitivity to it, stress may affect depressive symptomatology differentially. Applying the stress-diathesis hypothesis to older adults, we postulate: (1) recent stress will associate with increased depressive symptom levels and (2) this effect will be greater for individuals with at least one short allele of the serotonin transporter gene promoter region (5-HTTLPR). Further, we employ a design that addresses specific limitations of many prior studies that have examined the 5-HTTLPR × SLE relation, by: (a) using a within-person repeated-measures design to address fluctuations that occur within individuals over time, increase power for detecting G × E, and address GE correlation; (b) studying reports of exogenous stressful events (those unlikely to be caused by depression) to help rule out reverse causation and negativity bias, and in order to assess stressors that are more etiologically relevant to depressive symptomatology in older adults. The sample is drawn from the Health and Retirement Study, a U.S. population-based study of older individuals (N = 28,248; mean age = 67.5; 57.3 % female; 80.7 % Non-Hispanic White, 14.9 % Hispanic/Latino, 4.5 % African American; genetic subsample = 12,332), from whom measures of depressive symptoms and exogenous stressors were collected biannually (1994-2010). Variation in the 5-HTTLPR was characterized via haplotype, using two single nucleotide polymorphisms (SNPs). Ordered logit models were constructed to predict levels of depressive symptoms from 5-HTTLPR and stressors, comparing results of the most commonly applied statistical approaches (i.e., comparing allelic and genotypic models, and continuous and categorical predictors) used in the literature. All models were stratified by race/ethnicity. Overall, results show a main effect of recent stress for all ethnic groups, and mixed results for the variation in 5-HTTLPR × stress interaction, contingent upon statistical model used. Findings suggest there may be a differential effect of stressors and 5-HTTLPR on depressive symptoms by ethnicity, but further research is needed, particularly when using a haplotype to characterize variation in 5-HTTLPR in population-based sample with a diverse ethnic composition.
Collapse
Affiliation(s)
- Thalida E Arpawong
- Department of Psychology, University of Southern California, 3620 South McClintock Ave, SGM 501 MC 1061, Los Angeles, CA, 90089-1061, USA.
| | - Jinkook Lee
- Dornsife Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA.,RAND Corporation, Santa Monica, CA, USA
| | - Drystan F Phillips
- Dornsife Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA.,RAND Corporation, Santa Monica, CA, USA
| | - Eileen M Crimmins
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Morgan E Levine
- Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Carol A Prescott
- Department of Psychology, University of Southern California, 3620 South McClintock Ave, SGM 501 MC 1061, Los Angeles, CA, 90089-1061, USA.,Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
20
|
Reinelt E, Barnow S, Stopsack M, Aldinger M, Schmidt CO, John U, Grabe HJ. Social support and the serotonin transporter genotype (5-HTTLPR) moderate levels of resilience, sense of coherence, and depression. Am J Med Genet B Neuropsychiatr Genet 2015; 168B:383-91. [PMID: 25989139 DOI: 10.1002/ajmg.b.32322] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 04/28/2015] [Indexed: 11/08/2022]
Abstract
Gene x environment interactions have mainly been investigated in models of psychopathology. However, the putative interplay between genes and beneficial environmental conditions on positive outcomes has rarely been addressed. We therefore examined the interaction between the serotonin transporter linked polymorphic region (5-HTTLPR) and social support on the sense of coherence (SOC), resilience, and depressive symptoms. Furthermore, we scrutinized our examinations by differentiating between individuals with and without childhood abuse. The sample included 1,811 participants from the general population (Study of Health in Pomerania, Germany). The triallelic genotype of 5-HTTLPR was determined and longitudinal data of social support were used. Among individuals with high social support no significant differences between 5-HTTLPR genotypes regarding all outcome variables were found. However, among those with low social support, carriers of at least one short allele reported significantly increased levels of SOC and resilience, as well as less depressive symptoms than carriers of the l/l genotype. This result was not modified by differentiating between those with childhood abuse and those without. In less supportive social environments the impact of distinct genotypes on behavioral outcomes might be more relevant than in supportive environments where social compensation might take place. Our findings indicate that both alleles of 5-HTTLPR contribute to the adaptability to different environmental conditions.
Collapse
Affiliation(s)
- Eva Reinelt
- Department of Clinical Psychology and Psychotherapy, Ruprecht-Karls-University, Heidelberg, Germany
| | - Sven Barnow
- Department of Clinical Psychology and Psychotherapy, Ruprecht-Karls-University, Heidelberg, Germany
| | - Malte Stopsack
- Department of Clinical Psychology and Psychotherapy, Ruprecht-Karls-University, Heidelberg, Germany
| | - Maren Aldinger
- Department of Clinical Psychology and Psychotherapy, Ruprecht-Karls-University, Heidelberg, Germany
| | - Carsten Oliver Schmidt
- Institute of Epidemiology and Social Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Ulrich John
- Institute of Epidemiology and Social Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Hans Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Helios Hospital Stralsund, Stralsund, Germany
| |
Collapse
|
21
|
Hornor G. Childhood trauma exposure and toxic stress: what the PNP needs to know. J Pediatr Health Care 2015; 29:191-8. [PMID: 25697767 DOI: 10.1016/j.pedhc.2014.09.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 09/11/2014] [Accepted: 09/20/2014] [Indexed: 10/24/2022]
Abstract
Trauma exposure in childhood is a major public health problem that can result in lifelong mental and physical health consequences. Pediatric nurse practitioners must improve their skills in the identification of trauma exposure in children and their interventions with these children. This continuing education article will describe childhood trauma exposure (adverse childhood experiences) and toxic stress and their effects on the developing brain and body. Adverse childhood experiences include a unique set of trauma exposures. The adverse childhood experiences or trauma discussed in this continuing education offering will include childhood exposure to emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, domestic violence, household substance abuse, household mental illness, parental separation or divorce, and a criminal household member. Thorough and efficient methods of screening for trauma exposure will be discussed. Appropriate intervention after identification of trauma exposure will be explored.
Collapse
|
22
|
Wielpuetz C, Kuepper Y, Grant P, Munk AJL, Hennig J. Variations in central serotonergic activity — Relevance of the 5-HTTLPR, life events and their interaction. Behav Brain Res 2015; 277:245-53. [DOI: 10.1016/j.bbr.2013.12.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 11/28/2013] [Accepted: 12/17/2013] [Indexed: 12/14/2022]
|
23
|
Sharpley CF, Palanisamy SKA, Glyde NS, Dillingham PW, Agnew LL. An update on the interaction between the serotonin transporter promoter variant (5-HTTLPR), stress and depression, plus an exploration of non-confirming findings. Behav Brain Res 2014; 273:89-105. [PMID: 25078292 DOI: 10.1016/j.bbr.2014.07.030] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 07/18/2014] [Accepted: 07/21/2014] [Indexed: 11/29/2022]
Abstract
In the three years since the most recent meta-analysis of the association between the serotonin transported promoter polymorphism (5-HTTLPR), stress and the development of depression, another 27 studies have been published on this issue, which is an increase of 50% more studies than were previously reviewed. In addition, previous findings of inconsistency of results across studies argued for further exploration of this relationship. From the 81 studies identified to June 2013, the significant relationship between the short form of the 5-HTTLPR was confirmed (p=.0000009), which is stronger than the relationship reported in the most recent meta-analysis in 2011. However, nearly 26% of the 81 studies reviewed failed to show any significant association between the 5-HTTLPR, stress and depression, and four studies found opposite results to those expected. Examination of the methodologies of all studies failed to indicate any flaws in the opposite or unequivocal studies, and the latter had larger sample sizes than those studies which supported the expected association, arguing that the null results were not an outcome of insufficient statistical power. The need to consider aspects of samples and measures of depression, particularly the presence of subtypes of depression in future research is discussed.
Collapse
Affiliation(s)
- Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, Australia; Centre for Autism Spectrum Disorders, Bond University, Robina, Qld, Australia.
| | - Suresh K A Palanisamy
- Collaborative Network Research, Mental Health and Well-being in Rural and Regional Communities & Centre for Bioactive Discovery in Health and Ageing, University of New England, Armidale, NSW, Australia
| | - Nicarla S Glyde
- School of Science & Technology, University of New England, Armidale, NSW, Australia
| | - Peter W Dillingham
- School of Science & Technology, University of New England, Armidale, NSW, Australia
| | - Linda L Agnew
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, Australia
| |
Collapse
|
24
|
Ugwu ID, Amico F, Carballedo A, Fagan AJ, Frodl T. Childhood adversity, depression, age and gender effects on white matter microstructure: a DTI study. Brain Struct Funct 2014; 220:1997-2009. [PMID: 24744150 DOI: 10.1007/s00429-014-0769-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 04/01/2014] [Indexed: 11/26/2022]
Abstract
Previous diffusion tensor imaging (DTI) studies have shown that various factors can affect white matter (WM) tract diffusivity. The aim of the present study was to investigate the effects of childhood adversity (CA), age and gender on WM diffusivity in tracts that are thought to be involved in emotional regulation in individuals with major depressive disorder (MDD) and healthy controls (HC). DTI was obtained from 46 subjects with MDD and 46 HC subjects. Data were pre-processed and deterministic tractography was applied in the cingulum, uncinate fasciculus (UF), fornix, superior longitudinal fasciculus (SLF) and fronto-occipital fasciculus (FOF). In subjects with a history of CA, fractional anisotropy (FA) was greater in the rostral cingulum (RC) and dorsal cingulum, whereas radial diffusivity (RD) was smaller in the RC when compared with subjects with no history of CA. In the UF, FOF and parahippocampal cingulum, FA was greater in the left hemisphere in the subjects with CA when compared with those without CA. Age affected FA, longitudinal diffusivity and RD in the UF, fornix, FOF and SLF, reflecting axonal and myelin degeneration with increasing age. Depression or gender did not have any effects on the diffusivity measures. Due to the cross-sectional nature of the study, a recall bias for CA and possible effects of medical treatment on diffusivity measures could have played a role. CA and age could increase the likelihood to develop WM microstructural anomalies in the brain affective network. Moreover, subjects with CA could be more vulnerable to FA changes.
Collapse
Affiliation(s)
- Izuchukwu D Ugwu
- Adelaide and Meath Hospital Incorporating the National Children's Hospital, Tallaght, Dublin 24, Dublin, Ireland
| | | | | | | | | |
Collapse
|
25
|
Hornung OP, Heim CM. Gene-environment interactions and intermediate phenotypes: early trauma and depression. Front Endocrinol (Lausanne) 2014; 5:14. [PMID: 24596569 PMCID: PMC3925849 DOI: 10.3389/fendo.2014.00014] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 02/01/2014] [Indexed: 11/16/2022] Open
Abstract
This review focuses on current research developments in the study of gene by early life stress (ELS) interactions and depression. ELS refers to aversive experiences during childhood and adolescence such as sexual, physical or emotional abuse, emotional or physical neglect as well as parental loss. Previous research has focused on investigating and characterizing the specific role of ELS within the pathogenesis of depression and linking these findings to neurobiological changes of the brain, especially the stress response system. The latest findings highlight the role of genetic factors that increase vulnerability or, likewise, promote resilience to depression after childhood trauma. Considering intermediate phenotypes has further increased our understanding of the complex relationship between early trauma and depression. Recent findings with regard to epigenetic changes resulting from adverse environmental events during childhood promote current endeavors to identify specific target areas for prevention and treatment schemes regarding the long-term impact of ELS. Taken together, the latest research findings have underscored the essential role of genotypes and epigenetic processes within the development of depression after childhood trauma, thereby building the basis for future research and clinical interventions.
Collapse
Affiliation(s)
- Orla P. Hornung
- Institute of Medical Psychology, Charité University Medicine Berlin, Berlin, Germany
| | - Christine M. Heim
- Institute of Medical Psychology, Charité University Medicine Berlin, Berlin, Germany
- *Correspondence: Christine M. Heim, Institute of Medical Psychology, Charité University Medicine Berlin, Luisenstraße 57, Berlin 10117, Germany e-mail:
| |
Collapse
|
26
|
Nardi B, Marini A, Turchi C, Arimatea E, Tagliabracci A, Bellantuono C. Role of 5-HTTLPR polymorphism in the development of the inward/outward personality organization: a genetic association study. PLoS One 2013; 8:e82192. [PMID: 24358153 PMCID: PMC3864855 DOI: 10.1371/journal.pone.0082192] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 10/22/2013] [Indexed: 11/18/2022] Open
Abstract
Reciprocity with primary caregivers affects subjects' adaptive abilities toward the construction of the most useful personal meaning organization (PMO) with respect to their developmental environment. Within cognitive theory the post-rationalist approach has outlined two basic categories of identity construction and of regulation of cognitive and emotional processes: the Outward and the Inward PMO. The presence of different, consistent clinical patterns in Inward and Outward subjects is paralleled by differences in cerebral activation during emotional tasks on fMRI and by different expression of some polymorphisms in serotonin pathways. Since several lines of evidence support a role for the 5-HTTLPR polymorphism in mediating individual susceptibility to environmental emotional stimuli, this study was conducted to investigate its influence in the development of the Inward/Outward PMO. PMO was assessed and the 5-HTTLPR polymorphism investigated in 124 healthy subjects who were subdivided into an Inward (n = 52) and an Outward (n = 72) group. Case-control comparisons of short allele (S) frequencies showed significant differences between Inwards and Outwards (p = 0.036, χ2 test; p = 0.026, exact test). Genotype frequencies were not significantly different although values slightly exceeded p≤0.05 (p = 0.056, χ2 test; p = 0.059, exact test). Analysis of the 5-HTTLPR genotypes according to the recessive inheritance model showed that the S/S genotype increased the likelihood of developing an Outward PMO (p = 0.0178, χ2 test; p = 0.0143, exact test; OR = 3.43, CI (95%) = 1.188–9.925). A logistic regression analysis confirmed the association between short allele and S/S genotypes with the Outward PMO also when gender and age were considered. However none of the differences remained significant after correction for multiple testing, even though using the recessive model they approach significance. Overall our data seem to suggest a putative genetic basis for interindividual differences in PMO development.
Collapse
Affiliation(s)
- Bernardo Nardi
- Psychiatric Unit, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy
| | - Alessandra Marini
- Psychiatric Unit, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy
| | - Chiara Turchi
- Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, Italy
- * E-mail:
| | - Emidio Arimatea
- Psychiatric Unit, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy
| | - Adriano Tagliabracci
- Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, Italy
| | - Cesario Bellantuono
- Psychiatric Unit, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy
| |
Collapse
|
27
|
Serotonergic genes and suicide: a systematic review. Eur Neuropsychopharmacol 2013; 23:1125-42. [PMID: 23742855 DOI: 10.1016/j.euroneuro.2013.03.013] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 02/12/2013] [Accepted: 03/24/2013] [Indexed: 12/12/2022]
Abstract
Suicide is one of the leading causes of death in the world. Its aetiology is complex and diverse, however, epidemiological studies show that suicidal behavior is partly heritable. Neurobiological evidence implicates serotonergic dysfunction in suicidality, stimulating genetic research to focus on genes related to the serotonergic system. In this paper, we review evidence from studies examining the association between various serotonergic genes (Tryptophan Hydroxylase genes: TPH1; TPH2, Serotonin Transporter gene: 5-HTTLPR in SLC6A4, Serotonin Receptor genes: HTR1A, HTR2A, HTR1B, HTR2C and Monoamine Oxidase A gene: MAOA) and suicidal behavior. The data show associations between variation on the TPH1 gene and 5-HTTLPR gene and violent suicidal behavior in Caucasian populations, with the least inconsistencies. Results are mixed for the TPH2 gene and serotonin receptor genes, but for some genes, studies that include haplotypic analyses or that examine a larger coding region of the genes tend to provide more reliable results. Findings on endophenotypes of suicidality, such as aggression and impulsivity traits, show positive associations for the TPH1, HTR2A, and MAOA genes, but need further replication, since negative associations are also occasionally reported. Since genes can only partially explain suicidal risk, several studies during the past decade have tried to incorporate environmental factors in the susceptibility model. Studies to date show that variation on the 5-HTTLPR, MAOA and HTR2A gene can interact with stressful life events to increase risk for suicidal behavior. Limitations of case-control studies are discussed and future considerations are put forward with regard to endophenotypic measurements and gene-environment interactions.
Collapse
|
28
|
Wang L, Paul N, Stanton SJ, Greeson JM, Smoski MJ. Loss of sustained activity in the ventromedial prefrontal cortex in response to repeated stress in individuals with early-life emotional abuse: implications for depression vulnerability. Front Psychol 2013; 4:320. [PMID: 23761775 PMCID: PMC3671570 DOI: 10.3389/fpsyg.2013.00320] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 05/17/2013] [Indexed: 11/16/2022] Open
Abstract
Repeated psychosocial stress in early-life has significant impact on both behavior and neural function which, together, increase vulnerability to depression. However, neural mechanisms related to repeated stress remain unclear. We hypothesize that early-life stress may result in a reduced capacity for cognitive control in response to a repeated stressor, particularly in individuals who developed maladaptive emotional processing strategies, namely trait rumination. Individuals who encountered early-life stress but have adaptive emotional processing, namely trait mindfulness, may demonstrate an opposite pattern. Using a mental arithmetic task to induce mild stress and a mindful breathing task to induce a mindful state, we tested this hypothesis by examining blood perfusion changes over time in healthy young men. We found that subjects with early-life stress, particularly emotional abuse, failed to sustain neural activation in the orbitofrontal and ventromedial prefrontal cortex (vmPFC) over time. Given that the vmPFC is known to regulate amygdala activity during emotional processing, we subsequently compared the perfusion in the vmPFC and the amygdala in depression-vulnerable (having early-life stress and high in rumination) and resilient (having early-life stress and high in mindfulness) subjects. We found that depression-vulnerable subjects had increased amygdala perfusion and reduced vmPFC perfusion during the later runs than that during the earlier stressful task runs. In contrast, depression-resilient individuals showed the reverse pattern. Our results indicate that the vmPFC of depression-vulnerable subjects may have a limited capacity to inhibit amygdala activation to repeated stress over time, whereas the vmPFC in resilient individuals may adapt to stress quickly. This pilot study warrants future investigation to clarify the stress-related neural activity pattern dynamically to identify depression vulnerability at an individual level.
Collapse
Affiliation(s)
- Lihong Wang
- Center for Biomedical Research Imaging, Tsinghua University , Beijing , China ; Brain Imaging and Analysis Center, Duke University Medical Center , Durham, NC , USA ; Department of Psychiatry and Behavioral Science, Duke University Medical Center , Durham, NC , USA
| | | | | | | | | |
Collapse
|
29
|
Graham DP, Helmer DA, Harding MJ, Kosten TR, Petersen NJ, Nielsen DA. Serotonin transporter genotype and mild traumatic brain injury independently influence resilience and perception of limitations in veterans. J Psychiatr Res 2013; 47:835-42. [PMID: 23478049 PMCID: PMC3643301 DOI: 10.1016/j.jpsychires.2013.02.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 01/22/2013] [Accepted: 02/14/2013] [Indexed: 02/05/2023]
Abstract
Evidence indicates that individuals with the 5-HTTLPR variant short/short genotype have increased sensitivity to both positive and negative perceptions of perceived social support. The aim of this study was to evaluate this association among Veterans in the context of mild traumatic brain injury (TBI). As part of a larger TBI center, we performed a cross-sectional study of 67 OEF/OIF/OND Veterans (41 with TBI and 26 controls without TBI) who completed the questionnaires and consented to genetic testing. The primary measures included the Connor-Davidson Resilience Scale (CDRISC) and the Perceived Limitations in community participation subscale of the Community Reintegration of Service Members Instrument (CRIS-PL). Both 5-HTTLPR genotype and TBI status were independently associated with the CRIS-PL (p = .009 for genotype, p = .001 for TBI) and the CDRISC (p = .015 for genotype, p = .003 for TBI) scores. This study suggests that both the 5-HTTLPR genotype and TBI status independently, in an almost equal but opposite direction, influence resilience and perceived limitations to social participation. Further, resilience appears more sensitive to perceived limitations in Veterans carrying an S'S' genotype than in L' carriers, but only in the context of having sustained a TBI. While having a TBI appeared to increase a Veteran's sensitivity to social stress, the Veteran's who were L' allele carriers with a TBI fared the worst, with lower resilience and more perceived limitations for community participation compared to L' carrier Veterans without a TBI or Veterans with the S'S' genotype regardless of TBI status.
Collapse
Affiliation(s)
- David P Graham
- Neurorehabilitation: Neurons to Networks Traumatic Brain Injury Center of Excellence, Michael E. DeBakey Veterans Affairs (VA) Medical Center, Houston, TX 77030, USA.
| | | | | | | | | | | |
Collapse
|
30
|
Sharpley CF, Wootten AC, Bitsika V, Christie DRH. Variability Over Time-Since- Diagnosis in the Protective Effect of Psychological Resilience Against Depression in Australian Prostate Cancer Patients. Am J Mens Health 2013; 7:414-22. [DOI: 10.1177/1557988313477126] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Although there is some evidence that psychological resilience may “buffer” against depression following major stressors, no data have been reported on the nature and variability of this buffering effect among prostate cancer patients during the 5 years following their initial diagnosis. Patients from two sites in Australia and who had received their initial diagnosis within 5 years ( n = 255) were surveyed, and the results indicated that there was a significant inverse relationship between resilience and depression in the overall data, but that was mostly accounted for by a single factor of the resilience scale (“Confidence to cope with change”). Variability in that buffering effect was noted over time since diagnosis, with peaks during the first 6 months, at 24 and 60 months. These findings support the argument to develop focused psychiatric interventions at various periods following a diagnosis of prostate cancer.
Collapse
Affiliation(s)
| | - Addie C. Wootten
- University of New England, Armidale, New South Wales, Australia
- Australian Prostate Cancer Research Centre Epworth, Melbourne, Victoria, Australia
| | | | - David R. H. Christie
- University of New England, Armidale, New South Wales, Australia
- Premion, Albion, Queensland, Australia
| |
Collapse
|
31
|
Lee H, Williams RA. Effects of parental alcoholism, sense of belonging, and resilience on depressive symptoms: a path model. Subst Use Misuse 2013; 48:265-73. [PMID: 23302055 PMCID: PMC4782792 DOI: 10.3109/10826084.2012.754899] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This paper explored the relationships between parental alcoholism, sense of belonging, resilience, and depressive symptoms among Koreans in the U.S. Data from 206 Koreans (Mean age = 28.4 years; 59.8% females) living in a Midwestern state were collected in 2009, using a web-based survey, which included Children of Alcoholic Screening Test, Sense of Belonging Instrument, Connor-Davidson Resilience Scale, and Beck Depression Inventory-II. Path analysis results revealed sense of belonging as the most powerful, and resilience as the second important factor, resisting depressive symptoms associated with parental alcoholism. Implications for practice and research and study limitations are discussed. The study's limitations are noted.
Collapse
Affiliation(s)
- Hyunhwa Lee
- Intramural Research Program, NIH NINR, Bethesda, MD 20895, USA.
| | | |
Collapse
|
32
|
Hemmings SMJ, Martin LI, Klopper M, van der Merwe L, Aitken L, de Wit E, Black GF, Hoal EG, Walzl G, Seedat S. BDNF Val66Met and DRD2 Taq1A polymorphisms interact to influence PTSD symptom severity: a preliminary investigation in a South African population. Prog Neuropsychopharmacol Biol Psychiatry 2013; 40:273-80. [PMID: 23103549 DOI: 10.1016/j.pnpbp.2012.10.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 10/15/2012] [Accepted: 10/17/2012] [Indexed: 12/16/2022]
Abstract
BACKGROUND We evaluated the role that selected variants in serotonin transporter (5-HTT), dopamine receptor 2 (DRD2) and brain-derived neurotrophic factor (BDNF) genes play in PTSD symptom severity in an at-risk population. We also investigated the interaction between the genetic variants to determine whether these variables and the interactions between the variables influenced the severity of PTSD symptoms. METHODS PTSD symptoms were quantitatively assessed using the Davidson Trauma Scale (DTS) in 150 participants from an at-risk South African population. All participants were genotyped for the 5-HTTLPR, DRD2 Taq1A and BDNF Val66Met polymorphisms. Gene-gene interactions were investigated using various linear models. All analyses were adjusted for age, gender, major depressive disorder diagnosis, level of resilience, level of social support and alcohol dependence. RESULTS A significant interaction effect between DRD2 Taq1A and BDNF Val66Met variants on DTS score was observed. On the background of the BDNF Val66Val genotype, DTS score increased significantly with the addition of a DRD2 Taq1A A1 allele. However, on the BDNF Met66 allele background, the addition of an A1 allele was found to reduce total DTS score. CONCLUSIONS This study provides preliminary evidence for an epistatic interaction between BDNF Val66Met and DRD2 Taq1A polymorphisms on the severity of PTSD symptoms, where both too little and too much dopamine can result in increased PTSD symptom severity.
Collapse
Affiliation(s)
- Sian M J Hemmings
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Abstract
AbstractThe past decade has witnessed an exponential growth in studies that have attempted to identify the genetic polymporphisms that moderate the influence of environmental risks on mental disorders. What tends to be neglected in these Gene × Environment (G × E) interaction studies has been a focus on resilience, which refers to a dynamic pattern of positive adaptation despite the experience of a significant trauma or adversity. In this article, we argue that one step toward advancing the field of developmental psychopathology would be for G × E research to consider resilience instead of focusing almost exclusively on mental disorders. After providing an up-to-date summary on the expanding definitions and models of resilience, and the available evidence regarding measured G × E studies of childhood maltreatment, we discuss why resilience would be a worthwhile phenotype for studies of measured G × E. First, although G × E hypotheses require that there be an environmental risk (e-risk) involved in a causal process that leads to psychopathology, e-risks are typically not included in the diagnostic criteria for most psychiatric disorders. In contrast, resilience by definition includes an e-risk. Second, G × E hypotheses require that there is evidence of variability in response to an environmental stressor, and resilience often represents the positive end on this continuum of adaptation. Third, both resilience and G × E are best understood from a developmental perspective. Fourth, although resilient outcomes are not public health concerns, the types of adversities (e.g., childhood maltreatment, poverty, or exposure to natural disasters) that are often investigated in studies of resilience certainly are. Understanding how some individuals, perhaps because of their genetic makeup, are able to withstand such adversities can inform prevention and intervention efforts to improve mental health.
Collapse
|
34
|
|