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Hu H, Zarate CA, Verbalis J. Arginine vasopressin in mood disorders: A potential biomarker of disease pathology and a target for pharmacologic intervention. Psychiatry Clin Neurosci 2024. [PMID: 38923665 DOI: 10.1111/pcn.13703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 05/15/2024] [Accepted: 05/24/2024] [Indexed: 06/28/2024]
Abstract
Vasopressin or arginine-vasopressin (AVP) is a neuropeptide molecule known for its antidiuretic effects and serves to regulate plasma osmolality and blood pressure. The existing literature suggests that AVP plays a multifaceted-though less well-known-role in the central nervous system (CNS), particularly in relation to the pathophysiology and treatment of mood disorders. Animal models have demonstrated that AVP is implicated in regulating social cognition, affiliative and prosocial behaviors, and aggression, often in conjunction with oxytocin. In humans, AVP is implicated in mood disorders through its effects on the hypothalamic-pituitary-adrenal (HPA) axis as well as on the serotoninergic and glutamatergic systems. Measuring plasma AVP has yielded interesting but mixed results in mood and stress-related disorders. Recent advances have led to the development of copeptin as a stable and reliable surrogate biomarker for AVP. Another interesting but relatively unexplored issue is the interaction between the osmoregulatory system and mood disorder pathophysiology, given that psychotropic medications often cause dysregulation of AVP receptor expression or signaling that can subsequently lead to clinical syndromes like syndrome of inappropriate diuresis and diabetes insipidus. Finally, pharmaceutical trials of agents that act on V1a and V1b receptor antagonists are still underway. This narrative review summarizes: (1) the neurobiology of the vasopressinergic system in the CNS; (2) the interaction between AVP and the monoaminergic and glutamatergic pathways in the pathophysiology and treatment of mood disorders; (3) the iatrogenic AVP dysregulation caused by psychotropic medications; and (4) the pharmaceutical development of AVP receptor antagonists for the treatment of mood disorders.
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Affiliation(s)
- Hiroe Hu
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Joseph Verbalis
- Department of Endocrinology, Georgetown University, Washington, District of Columbia, USA
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Zhang Y, Gong L, Feng Q, Hu K, Liu C, Jiang T, Zhang Q. Association between negative life events through mental health and non-suicidal self-injury with young adults: evidence for sex moderate correlation. BMC Psychiatry 2024; 24:466. [PMID: 38914977 PMCID: PMC11197180 DOI: 10.1186/s12888-024-05880-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 05/31/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) has exhibited an increasing trend in recent years and is now globally recognized as a major public health problem among adolescents and young adults. Negative life events (NLEs) are positively associated with NSSI. We sought to explore (1) whether sex plays a role in the risk of NLEs leading to NSSI and (2) the role played by mental health (MH). METHODS We adopted a multi-stage cluster sampling method to select college students across four grades from May to June 2022. Generalized linear models were used to evaluate the relationships between NLEs, sex, MH and NSSI, presented as incidence-rate ratios (RRs) with 95% confidence intervals (CIs). We examined the complex relationship between these variables using the PROCESS method for moderation analysis. RESULTS Following the exclusion of data that did not meet the study requirements, data from 3,578 students (mean age: 20.53 [± 1.65] years) were included. Poisson regression results indicate that high-level NLEs (RR = 0.110, 95%CI: 0.047-0.173) are associated with increased NSSI. Furthermore, interaction effects were observed among sex, NLEs and NSSI. MH and sex moderated the relationship between NLEs and NSSI. CONCLUSION Identifying risk factors for NSSI is also important when exploring the interaction between NLEs and MH given the potential for NSSI to significantly increase the risk of later psychopathological symptoms and substance abuse problems. In addition, the significance of sex differences in risk factors for NSSI should be determined. This study evaluated how the impact of NLEs on NSSI can be reduced among adolescents from multiple perspectives.
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Affiliation(s)
- Yi Zhang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Li Gong
- Wuxi Huishan District People's Hospital, Wuxi, Jiangsu, 214187, China
| | - Qing Feng
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
| | - Keyan Hu
- The First Affiliated Hospital, College of Clinical Medicine of Henan, University of Science and Technology, Luoyang, Henan, 471003, China
| | - Chao Liu
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
| | - Tian Jiang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China.
| | - Qiu Zhang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China.
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Chen S, Fu T, Wang Y, Sun G. Childhood trauma, psychache, and depression among university students: a moderated mediation model. Front Psychiatry 2024; 15:1414105. [PMID: 38979495 PMCID: PMC11228253 DOI: 10.3389/fpsyt.2024.1414105] [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: 04/08/2024] [Accepted: 06/10/2024] [Indexed: 07/10/2024] Open
Abstract
Background Childhood trauma is a potential threat to depression and can have a lifelong impact on the mental health of university students. Our study aimed to construct a moderated mediation model to explore the relationship between childhood trauma, psychache, ambivalence over emotional expression, physical activity, and depression in university students. Methods A cross-sectional study was conducted in three universities in China, recruiting 476 university students using self-report questionnaires. The moderated mediation model was examined using the SPSS PROCESS model 21. Results Ambivalence over emotional expression (F=12.843), childhood trauma (F=117.639), and psychache (F=581.594) all had a significant positive effect on depression (p<0.001), explaining 2.9%, 21.7%, and 56.8% of the variance, respectively. On the chain of influence between childhood trauma and depression, the mediating effect of psychache, the moderating effect of ambivalence over emotional expression, and the moderating effect of physical activity are all significant the overall indirect effect value of the three is 0.287, accounting for 61.59% of the total effect. Conclusion This study investigated the relationship between childhood trauma, ambivalence over emotional expression, psychache, physical activity, and depression in university students. Future interventions should focus on developing good emotional expression among university students, increasing opportunities for physical activity, and reducing psychache to reduce depression.
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Affiliation(s)
- Shufeng Chen
- School of Physical Education, Shandong University, Jinan, China
| | - Tiantian Fu
- School of Physical Education, Shandong University, Jinan, China
| | - Yiwen Wang
- School of Physical Education, Shandong University, Jinan, China
| | - Guoxiao Sun
- School of Physical Education, Shandong University, Jinan, China
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Richardson T, Egglishaw A, Sood M. Does Childhood Trauma Predict Impulsive Spending in Later Life? An Analysis of the Mediating Roles of Impulsivity and Emotion Regulation. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:275-281. [PMID: 38938974 PMCID: PMC11199441 DOI: 10.1007/s40653-023-00600-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 06/29/2024]
Abstract
We sought to investigate whether adverse childhood experiences increase impulsive spending in later life, and whether emotion dysregulation and impulsivity mediate this association. Limited research has examined associations between these factors, and examining the mechanisms involved may inform interventions for impulsive spending. This study used a cross-sectional, correlational design including 189 adult participants who completed an online survey assessing childhood trauma, adverse childhood experiences, impulsive spending, impulsivity, and emotion dysregulation. Greater adverse childhood experiences and childhood trauma were positively correlated with impulsive spending, as well as general impulsivity and emotion dysregulation. Mediation analyses indicated that emotion dysregulation and greater impulsivity accounted for the positive relationship between childhood trauma and impulse spending. Adverse childhood experiences and childhood trauma are associated with increased risk of impulse spending in adulthood via elevated general impulsivity and emotion dysregulation.
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Affiliation(s)
- Thomas Richardson
- School of Psychology, University of Southampton, Building 44, Highfield Campus, University Road, Southampton, SO17 1BJ England, UK
| | - Annelise Egglishaw
- School of Psychology, University of Southampton, Building 44, Highfield Campus, University Road, Southampton, SO17 1BJ England, UK
| | - Monica Sood
- School of Psychology, University of Southampton, Building 44, Highfield Campus, University Road, Southampton, SO17 1BJ England, UK
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Qin Q, Jiang Y, Mei X, Zhu Y, Li H, Li S, Chen K, Zhang C, Wang X, Bai H, Zhang J, Wang W. The effect of childhood trauma on depression in college students: A moderated mediation model. J Affect Disord 2024; 352:490-497. [PMID: 38403134 DOI: 10.1016/j.jad.2024.02.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/05/2024] [Accepted: 02/17/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE Childhood trauma is considered as a critical risk factor for depression. Although many studies have investigated the pathway of Childhood trauma to depression, especially the mediating or moderating effects of cognitive emotion regulation strategies or neuroticism or stress perception, the results were inconsistent and the underlying psychological mechanisms of depression remain unclear. This study aims to explore the influence and mechanism of childhood trauma on depression in college students, and establish a full model among these interactive factors. METHODS 1272 college students were surveyed using the childhood trauma questionnaire (CTQ), short version of center for epidemiologic studies depression scale (CES-D), Chinese perceived stress scale (CPSS), neuroticism extraversion openness five-factor inventory (NEO-FFI), and the Cognitive Emotion Regulation Questionnaire (CERQ). RESULTS (1) Childhood trauma, neuroticism, stress perception, and maladaptive cognitive emotion regulation strategies were all significantly and positively correlated with depression among college students; (2) Stress perception and neuroticism act as a chain mediator between childhood trauma and depression in college students. (3) Maladaptive cognitive emotion regulation strategies play a moderating role in "childhood trauma-neuroticism-depression". CONCLUSION Childhood trauma increases the risk of depression in college students by affecting neuroticism and stress perception, and high levels of maladaptive cognitive emotion regulation strategies link neuroticism and enhance the effect of childhood trauma on depression in college students.
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Affiliation(s)
- Qiyue Qin
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Yulian Jiang
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Xian Mei
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China; School of Qian Xuesen College, Xi'an Jiaotong University, Xi'an, Shanxi 710049, China
| | - Yuqiong Zhu
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Hui Li
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Shuxuan Li
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Kexin Chen
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Chen Zhang
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Xiucheng Wang
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Huaiyu Bai
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Jing Zhang
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China.
| | - Wenjuan Wang
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China.
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Miguel-Alvaro A, Messman BA, Weiss NH, Contractor AA. Do childhood experiences influence associations between posttraumatic stress disorder symptoms and positive autobiographical memories among military veteran students? An exploratory study. Memory 2024; 32:540-551. [PMID: 38727529 PMCID: PMC11262963 DOI: 10.1080/09658211.2024.2348685] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 04/16/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Evidence links posttraumatic stress disorder (PTSD) symptoms and features of positive autobiographical memories (accessibility, vividness, coherence, sharing, emotional intensity, distancing). There is a knowledge gap on how adverse childhood experiences (ACEs) and benevolent childhood experiences (BCEs) may influence these relationships. OBJECTIVES The current study explored whether the number ACEs or BCEs moderated associations between PTSD symptom severity and features of positive autobiographical memories. DESIGN AND METHODS The sample included 124 student military veterans who had experienced a trauma (Mage = 33.90; 77.4% male; 75.0% White). RESULTS Path analyses showed more PTSD symptom severity was significantly associated with less positive autobiographical memory vividness (β = -0.26, p = .019, R2 = 0.06). Further, the number of ACEs moderated the relationship between PTSD symptom severity and positive autobiographical memory accessibility (β = -0.25, p = .023, R2 = 0.10) and vividness (β = -0.20, p = .024, R2 = 0.10). Among individuals with more ACEs (1 SD above the mean) compared to those with fewer ACEs (1 SD below the mean), less accessibility and vividness of positive autobiographical memories was associated with greater PTSD symptom severity. The number of BCEs was not a significant moderator. CONCLUSIONS Positive memory-based interventions may be particularly useful to address PTSD symptoms among military veterans with a history of childhood adversity.
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Affiliation(s)
| | - Brett A Messman
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
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Hsueh YZ, Huang CY, Kuo PH, Cheng YC, Huang MC, Chiu CC, Kuo CJ, Chen PY, Chen WY. Cluster analysis exploring the impact of childhood neglect on cognitive function in patients with bipolar disorder. Int J Bipolar Disord 2024; 12:13. [PMID: 38676782 PMCID: PMC11055839 DOI: 10.1186/s40345-024-00335-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a severe mental disorder related to neurocognitive deficits. Exposure to childhood trauma is associated with worse cognitive performance. Different compositions of childhood trauma in BD and their impacts on cognition are rarely reported. METHODS We used the Brief Assessment of Cognition in Affective Disorders (BAC-A) to assess cognitive performance and the Chinese version of the Short Form of the Childhood Trauma Questionnaire (C-CTQ-SF) to assess childhood trauma experience among 55 euthymic BD patients. Cluster analysis was applied to dissect their childhood trauma experiences, which revealed three distinct clusters: a low trauma group, neglect-focus group, and multiple-trauma-experience group. We compared the cognitive function between the three clusters and used a generalized linear model to evaluate the impact of childhood neglect on cognitive domains. RESULTS The neglect-focus cluster showed prominent exposures to physical and emotional neglect (41.8%). BD patients in this cluster performed worse in BAC-A compared with patients in the multiple trauma cluster, especially in working memory and processing speed. The neglect-focus group revealed a significant negative effect on the composite score (ß = -0.904, p = 0.025) and working memory (ß = -1.150, p = 0.002) after adjusting sex, age, education year, BMI and total psychotropic defined daily dose. CONCLUSIONS Distinct patterns of childhood trauma experience are seen in BD patients and are related with different cognitive profiles. Early exposure of neglect-focus trauma was associated with the worst cognitive performance in current study. Further studies investigating the intensity of the neglect, as well as individual resilience and coping mechanisms in BD, are warranted.
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Affiliation(s)
- Yuan-Zhi Hsueh
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan
| | - Cho-Yin Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ying-Chih Cheng
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan
| | - Ming-Chyi Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chih Chiang Chiu
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chian-Jue Kuo
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Po-Yu Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wen-Yin Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan.
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan.
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
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Negrón-Oyarzo I, Dib T, Chacana-Véliz L, López-Quilodrán N, Urrutia-Piñones J. Large-scale coupling of prefrontal activity patterns as a mechanism for cognitive control in health and disease: evidence from rodent models. Front Neural Circuits 2024; 18:1286111. [PMID: 38638163 PMCID: PMC11024307 DOI: 10.3389/fncir.2024.1286111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/11/2024] [Indexed: 04/20/2024] Open
Abstract
Cognitive control of behavior is crucial for well-being, as allows subject to adapt to changing environments in a goal-directed way. Changes in cognitive control of behavior is observed during cognitive decline in elderly and in pathological mental conditions. Therefore, the recovery of cognitive control may provide a reliable preventive and therapeutic strategy. However, its neural basis is not completely understood. Cognitive control is supported by the prefrontal cortex, structure that integrates relevant information for the appropriate organization of behavior. At neurophysiological level, it is suggested that cognitive control is supported by local and large-scale synchronization of oscillatory activity patterns and neural spiking activity between the prefrontal cortex and distributed neural networks. In this review, we focus mainly on rodent models approaching the neuronal origin of these prefrontal patterns, and the cognitive and behavioral relevance of its coordination with distributed brain systems. We also examine the relationship between cognitive control and neural activity patterns in the prefrontal cortex, and its role in normal cognitive decline and pathological mental conditions. Finally, based on these body of evidence, we propose a common mechanism that may underlie the impaired cognitive control of behavior.
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Affiliation(s)
- Ignacio Negrón-Oyarzo
- Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
| | - Tatiana Dib
- Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
| | - Lorena Chacana-Véliz
- Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
- Programa de Doctorado en Ciencias Mención en Neurociencia, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
| | - Nélida López-Quilodrán
- Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
- Programa de Doctorado en Ciencias Mención en Neurociencia, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
| | - Jocelyn Urrutia-Piñones
- Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
- Programa de Doctorado en Ciencias Mención en Neurociencia, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
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Brewerton TD, Gavidia I, Suro G, Perlman MM. Associations between major depressive and bipolar disorders and eating disorder, PTSD, and comorbid symptom severity in eating disorder patients. EUROPEAN EATING DISORDERS REVIEW 2024; 32:188-200. [PMID: 37788327 DOI: 10.1002/erv.3035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 09/05/2023] [Accepted: 09/20/2023] [Indexed: 10/05/2023]
Abstract
OBJECTIVE Major depressive disorder (MDD) and bipolar disorder (BD) are commonly comorbid with eating disorders (EDs). However, there is limited data about the clinical features of such patients, especially their association with traumatic histories and PTSD, which occur commonly in patients admitted to residential treatment. METHODS Adults (≥18 years, 91% female, n = 2155) admitted to residential ED treatment were evaluated upon admission for DSM-5 defined MDD and BD. Patients were divided into three groups based on an admission diagnosis of no mood disorder (NMD), MDD, and BD (types I and II) and compared on a number of demographic variables, clinical features and assessments. RESULTS Mood disorders occurred in 76.4% of participants. There were statistically significant differences across groups in most measures with the BD group showing higher rates and doses of traumatic events; higher current PTSD; higher BMIs; higher severity of ED, depression and state-trait anxiety symptoms; worse quality of life; and higher rates of substance use disorders. Similarly, the MDD group had higher rates than the NMD group on most measures. CONCLUSIONS These findings have important implications for prevention, treatment and long-term follow-up and highlight the need for early trauma-focused treatment of ED patients with comorbid mood disorders and PTSD.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
- Timothy D. Brewerton, MD, LLC, Mt. Pleasant, South Carolina, USA
- Monte Nido and Affiliates, Miami, Florida, USA
| | | | - Giulia Suro
- Monte Nido and Affiliates, Miami, Florida, USA
| | - Molly M Perlman
- Monte Nido and Affiliates, Miami, Florida, USA
- Department of Psychiatry and Behavioral Health, Florida International University Herbert Wertheim College of Medicine, Miami, Florida, USA
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Yilgör A, Kurhan F. Is Childhood Trauma a Risk Factor for Resistant Epilepsy? JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:1228-1244. [PMID: 37815052 DOI: 10.1177/08862605231203964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Childhood traumas have been considered risk factors for many psychiatric disorders. Recent studies demonstrated that childhood traumas can also be considered risk factors for neurological diseases. In this context, the objective of this study is to investigate the effects of childhood traumas on treatment resistance in patients with epilepsy. The study sample consisted of 85 epilepsy patients, 40 male and 45 female, who were diagnosed and followed up by a neurologist. Of these patients, 45 were being followed up with the diagnosis of refractory epilepsy, and 40 were being followed up with the diagnosis of treatment-responsive epilepsy. Cranial magnetic resonance imaging and electroencephalography were performed on all patients. In addition, all patients were administered childhood trauma questionnaire (CTQ) and Hamilton depression rating scale (HAM-D). Epilepsy patients included in the study were divided into refractory epilepsy and treatment-responsive epilepsy groups. There was no significant difference between the groups in sociodemographic characteristics. On the other hand, total CTQ and all CTQ subscale scores and HAM-D scores were significantly higher in the refractory epilepsy group than in the treatment-responsive epilepsy group. This study demonstrates that childhood traumas may contribute to treatment resistance in epilepsy patients. Therefore, it is recommended that a history of childhood traumas be routinely queried in the treatment of epilepsy patients.
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Affiliation(s)
- Abdullah Yilgör
- Faculty of Medicine, Department of Neurology, Van Yuzuncu Yil University, Turkey
| | - Faruk Kurhan
- Faculty of Medicine, Department of Psychiatry, Van Yuzuncu Yil University, Turkey
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Qu G, Liu H, Ma S, Han T, Zhang H, Sun L, Qin Q, Chen M, Sun Y. Inflammatory burden of adolescents with childhood maltreatment: results from baseline data of a school cohort. Eur Child Adolesc Psychiatry 2024; 33:539-548. [PMID: 36877251 DOI: 10.1007/s00787-023-02181-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 02/27/2023] [Indexed: 03/07/2023]
Abstract
Increasing studies have investigated inflammatory burden of adults with childhood adversity, but less is known about how childhood maltreatment affects the inflammation level of adolescents. Baseline data of a school cohort of physical and mental health status and life experience survey on primary and secondary school students in Anhui Province, China was used. Childhood maltreatment of children and adolescents was assessed by Chinese version of Childhood Trauma Questionnaire-Short Form (CTQ-SF). Urine samples were collected to assess levels of soluble urokinase Plasminogen Activator Receptor (suPAR), C-reactive protein (CRP) and cytokines interleukin-6 (IL-6) by enzyme-linked immunosorbent assay (ELISA). Logistic regression was conducted to examine the association between childhood maltreatment exposure and risk of high inflammation burden. A total of 844 students were included with mean age 11.41 ± 1.57 years old. Adolescents with emotional abuse were significantly more likely to have high level of IL-6 (OR = 3.59, 95% CI 1.16-11.14). In addition, adolescents with emotional abuse were more likely to show high IL-6 and high suPAR combination (OR = 33.41, 95% CI 1.69-659.22), and high IL-6 and low CRP combination (OR = 4.34, 95% CI 1.29-14.55). Subgroup analyses showed that emotional abuse was associated with high IL-6 burden among boys or adolescents with depression. Childhood emotional abuse was positively associated with higher burden of IL-6. Early detection and prevention of emotional abuse for children and adolescents, especially for boys or adolescents with depression status, may be helpful for preventing elevated inflammatory burden and related health problems.
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Affiliation(s)
- Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shaodi Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Tiantian Han
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Huimei Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Liang Sun
- Fuyang Center for Disease Control and Prevention, No.19, Zhongnan Avenue, Fuyang, 236000, Anhui, China
| | - Qirong Qin
- Ma'anshan Center for Disease Control and Prevention, No.849, Jiangdong Avenue, Ma'anshan, 243000, Anhui, China
| | - Mingchun Chen
- Changfeng Center for Disease Control and Prevention, Changfeng, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
- Chaohu Hospital, Anhui Medical University, Hefei, 238000, Anhui, China.
- Center for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
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Fine NB, Neuman Fligelman E, Carlton N, Bloch M, Hendler T, Helpman L, Seligman Z, Armon DB. Integration of limbic self-neuromodulation with psychotherapy for complex post-traumatic stress disorder: treatment rationale and case study. Eur J Psychotraumatol 2024; 15:2256206. [PMID: 38166532 PMCID: PMC10769120 DOI: 10.1080/20008066.2023.2256206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/24/2023] [Indexed: 01/04/2024] Open
Abstract
Treatment Rationale: Exposure to repeated sexual trauma, particularly during childhood, often leads to protracted mental health problems. Childhood adversity is specifically associated with complex posttraumatic stress disorder (PTSD) presentation, which is particularly tenacious and treatment refractory, and features severe emotion dysregulation. Augmentation approaches have been suggested to enhance treatment efficacy in PTSD thus integrating first-line psychotherapy with mechanistically informed self-neuromodulation procedures (i.e. neurofeedback) may pave the way to enhanced clinical outcomes. A central neural mechanism of PTSD and emotion dysregulation involves amygdala hyperactivity that can be volitionally regulated by neurofeedback. We outline a treatment rationale that includes a detailed justification for the potential of combining psychotherapy and NF and delineate mechanisms of change. We illustrate key processes of reciprocal interactions between neurofeedback engagement and therapeutic goals.Case Study: We describe a clinical case of a woman with complex PTSD due to early and repetitive childhood sexual abuse using adjunctive neurofeedback as an augmentation to an ongoing, stable, traditional treatment plan. The woman participated in (a) ten sessions of neurofeedback by the use of an fMRI-inspired EEG model of limbic related activity (Amygdala Electrical-Finger-Print; AmygEFP-NF), (b) traditional weekly individual psychotherapy, (c) skills group. Before and after NF training period patient was blindly assessed for PTSD symptoms, followed by a 1, 3- and 6-months self-report follow-up. We demonstrate mechanisms of change as well as the clinical effectiveness of adjunctive treatment as indicated by reduced PTSD symptoms and improved daily functioning within this single case.Conclusions: We outline an integrative neuropsychological framework for understanding the unique mechanisms of change conferring value to conjoining NF applications with trauma-focused psychotherapy in complex PTSD.
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Affiliation(s)
- Naomi B. Fine
- Faculty of Social Sciences, School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Sagol Brain Institute Tel-Aviv, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Ellie Neuman Fligelman
- Lotem Center for Treatment of Sexual Trauma, Department of Psychiatry, Sourasky Medical Center, Tel Aviv, Israel
| | - Nora Carlton
- Lotem Center for Treatment of Sexual Trauma, Department of Psychiatry, Sourasky Medical Center, Tel Aviv, Israel
| | - Miki Bloch
- Psychiatric Department, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Talma Hendler
- Faculty of Social Sciences, School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Sagol Brain Institute Tel-Aviv, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Liat Helpman
- Psychiatric Department, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Department of Counseling and Human Development, University of Haifa, Haifa, Israel
| | - Zivya Seligman
- Lotem Center for Treatment of Sexual Trauma, Department of Psychiatry, Sourasky Medical Center, Tel Aviv, Israel
| | - Daphna Bardin Armon
- Lotem Center for Treatment of Sexual Trauma, Department of Psychiatry, Sourasky Medical Center, Tel Aviv, Israel
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13
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Fine NB, Helpman L, Armon DB, Gurevitch G, Sheppes G, Seligman Z, Hendler T, Bloch M. Amygdala-related electroencephalogram neurofeedback as add-on therapy for treatment-resistant childhood sexual abuse posttraumatic stress disorder: feasibility study. Psychiatry Clin Neurosci 2024; 78:19-28. [PMID: 37615935 DOI: 10.1111/pcn.13591] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 08/25/2023]
Abstract
AIM Childhood sexual abuse (CSA) among women is an alarmingly prevalent traumatic experience that often leads to debilitating and treatment-refractory posttraumatic stress disorder (PTSD), raising the need for novel adjunctive therapies. Neuroimaging investigations systematically report that amygdala hyperactivity is the most consistent and reliable neural abnormality in PTSD and following childhood abuse, raising the potential of implementing volitional neural modulation using neurofeedback (NF) aimed at down-regulating amygdala activity. This study aimed to reliably probe limbic activity but overcome the limited applicability of functional magnetic resonance imaging (fMRI) NF by using a scalable electroencephalogram NF probe of amygdala-related activity, termed amygdala electrical-finger-print (amyg-EFP) in a randomized controlled trial. METHOD Fifty-five women with CSA-PTSD who were in ongoing intensive trauma-focused psychotherapy for a minimum of 1 year but still met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) PTSD criteria were randomized to either 10 add-on sessions of amyg-EFP-NF training (test group) or continuing psychotherapy (control group). Participants were blindly assessed for PTSD symptoms before and after the NF training period, followed by self-reported clinical follow-up at 1, 3, and 6 months, as well as one session of amygdala real-time fMRI-NF before and after NF training period. RESULTS Participants in the test group compared with the control group demonstrated a marginally significant immediate reduction in PTSD symptoms, which progressively improved during the follow-up period. In addition, successful neuromodulation during NF training was demonstrated. CONCLUSION This feasibility study for patients with treatment-resistant CSA-PTSD indicates that amyg-EFP-NF is a viable and efficient intervention.
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Affiliation(s)
- Naomi B Fine
- School of Psychological Sciences, Faculty of Social Sciences, Tel-Aviv University, Tel Aviv, Israel
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Liat Helpman
- Womens' Reproductive Mental Health research Unit, Psychiatric Department, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Department of Counseling and Human Development, University of Haifa, Haifa, Israel
| | - Daphna Bardin Armon
- Lotem Center for Treatment of Sexual Trauma, Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Guy Gurevitch
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Gal Sheppes
- School of Psychological Sciences, Faculty of Social Sciences, Tel-Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Zivya Seligman
- Lotem Center for Treatment of Sexual Trauma, Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Talma Hendler
- School of Psychological Sciences, Faculty of Social Sciences, Tel-Aviv University, Tel Aviv, Israel
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Miki Bloch
- Womens' Reproductive Mental Health research Unit, Psychiatric Department, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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14
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Jin X, Wang Y, Huang C, Luo X, Gao X, Shen Y. The association between childhood maltreatment and internet addiction among Chinese junior middle school students: prospective cohort study. BJPsych Open 2023; 10:e5. [PMID: 38053389 PMCID: PMC10755546 DOI: 10.1192/bjo.2023.606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/04/2023] [Accepted: 10/12/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Childhood maltreatment is associated with internet addiction, but most evidence is from retrospective studies. AIMS We aimed to investigate the relationship between childhood maltreatment and internet addiction through a prospective cohort design. METHOD In a prospective cohort study, self-reported data on childhood maltreatment (Childhood Trauma Questionnaire - Short Form) at baseline, and internet addiction (Revised Chinese Internet Addiction Scale) at baseline and 6-month follow-up, were collected online from 756 Chinese junior middle school students aged 11-15 years and residing in Changsha, Hunan Province. Demographic data and covariates such as depression, anxiety, stress (Depression, Anxiety, and Stress Scale 21) and insomnia (Athens Insomnia Scale) were also surveyed at baseline. Logistic regression analysis measured the association between childhood maltreatment and internet addiction, and gender-related differences. RESULTS Childhood maltreatment was prevalent in Chinese junior middle school students (37.83%), and the incidence rate of internet addiction was 9.26% at the 6-month follow-up. Emotional abuse was a significant risk factor for internet addiction (adjusted odds ratio 2.618, 95% CI 1.194-5.738; P = 0.016) in both males and females. CONCLUSIONS This study suggests a high prevalence of childhood maltreatment in Chinese junior middle school students, and that emotional abuse plays a significant role in internet addiction. More attention should be paid to parenting style and adolescents' mental health.
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Affiliation(s)
- Xingyue Jin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yuxin Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Chunxiang Huang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xuerong Luo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xueping Gao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yanmei Shen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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15
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Liang Y, Yang L. Sex Differences in Complex Posttraumatic Stress Disorder Network among Chinese Young Adults. Behav Sci (Basel) 2023; 13:846. [PMID: 37887496 PMCID: PMC10604758 DOI: 10.3390/bs13100846] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023] Open
Abstract
Evidence suggests that sex differences commonly occur in trauma-related disorders. The current study aims to explore sex differences in complex posttraumatic stress disorder (CPTSD) symptom networks among Chinese young adults with childhood trauma. The current study utilized a representative sample of college students in Beijing and included 1416 participants (409 men and 907 women) who had childhood trauma experience. CPTSD symptoms were evaluated using the International Trauma Questionnaire. Regularized partial correlation network analysis and Bayesian network analysis were used to estimate the network structure and possible causality of CPTSD symptoms for both sexes. Male and female CPTSD symptom networks had differences in strength centrality and bridge centrality. Nightmares and feelings of failure had the highest strength centrality, and long-term upset and nightmares had the highest bridge centrality for men. Hypervigilance and feelings of failure had the highest strength centrality, and long-term upset and exaggerated startle response had the highest bridge centrality for women. The current study provides the first evidence of sex differences in the CPTSD symptom network among Chinese young adults with childhood trauma. Young men and women differed in highly central symptoms, which may speak to sex specificity in the main manifestations of CPTSD symptoms.
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Affiliation(s)
- Yiming Liang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
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16
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Shold JN, Maurer JM, Reynolds BL, Gullapalli AR, Allen CH, Edwards BG, Anderson NE, Harenski CL, Neumann CS, Kiehl KA. Psychometric properties of the Trauma Checklist 2.0 and its predictive utility of felony re-offending among high-risk juvenile offenders. Child Adolesc Psychiatry Ment Health 2023; 17:111. [PMID: 37735417 PMCID: PMC10514945 DOI: 10.1186/s13034-023-00656-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Incarcerated youth are characterized by particularly high rates of childhood trauma, a significant risk factor for outcomes including risky behaviors and recidivism. Trauma-based interventions can ameliorate the negative effects of childhood trauma; however, a critical part of success is careful trauma screening. Due to the limitations associated with commonly used self-report trauma assessments, our team developed the Trauma Checklist (TCL), a trained-rater assessment of childhood trauma specifically created for use with forensic populations. The TCL is designed to provide a more comprehensive assessment of trauma, incorporating categories that are of specific relevance for incarcerated individuals (e.g., traumatic loss). Here, we discuss the continued development made to our original trauma assessment and explore the psychometric properties of this expanded assessment (herein termed the TCL 2.0). METHOD We examined relationships between TCL 2.0 scores, measures of psychopathology, and psychopathic traits in a sample of incarcerated male juvenile offenders (n = 237). In addition, we examined whether TCL 2.0 scores were associated with time to felony re-offense via Cox proportional-hazard regression analyses. RESULTS We examined dimensionality of the TCL 2.0 using a principal component analysis (PCA), the results of which were confirmed via exploratory structural equation modeling; the PCA yielded a two-component solution (i.e., PC1 and PC2). We observed that PC1 (Experienced Trauma) scores were positively correlated with mood disorder diagnoses. TCL 2.0 total scores were positively correlated with post-traumatic stress disorder symptomatology and psychopathic traits. Finally, higher PC2 (Community Trauma) scores were associated with faster time to felony re-offending. CONCLUSIONS These results suggest that the TCL 2.0 may be a beneficial screening tool to provide high-risk youth with appropriate trauma-informed treatment.
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Affiliation(s)
- Jenna N Shold
- The Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106-4188, USA.
| | - J Michael Maurer
- The Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106-4188, USA
| | - Brooke L Reynolds
- The Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106-4188, USA
- School of Graduate Psychology, Pacific University, 705 SE Baseline Street, Hillsboro, OR, 97123, USA
| | - Aparna R Gullapalli
- The Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106-4188, USA
| | - Corey H Allen
- The Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106-4188, USA
| | - Bethany G Edwards
- The Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106-4188, USA
- Department of Psychology, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA
| | - Nathaniel E Anderson
- The Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106-4188, USA
| | - Carla L Harenski
- The Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106-4188, USA
| | - Craig S Neumann
- Department of Psychology, University of North Texas, 1155 Union Circle 311280, Denton, TX, 76203-5017, USA
| | - Kent A Kiehl
- The Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106-4188, USA.
- Departments of Psychology, Neuroscience, and Law, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA.
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Cugliari G. FKBP5, a Modulator of Stress Responses Involved in Malignant Mesothelioma: The Link between Stress and Cancer. Int J Mol Sci 2023; 24:ijms24098183. [PMID: 37175892 PMCID: PMC10179631 DOI: 10.3390/ijms24098183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 04/15/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023] Open
Abstract
Malignant pleural mesothelioma (MPM) is a rare tumour characterized by a long latency period after asbestos exposure and poor survival [...].
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Affiliation(s)
- Giovanni Cugliari
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
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18
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Walter HJ, Abright AR, Bukstein OG, Diamond J, Keable H, Ripperger-Suhler J, Rockhill C. Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders. J Am Acad Child Adolesc Psychiatry 2023; 62:479-502. [PMID: 36273673 DOI: 10.1016/j.jaac.2022.10.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To enhance the quality of care and clinical outcomes for children and adolescents with major depressive disorder (MDD) and persistent depressive disorder (PDD). The aims are as follows: (1) to summarize empirically based guidance about the psychosocial and psychopharmacologic treatment of MDD and PDD in children and adolescents; and (2) to summarize expert-based guidance about the assessment of these disorders as an integral part of treatment, and the implementation of empirically based treatments for these disorders in clinical practice. METHOD Statements about the treatment of MDD and PDD are based upon empirical evidence derived from a critical systematic review of the scientific literature conducted by the Research Triangle Institute International-University of North Carolina at Chapel Hill (RTI-UNC) Evidence-based Practice Center under contract with the Agency for Healthcare Research and Quality (AHRQ). Evidence from meta-analyses published since the AHRQ/RTI-UNC review is also presented to support or refute the AHRQ findings. Guidance about the assessment and clinical implementation of treatments for MDD and PDD is informed by expert opinion and consensus as presented in previously published clinical practice guidelines, chapters in leading textbooks of child and adolescent psychiatry, the DSM-5-TR, and government-affiliated prescription drug information websites. RESULTS Psychotherapy (specifically, cognitive-behavioral and interpersonal therapies) and selective serotonin reuptake inhibitor (SSRI) medication have some rigorous (randomized controlled trials, meta-analyses) empirical support as treatment options. Because effective treatment outcomes are predicated in part upon accuracy of the diagnosis, depth of the clinical formulation, and breadth of the treatment plan, comprehensive, evidence-based assessment may enhance evidence-based treatment outcomes. CONCLUSION Disproportionate to the magnitude of the problem, there are significant limitations in the quality and quantity of rigorous empirical support for the etiology, assessment, and treatment of depression in children and adolescents. In the context of a protracted severe shortage of child and adolescent-trained behavioral health specialists, the demonstration of convenient, efficient, cost-effective, and user-friendly delivery mechanisms for safe and effective treatment of MDD and PDD is a key research need. Other research priorities include the sequencing and comparative effectiveness of depression treatments, delineation of treatment mediators and moderators, effective approaches to treatment nonresponders and disorder relapse/recurrence, long-term effects and degree of suicide risk with SSRI use, and the discovery of novel pharmacologic or interventional treatments.
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Herd T, Palmer L, Font S. Prevalence of Mental Health Diagnoses Among Early Adolescents Before and During Foster Care. J Dev Behav Pediatr 2023; 44:e269-e276. [PMID: 37126598 PMCID: PMC10154045 DOI: 10.1097/dbp.0000000000001191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 03/14/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE This study aimed to characterize the rates and types of diagnosed mental health (MH) disorders among children and adolescents before and during foster care (FC) overall and by race and ethnicity. METHODS We used population-based linked administrative data of medical assistance (public insurance) claims records and child protective services data from a cohort of early adolescents who entered FC at 10 to 14 years old. MH diagnoses were coded according to the International Classification of Diseases, Ninth and Tenth Revisions, Clinical Modification (ICD-9 and ICD-10) and included adjustment disorders, disruptive disorders, attention-deficit/hyperactivity disorder (ADHD), anxiety disorders, mood disorders, attachment disorders, autism, and other disorders. RESULTS Before FC entry, 41% of children and adolescents had at least 1 MH diagnosis. Attention-deficit/hyperactivity disorder (25%), mood disorders (18%), and disruptive disorders (15%) were the most common pre-entry diagnoses. Among early adolescents entering FC with no previous diagnosis, 52% were later diagnosed with adjustment disorder (accounting for 73% of all youth with a new diagnosis during FC). White early adolescents had higher rates of diagnosed MH disorders before FC, whereas racial/ethnic minority early adolescents were more likely to receive a MH diagnosis during FC. Black early adolescents were more likely than White and Hispanic early adolescents to be diagnosed with disruptive disorders and less likely to be diagnosed with anxiety or adjustment disorders during FC. CONCLUSION Results highlight the high rates of MH needs among early adolescents before entry into FC, whether detected before or during FC. Results also illustrate disparities in pre-entry MH care between racial/ethnic minority and White early adolescents, with minority youth less likely to be receiving services before entry.
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Affiliation(s)
- Toria Herd
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Lindsey Palmer
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Sarah Font
- Department of Sociology and Criminology, The Pennsylvania State University, University Park, PA, USA
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Fares-Otero NE, De Prisco M, Oliva V, Radua J, Halligan SL, Vieta E, Martinez-Aran A. Association between childhood maltreatment and social functioning in individuals with affective disorders: A systematic review and meta-analysis. Acta Psychiatr Scand 2023. [PMID: 37105552 DOI: 10.1111/acps.13557] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 04/06/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE Childhood maltreatment has been linked to impairments in social functioning and social cognition in adults with affective disorders. However, conclusions have been limited by inconsistent findings across different maltreatment subtypes and social domains. We conducted a systematic review and meta-analysis to quantify associations between childhood maltreatment (overall and subtypes - physical, emotional and/or sexual abuse, and/or physical and/or emotional neglect) and different domains of social functioning and social cognition in adults with affective disorders (bipolar disorder or major depressive disorder). We also examined effect moderators and mediators of these associations. METHODS A systematic search was performed on 12.12.2022 which identified 29 studies included in qualitative synthesis (n = 3022 individuals with affective disorders), of which 27 (n = 2957) were pooled in meta-analyses. Across studies, five social functioning and five social cognition domains were examined, of which four domains of social functioning and two domains of social cognition had sufficient data for meta-analysis (PROSPERO CRD42022288976). RESULTS Social functioning: childhood maltreatment was associated with lower global social functioning (r = -0.11 to -0.20), poorer interpersonal relations (r = -0.18 to -0.33), and with aggressive behaviour (r = 0.20-0.29) but was unrelated to vocational functioning. Emotional abuse and emotional neglect showed the largest magnitudes of effect. Social cognition: there was no meta-analytic evidence of associations between maltreatment and social cognition domains. Exploratory moderation analyses did not identify any consistent moderators. Narrative synthesis identified attachment style as possible moderator, and sensory patterns, anxiety, and depressive symptoms as possible mediators between childhood maltreatment and social outcomes. Overall, the available evidence was limited, particularly in relation to social cognition. CONCLUSIONS Adults with affective disorders are at risk of social functioning difficulties after childhood maltreatment exposure, an effect observed across multiple maltreatment subtypes, social functioning domains, and diagnoses. Addressing social functioning problems may benefit maltreated adults with both bipolar disorder and major depressive disorder.
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Affiliation(s)
- Natalia E Fares-Otero
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Michele De Prisco
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Vincenzo Oliva
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Joaquim Radua
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
- Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Anabel Martinez-Aran
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
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21
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Zannas AS. Molecular integrators of stress and aging: the example of FKBP5. Acta Neuropathol 2023; 145:713-715. [PMID: 37020089 DOI: 10.1007/s00401-023-02572-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 04/02/2023] [Accepted: 04/03/2023] [Indexed: 04/07/2023]
Affiliation(s)
- Anthony S Zannas
- Department of Psychiatry, University of North Carolina, 438 Taylor Hall, 109 Mason Farm Rd, Chapel Hill, NC, 27599-7096, USA.
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA.
- Carolina Stress Initiative, University of North Carolina, Chapel Hill, NC, USA.
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22
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Subramanian I, McDaniels B, Farahnik J, Mischley LK. Childhood Trauma and Parkinson Disease: Associations of Adverse Childhood Experiences, Disease Severity, and Quality of Life. Neurol Clin Pract 2023; 13:e200124. [PMID: 36891464 PMCID: PMC9987208 DOI: 10.1212/cpj.0000000000200124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 11/04/2022] [Indexed: 02/22/2023]
Abstract
Background and Objectives Childhood trauma has been shown to be associated with adverse health outcomes that can last a lifetime. The effects of trauma have not been evaluated in a Parkinson disease (PD) population. The goal of this study was to survey individuals with PD to evaluate whether the intensity of childhood trauma is associated with individual symptoms, overall disease severity, or quality of life. Methods An Internet-based observational survey was designed to evaluate modifiable variables associated with PD progression. In this cross-sectional analysis, adverse childhood experiences (ACEs) were used as a measure of childhood trauma, patient-reported outcomes in PD for the primary measure of PD severity, and Patient-Reported Outcomes Measurement Information System (PROMIS) Global for quality of life (QoL). Results Seven hundred twelve of 900 participants (79%) responded to the questions related to childhood trauma. Among respondents, QoL decreased as incidence of childhood trauma increased. Individuals with ACE scores 4 or higher reported greater symptom severity for 45% of the variables tested, including apathy, muscle pain, daytime sleepiness, restless leg syndrome, depression, fatigue, comprehension, and anxiety (p < 0.05) compared with individuals with trauma scores of zero. Discussion These data suggest childhood trauma is associated with a mild increase in overall patient-reported PD severity, specifically mood and other nonmotor and motor symptoms. While the associations were statistically significant, the impact of trauma was less robust than previously described predictors of severity, such as diet, exercise, and social connection. Future research should attempt to include more diverse populations, attempt to improve the response rate of these sensitive questions, and, most importantly, determine whether the adverse outcomes associated with childhood trauma can be mitigated with lifestyle modification, psychosocial support, and intervention in adulthood.
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Affiliation(s)
- Indu Subramanian
- David Geffen School of Medicine (IS), UCLA, Department of Neurology, Los Angeles, CA; SW PADRECC (IS), West Los Angeles, Veterans Administration, CA; Department of Rehabilitation and Health Services (BM), University of North Texas, Denton; Bastyr University Research Institute (JF, LKM); and Department of Radiology (LKM), University of Washington
| | - Bradley McDaniels
- David Geffen School of Medicine (IS), UCLA, Department of Neurology, Los Angeles, CA; SW PADRECC (IS), West Los Angeles, Veterans Administration, CA; Department of Rehabilitation and Health Services (BM), University of North Texas, Denton; Bastyr University Research Institute (JF, LKM); and Department of Radiology (LKM), University of Washington
| | - Joshua Farahnik
- David Geffen School of Medicine (IS), UCLA, Department of Neurology, Los Angeles, CA; SW PADRECC (IS), West Los Angeles, Veterans Administration, CA; Department of Rehabilitation and Health Services (BM), University of North Texas, Denton; Bastyr University Research Institute (JF, LKM); and Department of Radiology (LKM), University of Washington
| | - Laurie K Mischley
- David Geffen School of Medicine (IS), UCLA, Department of Neurology, Los Angeles, CA; SW PADRECC (IS), West Los Angeles, Veterans Administration, CA; Department of Rehabilitation and Health Services (BM), University of North Texas, Denton; Bastyr University Research Institute (JF, LKM); and Department of Radiology (LKM), University of Washington
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23
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O'Brien B, Lee J, Kim S, Nandra GS, Pannu P, Swann AC, Murphy N, Tamman AJF, Amarneh D, Lijffijt M, Averill LA, Mathew SJ. Replication of distinct trajectories of antidepressant response to intravenous ketamine. J Affect Disord 2023; 321:140-146. [PMID: 36302492 DOI: 10.1016/j.jad.2022.10.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/08/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The goal of this study was to replicate previous findings of three distinct treatment response pathways associated with repeated intravenous (IV) ketamine infusions among patients with major depressive disorder (MDD). METHODS We conducted growth mixture modeling to estimate latent classes of change in depression (Quick Inventory of Depressive Symptomatology-Self Report, QIDS-SR) across six treatment visits in 298 patients with MDD treated with IV ketamine in an outpatient community clinic. Mean age was 40.36 and patients were primarily male (58.4 %). The sample had relatively severe depression (QIDS-SR = 16.61) at pre-treatment and the majority had not responded to at least two prior medications. RESULTS Best-fit indices indicated three trajectory groups to optimally demonstrate non-linear, quadratic changes in depressive symptoms during ketamine treatment. Two groups had severe depression at baseline but diverged into a group of modest improvement over the treatment course (n = 78) and a group of patients with rapid improvement (n = 103). A third group had moderate depression at baseline with moderate improvement during the treatment course (n = 117). Additional planned trajectory comparisons showed that suicidality at entry was higher in the high depression groups and that change in suicidality severity followed that of depression. LIMITATIONS This was a retrospective analysis of a naturalistic sample. Patients were unblinded and more heterogenous than those included in most controlled clinical trial samples. CONCLUSIONS This replication study in an independent community-based ketamine clinic sample revealed similar response trajectories, with only about a third of depressed patients benefitting substantially from an acute induction course of ketamine infusions.
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Affiliation(s)
- Brittany O'Brien
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, 1977 Butler Boulevard, Houston, TX 77030, USA; Michael E. DeBakey VA Medical Center, 2002 Holcombe Boulevard, Houston, TX 77030, USA. Brittany.o'
| | - Jaehoon Lee
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, 1977 Butler Boulevard, Houston, TX 77030, USA; Texas Tech University, Department of Educational Psychology, Leadership, and Counseling, 2500 Broadway, Lubbock, TX, 79409, USA; The Menninger Clinic, 12301 S Main Street, Houston, TX, 77035, USA
| | - Seungman Kim
- Texas Tech University, Department of Educational Psychology, Leadership, and Counseling, 2500 Broadway, Lubbock, TX, 79409, USA
| | - Guriqbal S Nandra
- IV Solution and Ketamine Centers of Chicago and Kansas City, 712 North Dearborn Street, Chicago, IL 60654, USA
| | - Prabhneet Pannu
- IV Solution and Ketamine Centers of Chicago and Kansas City, 712 North Dearborn Street, Chicago, IL 60654, USA
| | - Alan C Swann
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, 1977 Butler Boulevard, Houston, TX 77030, USA; Michael E. DeBakey VA Medical Center, 2002 Holcombe Boulevard, Houston, TX 77030, USA
| | - Nicholas Murphy
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, 1977 Butler Boulevard, Houston, TX 77030, USA; The Menninger Clinic, 12301 S Main Street, Houston, TX, 77035, USA
| | - Amanda J F Tamman
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, 1977 Butler Boulevard, Houston, TX 77030, USA; Michael E. DeBakey VA Medical Center, 2002 Holcombe Boulevard, Houston, TX 77030, USA
| | - Dania Amarneh
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, 1977 Butler Boulevard, Houston, TX 77030, USA; Michael E. DeBakey VA Medical Center, 2002 Holcombe Boulevard, Houston, TX 77030, USA
| | - Marijn Lijffijt
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, 1977 Butler Boulevard, Houston, TX 77030, USA; Michael E. DeBakey VA Medical Center, 2002 Holcombe Boulevard, Houston, TX 77030, USA
| | - Lynnette A Averill
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, 1977 Butler Boulevard, Houston, TX 77030, USA; Michael E. DeBakey VA Medical Center, 2002 Holcombe Boulevard, Houston, TX 77030, USA
| | - Sanjay J Mathew
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, 1977 Butler Boulevard, Houston, TX 77030, USA; Michael E. DeBakey VA Medical Center, 2002 Holcombe Boulevard, Houston, TX 77030, USA; The Menninger Clinic, 12301 S Main Street, Houston, TX, 77035, USA
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24
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Fijtman A, Clausen A, Kauer-Sant'Anna M, Morey R. Trauma history in veterans with bipolar disorder and its impact on suicidality. J Psychiatr Res 2023; 157:119-126. [PMID: 36463626 DOI: 10.1016/j.jpsychires.2022.10.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/22/2022] [Accepted: 10/28/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVES Veterans are at increased risk for exposure to trauma, developing serious mental illnesses, and death by suicide. History of trauma correlates with worsening outcomes in patients with bipolar disorder. This study investigated associations between trauma exposure (type and timing) and suicide attempt in Veterans with bipolar disorder. METHODS One hundred six Veterans with a diagnosis of bipolar disorder and 815 Veterans with no psychiatric history (age rage = 20-72 years old) completed a clinical questionnaire, the Beck Scale for Suicide Ideation, and the Traumatic Live Events Questionnaire. Multinomial logistic regressions investigated correlations between diagnosis, time of trauma (before, during, or after the military), trauma type (attack, illness, accident, child violence, child sexual abuse, and adult sexual abuse), and suicide attempt. RESULTS Seventy-five Veterans with bipolar disorder had comorbid PTSD. Controlling for PTSD, Veterans with bipolar disorder had a higher prevalence of trauma including physical assault [odds ratio (OR) = 2.85; 95% confidence interval (CI) = 1.39-5.86] and child sexual trauma (OR = 2.89; CI = 1.38-6.05). Veterans with bipolar disorder who endorsed previous suicide attempts (n = 42) had significantly higher levels of exposure to childhood trauma (OR = 5.69; CI = 1.84-17.62). CONCLUSIONS Results support incorporating history of previous trauma exposure when assessing Veterans at risk for bipolar disorder. Especially, trauma characterized as attack and childhood sexual abuse. Particular attention should be given to Veterans with bipolar disorder and exposure to trauma during childhood, which may be associated with increased risk of suicidality.
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Affiliation(s)
- Adam Fijtman
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, 3643 N. Roxboro St, Durham, NC, 27704, USA.
| | - Ashley Clausen
- St. Vincent Hospital, Department of Behavioral Health, 2900 12th Ave N, Billings, MT, 59101, USA.
| | - Marcia Kauer-Sant'Anna
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, 90035-903, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Porto Alegre, RS, 90035-002, Brazil.
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- Durham VA Medical Center, 508 Fulton St. Durham, NC. 27705, USA
| | - Rajendra Morey
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, 3643 N. Roxboro St, Durham, NC, 27704, USA; Durham VA Medical Center, 508 Fulton St. Durham, NC. 27705, USA.
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25
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Li Z, Liu X, Ma R, Feng S, Zheng S, Zhu H, Yin D, Jia H. Cyclothymic Temperament, Physical Neglect, and Earlier Age of Onset Predict Poor Medication Adherence in Patients With Bipolar Disorder. J Nerv Ment Dis 2023; 211:35-39. [PMID: 36095277 DOI: 10.1097/nmd.0000000000001573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
ABSTRACT Individual-level risk factors may predict poor medication adherence (PMA) in bipolar disorder (BD). This study aimed to evaluate the association between affective temperament, childhood trauma, age of first onset, and PMA in patients with BD in China. A total of 168 patients completed the eight-item Morisky Medication Adherence Scale; the Short Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire; and the Childhood Trauma Questionnaire-Short Form. Scores were then compared between PMA and non-PMA groups. Binary logistic regression showed that age of first onset was negatively correlated with PMA ( β = -0.106, p = 0.002), whereas physical neglect and cyclothymic temperament were positively correlated with PMA ( β = 0.143, p = 0.029; β = 0.19, p = 0.001, respectively). These findings indicate that cyclothymic temperament, physical neglect, and earlier onset are predictors of PMA in patients with BD and that such patients may require further attention to improve medical compliance.
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26
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The role of childhood trauma, obesity and inflammatory biomarkers in the adherence to a digital intervention among bipolar disorder outpatients: A cluster analyses. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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27
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You JS, Lee CW, Park JY, Jang Y, Yu H, Yoon J, Kwon SS, Oh S, Park YS, Ryoo HA, Lee JH, Lee D, Lee J, Kim Y, Cho N, Ihm HK, Park CHK, Lee YC, Won HH, Kang HS, Beak JH, Ha TH, Myung W. Borderline Personality Pathology in Major Depressive Disorder, Bipolar I and II Disorder, and Its Relationship With Childhood Trauma. Psychiatry Investig 2022; 19:909-918. [PMID: 36444154 PMCID: PMC9708861 DOI: 10.30773/pi.2022.0114] [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: 05/10/2022] [Accepted: 08/21/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Mood disorder and borderline personality pathology (BPP) are frequently comorbid and relate to childhood trauma. We investigated the relationship between childhood trauma and BPP features in mood disorder patients versus controls. METHODS A total of 488 mood disorder patients, particularly major depressive disorder (MDD), bipolar I disorder (BD I), and bipolar II disorder (BD II), and 734 controls were included. We examined between-group BPP-related differences and correlated between BPP and childhood trauma using the Childhood Trauma Questionnaire-Short Form (CTQ) and the Personality Assessment Inventory-Borderline Features Scale. RESULTS BD II patients showed significantly higher BPP. Emotional abuse and neglect were prominently associated with BPP, while affective instability and negative relationships exhibited a stronger association with childhood trauma. We also found a positive relationship between childhood trauma and BPP in MDD, BD I, and BD II patients. CONCLUSION The findings of the present study imply that BPP features are more likely to be found in patients with BD II than BD I or MDD. Mood disorder patients with severe childhood trauma may have higher BPP features. Thus, further study of the relationship between childhood trauma and BPP features could improve the therapeutic approaches and help understand patients with mood disorders.
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Affiliation(s)
- Ji Seon You
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea
| | - Chan Woo Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ji Yoon Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yoonjeong Jang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyeona Yu
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Joohyun Yoon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sarah Soonji Kwon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sunghee Oh
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yun Seong Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyun A Ryoo
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jong Hun Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Daseul Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jakyung Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yeoju Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Nayoung Cho
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hong Kyu Ihm
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - C Hyung Keun Park
- Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea
| | - Yeong Chan Lee
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Hong-Hee Won
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyo Shin Kang
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Ji Hyun Beak
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Tae Hyon Ha
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
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28
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Mazurek B, Rose M, Schulze H, Dobel C. Systems Medicine Approach for Tinnitus with Comorbid Disorders. Nutrients 2022; 14:nu14204320. [PMID: 36297004 PMCID: PMC9611054 DOI: 10.3390/nu14204320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/26/2022] [Accepted: 10/06/2022] [Indexed: 11/07/2022] Open
Abstract
Despite the fact that chronic diseases usually occur together with a spectrum of possible comorbidities that may differ strongly between patients, they are classically still viewed as distinct disease entities and, consequently, are often treated with uniform therapies. Unfortunately, such an approach does not take into account that different combinations of symptoms and comorbidities may result from different pathological (e.g., environmental, genetic, dietary, etc.) factors, which require specific and individualised therapeutic strategies. In this opinion paper, we aim to put forward a more differentiated, systems medicine approach to disease and patient treatment. To elaborate on this concept, we focus on the interplay of tinnitus, depression, and chronic pain. In our view, these conditions can be characterised by a variety of phenotypes composed of variable sets of symptoms and biomarkers, rather than distinct disease entities. The knowledge of the interplay of such symptoms and biomarkers will provide the key to a deeper, mechanistic understanding of disease pathologies. This paves the way for prediction and prevention of disease pathways, including more personalised and effective treatment strategies.
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Affiliation(s)
- Birgit Mazurek
- Tinnitus Center, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
- Correspondence:
| | - Matthias Rose
- Medical Department, Division of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Holger Schulze
- Department of Otorhinolaryngology–Head and Neck Surgery, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Christian Dobel
- Department of Otorhinolaryngology, Jena University Hospital, 07743 Jena, Germany
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29
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Rosenfield PJ, Jiang D, Pauselli L. Childhood adversity and psychotic disorders: Epidemiological evidence, theoretical models and clinical considerations. Schizophr Res 2022; 247:55-66. [PMID: 34210561 DOI: 10.1016/j.schres.2021.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/31/2021] [Accepted: 06/04/2021] [Indexed: 02/08/2023]
Abstract
While genetic factors play a critical role in the risk for schizophrenia and other psychotic disorders, increasing evidence points to the role of childhood adversity as one of several environmental factors that can significantly impact the development, manifestations and outcome of these disorders. This paper reviews the epidemiological evidence linking childhood adversity and psychotic disorders and explores various theoretical models that seek to explain the connection. We discuss neurobiological parallels between the impact of childhood trauma and psychosis on the brain and then explore the impact of childhood adversity on different domains of clinical presentation. Finally, implications for prevention and treatment are considered, both on individual and structural levels.
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Affiliation(s)
- Paul J Rosenfield
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States of America.
| | - David Jiang
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States of America.
| | - Luca Pauselli
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States of America.
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30
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van Bentum JS, Sijbrandij M, Saueressig F, Huibers MJ. The association between childhood maltreatment and suicidal intrusions: A cross-sectional study. J Trauma Stress 2022; 35:1273-1281. [PMID: 35285097 PMCID: PMC9542979 DOI: 10.1002/jts.22821] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/27/2022] [Accepted: 02/09/2022] [Indexed: 11/18/2022]
Abstract
Childhood maltreatment may play an important role in the transition from suicidal ideation to suicidal behavior. Recently, research has begun evaluating the association between childhood maltreatment and involuntary and distressing intrusions about one's own suicide, also called suicidal intrusions. This cross-sectional, multicenter study aimed to investigate the association between childhood maltreatment and the severity of suicidal intrusions using online questionnaires. Participants were suicidal outpatients currently receiving treatment at a Dutch mental health institution (N = 149). The Childhood Trauma Questionnaire-Short Form and Suicidal Intrusions Attributes Scale were administered online. A simple linear regression was performed followed by a multiple linear regression with backward selection to separate the predictors of childhood maltreatment subscales. Next, significant predictor variables were used to perform an additional regression analysis with gender, age, posttraumatic stress disorder (PTSD) diagnosis, and depressive symptoms as potential covariates. The results showed that childhood maltreatment was significantly associated with suicidal intrusion scores, B = .22, t(147) = 2.010, p = .046. A multiple linear regression analysis showed that the only specific form of childhood maltreatment associated with suicidal intrusions was sexual abuse; the association remained after controlling for age, gender, PTSD diagnosis and depressive symptoms, F(5, 143) = 11.15, p < .001. In summary, the present study confirms the link between childhood maltreatment, particularly childhood sexual abuse, and suicidal intrusions. This finding implies that in the treatment of suicidal intrusions and suicidality, childhood sexual abuse should be identified and targeted with evidence-based treatments for PTSD.
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Affiliation(s)
- Jaël S. van Bentum
- Department of Clinical Neuro and Developmental PsychologyAmsterdam Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Marit Sijbrandij
- Department of Clinical Neuro and Developmental PsychologyAmsterdam Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamThe Netherlands,World Health Organization Collaborating Centre for Research and Dissemination of Psychological InterventionsVrije Universiteit AmsterdamThe Netherlands
| | - Fenna Saueressig
- Department of Clinical Neuro and Developmental PsychologyAmsterdam Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Marcus J.H. Huibers
- Department of Clinical Neuro and Developmental PsychologyAmsterdam Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamThe Netherlands,Department of PsychologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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31
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Xavier J, Bastos CR, Camerini L, Amaral PB, Jansen K, de Mattos Souza LD, da Silva RA, Pinheiro RT, Lara DR, Ghisleni G. Interaction between COMT Val 158 Met polymorphism and childhood trauma predicts risk for depression in men. Int J Dev Neurosci 2022; 82:385-396. [PMID: 35441426 DOI: 10.1002/jdn.10186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/28/2022] [Accepted: 04/03/2022] [Indexed: 11/08/2022] Open
Abstract
Depression is a disabling illness with complex etiology. While the Catechol-O-Methyltransferase (COMT) gene, in particular the functional Val158 Met polymorphism, has been related to depression, the mechanisms underlying this gene-disease association are not completely understood. Therefore, we explore the association of COMT Val158 Met polymorphism with depression as well as its interaction with childhood trauma in 1,136 young adults from a population-based study carried out in the city of Pelotas-Brazil. The diagnosis was performed through the Mini International Neuropsychiatric Interview 5.0 (MINI 5.0), and trauma was assessed with the childhood trauma questionnaire (CTQ). Total DNA was extracted and genotyped by real-time PCR and the QTLbase dataset was queried to perform large-scale quantitative trait locus (QTL) analysis. Our research showed no direct association between the Val158 Met polymorphism and the diagnosis of depression (women: χ2=0.10, d=1, p=0.751 and men: χ2=0.003, df=1 p=0.956). However, the Met-allele of the Val158 Met polymorphism modified the effect of childhood trauma in men [OR=2.58 (95% CI:1.05-6.29); p=0.038] conferring risk for depression only on those who suffer from trauma. The conditional effect from moderation analysis showed that trauma impacts the risk of depression only in men carrying the Met-allele (Effect: 0.9490, Standard Error (SE): 0.2570; p=0.0002). QTLbase and dataset for Val158 Met polymorphism were consistent for markers that influence chromatin accessibility transcription capacity including histone methylation and acetylation. The changes caused in gene regulation by childhood trauma exposure and polymorphism may serve as evidence of the mechanism whereby the interaction increases susceptibility to this disorder in men.
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Affiliation(s)
- Janaína Xavier
- Center of Health Sciences, Post-Graduation Program of Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Clarissa Ribeiro Bastos
- Center of Health Sciences, Post-Graduation Program of Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Laísa Camerini
- Center of Health Sciences, Post-Graduation Program of Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Paola Bajadares Amaral
- Center of Health Sciences, Post-Graduation Program of Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Karen Jansen
- Center of Health Sciences, Post-Graduation Program of Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Luciano Dias de Mattos Souza
- Center of Health Sciences, Post-Graduation Program of Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Ricardo Azevedo da Silva
- Center of Health Sciences, Post-Graduation Program of Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Ricardo Tavares Pinheiro
- Center of Health Sciences, Post-Graduation Program of Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Diogo Rizzato Lara
- Department of Cellular and Molecular Biology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gabriele Ghisleni
- Center of Health Sciences, Post-Graduation Program of Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Berardelli I, Sarubbi S, Rogante E, Erbuto D, Giuliani C, Lamis DA, Innamorati M, Pompili M. Association between Childhood Maltreatment and Suicidal Ideation: A Path Analysis Study. J Clin Med 2022; 11:jcm11082179. [PMID: 35456272 PMCID: PMC9027208 DOI: 10.3390/jcm11082179] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/23/2022] [Accepted: 04/05/2022] [Indexed: 02/04/2023] Open
Abstract
Epidemiological studies have suggested that childhood maltreatment increases suicidal ideation, and dissociative symptoms and hopelessness are involved in this relation. To better address this issue, we used a path analysis model to examine the role of different types of childhood maltreatment on suicidal ideation, investigating whether hopelessness and dissociative symptoms mediated this relation. A sample of 215 adult psychiatric inpatients was enrolled between January 2019 and January 2020, at the psychiatric unit of Sant’Andrea Medical Center in Rome, Italy. The Childhood Trauma Questionnaire (CTQ), Beck Hopelessness Scale (BHS), Dissociative Experiences Scale (DES-II), and Columbia-Suicide Severity Rating Scale (C-SSRS) were used to test the hypotheses. Results revealed that the presence of sexual abuse directly affected suicidal ideation (β = 0.18, SE = 0.8, p < 0.05), while emotional abuse and neglect indirectly increased suicidal ideation via dissociation (β = 0.05, SE = 0.02, 95% C.I. 0.01/0.09) and hopelessness (β = 0.10, SE = 0.03, 95% C.I. = 0.04/0.16). Professionals working with children should be aware of the long-term consequences of childhood maltreatment, particularly suicide risk. Furthermore, professionals working with adults should inquire about past childhood maltreatment.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Centre, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy; (I.B.); (D.E.)
| | - Salvatore Sarubbi
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy;
| | - Elena Rogante
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy;
| | - Denise Erbuto
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Centre, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy; (I.B.); (D.E.)
| | - Carlotta Giuliani
- Psychiatry Residency Training Program, Psychiatry Unit, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy;
| | - Dorian A. Lamis
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30303, USA;
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163 Rome, Italy;
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Centre, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy; (I.B.); (D.E.)
- Correspondence: ; Tel.: +39-063-377-5675; Fax: +39-063-377-5342
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Fortuna LR, Tobón AL, Anglero YL, Postlethwaite A, Porche MV, Rothe EM. Focusing on Racial, Historical and Intergenerational Trauma, and Resilience: A Paradigm to Better Serving Children and Families. Child Adolesc Psychiatr Clin N Am 2022; 31:237-250. [PMID: 35361362 DOI: 10.1016/j.chc.2021.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Research across populations demonstrates that intergenerational trauma can have lasting biological, psychological, and social consequences and affects groups of individuals in different ways. An appreciation of intergenerational trauma as experienced in diverse populations is important not only for understanding vulnerabilities and risk but also for cultivating opportunities for posttraumatic growth and healing. Understanding the contexts of trauma for children and families and the unveiling of structural inequities, both past and present, offers the opportunity to address these in using clinical and systems of care approaches in the public health spheres.
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Affiliation(s)
- Lisa R Fortuna
- University of California San Francisco, Zuckerberg San Francisco General Hospital, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Avenue 7M8, San Francisco, CA 94110, USA.
| | - Amalia Londoño Tobón
- National Institutes of Health, National Institute on Minority Health and Health Disparities, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Yohanis Leonor Anglero
- Boston Children's Hospital, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | | | - Michelle V Porche
- University of California San Francisco, Zuckerberg San Francisco General Hospital, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Avenue 7M8, San Francisco, CA 94110, USA
| | - Eugenio M Rothe
- Herbert Wertheim College of Medicine Florida International University, FIU Health Miami, 11200 Southwest 8th Street, Miami, FL 33199, USA
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Şahin-Bayındır G, Uysal-Yalçın S, Çömez-İkican T, Gölge ZB. The relationship between childhood trauma and the course of disease in female patients with bipolar disorder. Perspect Psychiatr Care 2022; 58:608-614. [PMID: 33931879 DOI: 10.1111/ppc.12821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/31/2021] [Accepted: 04/17/2021] [Indexed: 12/01/2022] Open
Abstract
PURPOSE This study aimed to determine the history of childhood trauma and the relationship between childhood trauma and the course of the disease in female patients with bipolar disorder. DESIGN AND METHODS This study was conducted on 80 female patients in an acute women's psychiatric clinic in a psychiatric hospital in Turkey between April and July 2016. FINDINGS Emotional abuse had a statistically negative effect on the onset of bipolar disorder (F = 7.830; p < 0.01). In addition, physical neglect had a statistically positive effect on the duration of treatment (F = 6.811; p < 0.05). PRACTICE IMPLICATIONS Psychiatric nurses must systematically assess childhood trauma and plan psychotherapeutic interventions accordingly.
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Affiliation(s)
- Gizem Şahin-Bayındır
- Department of Mental Health and Psychiatric Nursing, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Suna Uysal-Yalçın
- Department of Nursing, Faculty of Health Sciences, Kocaeli Health and Technology University, Kocaeli, Turkey
| | - Tuba Çömez-İkican
- Mental Health and Psychiatric Nursing Department, Institute of Graduate Education, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Zeynep Belma Gölge
- Department of Social Sciences, Institute of Forensic Sciences and Legal Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Epigenetic Mechanism of Depression after Early Life Stress. Neurosci Bull 2022; 38:692-694. [PMID: 35224707 PMCID: PMC9206051 DOI: 10.1007/s12264-022-00831-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 12/20/2021] [Indexed: 01/06/2023] Open
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Insomnia symptoms are associated with impaired resilience in bipolar disorder: Potential links with early life stressors may affect mood features and suicidal risk. J Affect Disord 2022; 299:596-603. [PMID: 34952125 DOI: 10.1016/j.jad.2021.12.042] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/01/2021] [Accepted: 12/18/2021] [Indexed: 11/23/2022]
Abstract
AIM The study aimed to investigate resilience and its association with early exposure to stressful events on the clinical manifestations of bipolar disorders (BDs), such as severity of mood symptoms, suicidal ideation and behaviors focusing on the possible role of insomnia symptoms. METHOD A sample of 188 adult participants with BD of type I or II were assessed during depressed phase using the Structural Clinical Interview for DSM-5 (SCID-5), the Beck Depression Inventory-II (BDI-II), the Young Mania Rating Scale (YMRS), the Early Trauma Inventory Self Report-Short Form (ETISR-SF), Resilience Scale for Adults (RSA), the Insomnia Severity Index (ISI) and the Scale for Suicide Ideation (SSI). Participants with or without clinically significant insomnia were compared and we carried out correlations, regression and mediation analyses. RESULTS Participants with insomnia showed a greater severity of depressive symptoms as well as of suicidal risk, early life stressors and lower level of resilience. Insomnia symptoms mediated the association between early life stress and low resilience, between low resilience in planning future and depressive symptoms (Z = 2.17, p = 0.029) and low resilience and suicidal risk (Z = 3.05, p = 0.0002) CONCLUSION: Insomnia may be related to the severity of BDs, to higher early life stressors and lower level of resilience. Assessing and targeting insomnia symptoms may potentially promote resilience in BDs in response to early life stressful events. These results should be interpreted in light of several limitations including the cross-sectional design affecting causal interpretations.
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Abstract
Early-life adverse events or childhood adversities (CAs) are stressors and harmful experiences severely impacting on a child's wellbeing and development. Examples of CAs include parental neglect, emotional and physical abuse and bullying. Even though the prevalence of CAs and their psychological effects in both healthy and psychiatric populations is established, only a paucity of studies have investigated the neurobiological firms associated with CAs in bipolar disorder (BD). In particular, the exact neural mechanisms and trajectories of biopsychosocial models integrating both environmental and genetic effects are still debated. Considering the potential impact of CAs on BD, including its clinical manifestations, we reviewed existing literature discussing the association between CAs and brain alterations in BD patients. Results showed that CAs are associated with volume alterations of several grey matter regions including the hippocampus, thalamus, amygdala and frontal cortex. A handful of studies suggest the presence of alterations in the corpus callosum and the pre-fronto-limbic connectivity at rest. Alterations in these regions of the brain of patients with BD are possibly due to the effect of stress produced by CAs, being hippocampus part of the hypothalamus-pituitary-adrenal axis and thalamus together with amygdala filtering sensory information and regulating emotional responses. However, results are mixed possibly due to the heterogeneity of methods and study design. Future neuroimaging studies disentangling between different types of CAs or differentiating between BD sub-types are needed in order to understand the link between CAs and BD.
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He J, Yan X, Wang R, Zhao J, Liu J, Zhou C, Zeng Y. Does Childhood Adversity Lead to Drug Addiction in Adulthood? A Study of Serial Mediators Based on Resilience and Depression. Front Psychiatry 2022; 13:871459. [PMID: 35509889 PMCID: PMC9058108 DOI: 10.3389/fpsyt.2022.871459] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/16/2022] [Indexed: 11/18/2022] Open
Abstract
Drug addiction is a common problem worldwide. Research has shown adverse childhood experiences (ACEs) to be an important factor related to drug addiction. However, there are few studies on how ACEs lead to drug addiction and the role of resilience and depression in this process. Thus, the main purposes of the study were to determine the proportion of those with adverse childhood experiences who take drugs in adulthood and how resilience and depression affect this relationship. The results showed that (1) greater severity of ACEs made individuals more likely to take drugs; (2) ACEs were positively correlated with depression, and resilience was negatively correlated with ACEs and depression; and (3) ACEs not only affected drug addiction through resilience or depression alone but also through the combined action of resilience and depression, indicating that depression led to drug addiction while resilience weakened the effect of ACEs on depression and drug addiction. Furthermore, in the serial mediation model, abuse, neglect, and family dysfunction were significant predictors of drug addiction. Our results are encouraging in that they provide guidance in understanding the complex relationships among ACEs, resilience, depression, and drug addiction.
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Affiliation(s)
- Jingzhen He
- Health Psychology Institution, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xinyu Yan
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Rufang Wang
- Health Psychology Institution, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Juyou Zhao
- Rehabilitation Department, Sichuan Drug Rehabilitation Administration, Chengdu, China
| | - Jun Liu
- Rehabilitation Department, Sichuan Drug Rehabilitation Administration, Chengdu, China
| | - Changwei Zhou
- Psychological Correction Center, Sichuan Ziyang Drug Rehabilitation Center, Ziyang, China
| | - Yumei Zeng
- Psychological Correction Center, Sichuan Ziyang Drug Rehabilitation Center, Ziyang, China
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Human FKBP5 negatively regulates transcription through inhibition of P-TEFb complex formation. Mol Cell Biol 2021; 42:e0034421. [PMID: 34780285 DOI: 10.1128/mcb.00344-21] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Although large number of recent studies indicate strong association of FKBP5 (aka FKBP51) functions with various stress-related psychiatric disorder, the overall mechanisms are poorly understood. Beyond a few studies indicating its functions in regulating glucocorticoid receptor-, and AKT-signalling pathways, other functional roles (if any) are unclear. In this study, we report an anti-proliferative role of human FKBP5 through negative regulation of expression of proliferation-related genes. Mechanistically, we show that, owing to same region of interaction on CDK9, human FKBP5 directly competes with CyclinT1 for functional P-TEFb complex formation. In vitro biochemical coupled with cell-based assays, showed strong negative effect of FKBP5 on P-TEFb-mediated phosphorylation of diverse substrates. Consistently, FKBP5 knockdown showed enhanced P-TEFb complex formation leading to increased global RNA polymerase II CTD phosphorylation and expression of proliferation-related genes and subsequent proliferation. Thus, our results show an important role of FKBP5 in negative regulation of P-TEFb functions within mammalian cells.
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Rengasamy M, Marsland A, McClain L, Kovats T, Walko T, Pan L, Price RB. Linking childhood trauma and cytokine levels in depressed adolescents. Psychoneuroendocrinology 2021; 133:105398. [PMID: 34479104 PMCID: PMC8530984 DOI: 10.1016/j.psyneuen.2021.105398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 07/28/2021] [Accepted: 08/21/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Evidence supports raised circulating levels of inflammatory mediators, such as interleukin-6 (IL-6) and tumor necrosis factor (TNFα), among clinically depressed adults, although preliminary findings in adolescents are mixed. Independently, meta-analyses identify correlations between childhood trauma and elevated cytokine levels in adulthood. Here, we examine the possible role of individual differences in exposure to childhood trauma in contributing to variability in cytokine levels in depressed adolescents. METHODS 52 depressed adolescents and 20 healthy adolescents completed measures of childhood trauma and provided blood for the assessment of plasma IL-6 and TNFα. Cross-sectional associations of childhood trauma and cytokine measures were assessed in both depressed and healthy adolescents, along with exploratory analysis of childhood trauma subtypes. Longitudinal relationships between childhood trauma and cytokine measures were also studied in an exploratory fashion within a subset of depressed participants (n = 36). RESULTS Higher childhood trauma (particularly emotional abuse) was positively associated with TNFα in depressed adolescents. Childhood trauma was not linked to longitudinal changes in cytokine levels. DISCUSSION In depressed adolescents, childhood trauma may relate to higher levels of the proinflammatory cytokine TNFα and contribute to heterogeneity in cytokine elevation among depressed adolescents. Such findings may ultimately help guide more effective individualized treatments for adolescents with depression.
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Affiliation(s)
- Manivel Rengasamy
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
| | - Anna Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
| | - Lora McClain
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Tessa Kovats
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Thomas Walko
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
| | - Lisa Pan
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Rebecca B Price
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA 15213, USA; Department of Psychology, University of Pittsburgh, Pittsburgh, USA
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Carleial S, Nätt D, Unternährer E, Elbert T, Robjant K, Wilker S, Vukojevic V, Kolassa IT, Zeller AC, Koebach A. DNA methylation changes following narrative exposure therapy in a randomized controlled trial with female former child soldiers. Sci Rep 2021; 11:18493. [PMID: 34531495 PMCID: PMC8445994 DOI: 10.1038/s41598-021-98067-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 09/02/2021] [Indexed: 02/08/2023] Open
Abstract
The aftermath of traumatization lives on in the neural and epigenetic traces creating a momentum of affliction in the psychological and social realm. Can psychotherapy reorganise these memories through changes in DNA methylation signatures? Using a randomised controlled parallel group design, we examined methylome-wide changes in saliva samples of 84 female former child soldiers from Eastern DR Congo before and six months after Narrative Exposure Therapy. Treatment predicted differentially methylated positions (DMPs) related to ALCAM, RIPOR2, AFAP1 and MOCOS. In addition, treatment associations overlapped at gene level with baseline clinical and social outcomes. Treatment related DMPs are involved in memory formation-the key agent in trauma focused treatments-and enriched for molecular pathways commonly affected by trauma related disorders. Results were partially replicated in an independent sample of 53 female former child soldiers from Northern Uganda. Our results suggest a molecular impact of psychological treatment in women with war-related childhood trauma.Trial registration: Addressing Heightened Levels of Aggression in Traumatized Offenders With Psychotherapeutic Means (ClinicalTrials.gov Identifier: NCT02992561, 14/12/2016).
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Affiliation(s)
- Samuel Carleial
- grid.9811.10000 0001 0658 7699Department of Psychology, Centre for Psychiatry, University of Konstanz, Feuerstein-Strasse. 55, Haus 22, 78479 Konstanz, Germany
| | - Daniel Nätt
- grid.5640.70000 0001 2162 9922Division of Neurobiology, Department of Biomedical and Clinical Sciences, University of Linköping, Building 463, Room 12.023, Linköping, Sweden
| | - Eva Unternährer
- grid.9811.10000 0001 0658 7699Department of Psychology, Centre for Psychiatry, University of Konstanz, Feuerstein-Strasse. 55, Haus 22, 78479 Konstanz, Germany ,grid.6612.30000 0004 1937 0642Child- and Adolescent Research Department, Psychiatric University Hospitals Basel (UPK), University of Basel, Basel, Switzerland
| | - Thomas Elbert
- grid.9811.10000 0001 0658 7699Department of Psychology, Centre for Psychiatry, University of Konstanz, Feuerstein-Strasse. 55, Haus 22, 78479 Konstanz, Germany ,Vivo International E.V., Postbox 5108, 78430 Konstanz, Germany
| | - Katy Robjant
- Vivo International E.V., Postbox 5108, 78430 Konstanz, Germany
| | - Sarah Wilker
- Vivo International E.V., Postbox 5108, 78430 Konstanz, Germany ,grid.7491.b0000 0001 0944 9128Department of Psychology and Sports Science, University of Bielefeld, 33501 Bielefeld, Germany
| | - Vanja Vukojevic
- grid.6612.30000 0004 1937 0642Psychiatric University Clinics, Transfaculty Research Platform, University of Basel, Wilhelm Klein-Strasse 27, CH-4012 Basel, Switzerland
| | - Iris-Tatjana Kolassa
- Vivo International E.V., Postbox 5108, 78430 Konstanz, Germany ,grid.6582.90000 0004 1936 9748Department of Clinical and Biological Psychology, Institute of Psychology & Education, University of Ulm, Ulm University, Ulm, Germany
| | - Anja C. Zeller
- grid.9811.10000 0001 0658 7699Department of Psychology, Centre for Psychiatry, University of Konstanz, Feuerstein-Strasse. 55, Haus 22, 78479 Konstanz, Germany ,Vivo International E.V., Postbox 5108, 78430 Konstanz, Germany
| | - Anke Koebach
- grid.9811.10000 0001 0658 7699Department of Psychology, Centre for Psychiatry, University of Konstanz, Feuerstein-Strasse. 55, Haus 22, 78479 Konstanz, Germany ,Vivo International E.V., Postbox 5108, 78430 Konstanz, Germany
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Shirvani-Farsani Z, Maloum Z, Bagheri-Hosseinabadi Z, Vilor-Tejedor N, Sadeghi I. DNA methylation signature as a biomarker of major neuropsychiatric disorders. J Psychiatr Res 2021; 141:34-49. [PMID: 34171761 DOI: 10.1016/j.jpsychires.2021.06.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/27/2021] [Accepted: 06/09/2021] [Indexed: 02/07/2023]
Abstract
DNA methylation is a broadly-investigated epigenetic modification that has been considered as a heritable and reversible change. Previous findings have indicated that DNA methylation regulates gene expression in the central nervous system (CNS). Also, disturbance of DNA methylation patterns has been associated with destructive consequences that lead to human brain diseases such as neuropsychiatric disorders (NPDs). In this review, we comprehensively discuss the mechanism and function of DNA methylation and its most recent associations with the pathology of NPDs-including major depressive disorder (MDD), schizophrenia (SZ), autism spectrum disorder (ASD), bipolar disorder (BD), and attention/deficit hyperactivity disorder (ADHD). We also discuss how heterogeneous findings demand further investigations. Finally, based on the recent studies we conclude that DNA methylation status may have implications in clinical diagnostics and therapeutics as a potential epigenetic biomarker of NPDs.
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Affiliation(s)
- Zeinab Shirvani-Farsani
- Department of Cell and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University G.C., Tehran, IR, Iran.
| | - Zahra Maloum
- Department of Cell and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University G.C., Tehran, IR, Iran.
| | - Zahra Bagheri-Hosseinabadi
- Department of Clinical Biochemistry, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
| | - Natalia Vilor-Tejedor
- BarcelonaBeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Carrer Wellington 30, 08005, Barcelona, Spain; Center for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Barcelona, Spain; Erasmus University Medical Center, Department of Clinical Genetics, Rotterdam, the Netherlands; Pompeu Fabra University, Barcelona, Spain.
| | - Iman Sadeghi
- BarcelonaBeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Carrer Wellington 30, 08005, Barcelona, Spain; Center for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Barcelona, Spain.
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Chang HT, Wu CD, Wang JD, Chen PS, Su HJ. Residential green space structures are associated with a lower risk of bipolar disorder: A nationwide population-based study in Taiwan. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 283:115864. [PMID: 33857883 DOI: 10.1016/j.envpol.2020.115864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 10/13/2020] [Accepted: 10/13/2020] [Indexed: 06/12/2023]
Abstract
Although many researchers have identified the potential psychological benefits offered by greenness, the association between green space structures and mental disorders is not well understood. The purpose of this study was to identify associations between green space structures and the incidence of bipolar disorder. To this end, we investigated 1,907,776 individuals collected from Taiwan's National Health Insurance Research Database. After a follow-up investigation from 2005 to 2016, among those with no history of bipolar disorder, 20,548 individuals were further found to be diagnosed with bipolar disorder. A geographic information system and landscape index were used to quantify three indices of green space structures: mean patch area (area and edge), mean fractal dimension index (shape), and mean proximity index (proximity). Additionally, greenness indices, the normalized difference vegetation index, and the enhanced vegetation index were used to confirm the association between greenness and incidence of bipolar disorder. These five indices were used to represent the individual's exposure according to the township of the hospital that they most frequently visited with symptoms of the common cold. Spearman's correlation analysis was performed to select variables by considering their collinearity. Subsequently, the frailty model for each index was used to examine the specific associations between those respective indices and the incidence of bipolar disorder by adjusting for related risk factors, such as socioeconomic status, metabolic syndrome, and air pollution. A negative association was identified between the mean patch area and the mean proximity index, and the incidence of bipolar disorder. In contrast, a positive association was found between the mean fractal dimension index and the incidence of bipolar disorder. We observed similar results in sensitivity testing and subgroup analysis. Exposure to green spaces with a larger area, greater proximity, lower complexity, and greener area may reduce the risk of bipolar disorder.
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Affiliation(s)
- Hao-Ting Chang
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, 70101, Taiwan
| | - Chih-Da Wu
- Department of Geomatics, College of Engineering, National Cheng Kung University, Tainan, 70101, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, 350, Taiwan
| | - Jung-Der Wang
- Department of Public Health, National Cheng Kung University, College of, Medicine, Tainan, 70101, Taiwan
| | - Po-See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of, Medicine, National Cheng Kung University, Tainan, 70101, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, 70101, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, 64000, Taiwan
| | - Huey-Jen Su
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, 70101, Taiwan.
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Bio DS, Moreno RA, Garcia-Otaduy MC, Nery F, Lafer B, Soeiro-de-Souza MG. Altered brain creatine cycle metabolites in bipolar I disorder with childhood abuse: A 1H magnetic resonance spectroscopy study. Prog Neuropsychopharmacol Biol Psychiatry 2021; 109:110233. [PMID: 33387596 DOI: 10.1016/j.pnpbp.2020.110233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/09/2020] [Accepted: 12/21/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Childhood abuse (CA) is a risk factor for a number of psychiatric disorders and has been associated with higher risk of developing bipolar disorders (BD). CA in BD has been associated with more severe clinical outcomes, but the neurobiological explanation for this is unknown. Few studies have explored in vivo measurement of brain metabolites using proton magnetic resonance spectroscopy (1H-MRS) in CA and no studies have investigated the association of CA severity with brain neurometabolites in BD. OBJECTIVE To investigate whether CA severity is associated with changes in anterior cingulate cortex (ACC) neurometabolite profile in BD and HC subjects. METHODS Fifty-nine BD I euthymic patients and fifty-nine HC subjects were assessed using the Childhood Trauma Questionnaire (CTQ) and underwent a 3-Tesla 1H-MRS scan. Severity of childhood abuse (physical, sexual and emotional) and its association with levels of brain metabolites was analyzed within each group. RESULTS BD patients had higher total scores on the CTQ and higher severity rates of sexual and physical abuse compared to HC subjects. Greater severity of physical and sexual abuse was associated with increased ACC PCr level and lower Cr/PCr ratio in the BD group only. CONCLUSION Sexual and physical abuse in BD patients, but not in HC subjects, appeared to be associated with creatine metabolism in the ACC, which can influence neuronal mitochondrial energy production. Further studies should investigate whether this is the mechanism underlying the association between CA and worse clinical outcomes in BD.
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Affiliation(s)
- Danielle Soares Bio
- Mood Disorders Unit (PROGRUDA), Department of Psychiatry, School of Medicine, University of São Paulo, Brazil
| | - Ricardo Alberto Moreno
- Mood Disorders Unit (PROGRUDA), Department of Psychiatry, School of Medicine, University of São Paulo, Brazil
| | | | - Fabiano Nery
- University of Cincinnati Medical Center, United States
| | - Beny Lafer
- Bipolar Disorders Program (PROMAN), Department of Psychiatry, School of Medicine, University of São Paulo, Brazil
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Erkoreka L, Zamalloa I, Rodriguez S, Muñoz P, Mendizabal I, Zamalloa MI, Arrue A, Zumarraga M, Gonzalez-Torres MA. Attachment anxiety as mediator of the relationship between childhood trauma and personality dysfunction in borderline personality disorder. Clin Psychol Psychother 2021; 29:501-511. [PMID: 34228846 DOI: 10.1002/cpp.2640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 11/11/2022]
Abstract
Insecure attachment has been described as mediating the relationship between childhood trauma and dysfunctional personality traits in different mental disorders. Despite the role insecure attachment and childhood trauma have independently demonstrated to play as determinants of borderline personality disorder, less is known about the mediating mechanisms explaining these associations. For the first time, we assessed adult attachment, childhood trauma and dimensional personality pathology in a sample of outpatients with borderline personality disorder and tested whether the association between childhood trauma and personality dysfunction was at least partially attributable to insecure attachment. The results showed that attachment anxiety fully mediated the relationship between specific types of trauma (emotional abuse and physical neglect) and emotional dysregulation. Further, emotional abuse was both directly associated with dissocial behaviour and indirectly via attachment anxiety (partial mediation). Emotional abuse has been described as an essential environmental factor for the development of borderline personality disorder and emotional dysregulation, on its part, as the core feature of the condition. Our results indicate that attachment anxiety explains the link between these central aspects of borderline personality disorder. Our findings are consistent with previous research and current etiological understanding of the condition and provide support for recommending a careful assessment of childhood traumatic experiences and adult attachment style to gain a more comprehensive insight into the symptoms and its heterogeneity. As a secondary aim, we assessed the effect parental mental illness may have in these mediation models, but no significant influence on childhood trauma, attachment or personality was found.
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Affiliation(s)
- Leire Erkoreka
- Department of Psychiatry, Galdakao-Usansolo Hospital, Osakidetza Basque Health Service, Galdakao, Spain.,Department of Neurosciences, University of the Basque Country UPV/EHU, Leioa, Spain.,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Iker Zamalloa
- Department of Neurosciences, University of the Basque Country UPV/EHU, Leioa, Spain
| | | | - Pedro Muñoz
- Eating Disorders Unit, Bizkaia Mental Health Network, Osakidetza Basque Health Service, Barakaldo, Spain
| | - Imanol Mendizabal
- Department of Neurosciences, University of the Basque Country UPV/EHU, Leioa, Spain
| | - M Isabel Zamalloa
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Neurochemical Research, Bizkaia Mental Health Network, Osakidetza Basque Health Service, Barakaldo, Spain
| | - Aurora Arrue
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Neurochemical Research, Bizkaia Mental Health Network, Osakidetza Basque Health Service, Barakaldo, Spain
| | - Mercedes Zumarraga
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Neurochemical Research, Bizkaia Mental Health Network, Osakidetza Basque Health Service, Barakaldo, Spain
| | - Miguel Angel Gonzalez-Torres
- Department of Neurosciences, University of the Basque Country UPV/EHU, Leioa, Spain.,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Psychiatry, Basurto University Hospital, Osakidetza Basque Health Service, Bilbao, Spain
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Pedrini L, Ferrari C, Lanfredi M, Bellani M, Porcelli S, Caletti E, Sala M, Rossetti MG, Piccin S, Dusi N, Balestrieri M, Perlini C, Lazzaretti M, Mandolini GM, Pigoni A, Boscutti A, Bonivento C, Serretti A, Rossi R, Brambilla P. The association of childhood trauma, lifetime stressful events and general psychopathological symptoms in euthymic bipolar patients and healthy subjects. J Affect Disord 2021; 289:66-73. [PMID: 33945916 DOI: 10.1016/j.jad.2021.04.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/19/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Psychopathological symptoms during euthymia in Bipolar Disorder (BD) affect quality of life and predispose to the occurrence of new acute episodes, however only few studies investigated potential risk-factors. This study aims to explore the association between childhood trauma (CT), lifetime stressful events (SLEs) and psychopathological symptoms in BD patients during euthymia and controls (HC). METHODS A total of 261 participants (93 euthymic patients with BD, 168 HC) were enrolled. Generalized linear models and multiple logistic models were used to assess the association among the Symptom Check List-90-R (SCL-90-R), the Infancy Trauma Interview, the Paykel Life Events Scale. RESULTS The rate of participants reporting CT was higher in BD (n=47; 53%) than HC (n=43; 30%) (p=0.001). The experience of neglect was strongly related to BD (OR 6.5; p=0.003). CT was associated to higher scores on the SCL-90-R subscales (all the subscales except Phobia). No effects of the interaction between CT and diagnosis were found on SCL-90-R. Finally, there was a main effect of CT on lifetime SLEs (p<.001), that was not associated with diagnosis (p=0.833), nor with the interaction between CT and diagnosis (p=0.624). LIMITATIONS The cross-sectional design does not allow causal inferences; the exclusion of subjects reporting medical or psychiatric comorbidity limits generalizability. CONCLUSIONS CT was associated both to psychopathological symptoms during euthymia and the lifetime SLEs, thus it may represent a vulnerability factor influencing the course of BD. Overall, these data contribute to overcome the limited evidences documenting the influence of environmental factors on euthymic phase in BD.
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Affiliation(s)
- Laura Pedrini
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, via Pilastroni 4, 25125, Italy.
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, via Pilastroni 4, 25125, Italy
| | - Mariangela Lanfredi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, via Pilastroni 4, 25125, Italy
| | - Marcella Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Stefano Porcelli
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy
| | - Elisabetta Caletti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 28, Milano, Italy
| | - Michela Sala
- Department of Mental Health, Azienda Sanitaria Locale Alessandria, via Venezia 6, 15121 Alessandria, Italy
| | - Maria Gloria Rossetti
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 28, Milano, Italy
| | - Sara Piccin
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, P.le S. Maria della Misericordia 33100 Udine, Italy
| | - Nicola Dusi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 28, Milano, Italy
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, P.le S. Maria della Misericordia 33100 Udine, Italy
| | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Matteo Lazzaretti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 28, Milano, Italy
| | - Gian Mario Mandolini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 28, Milano, Italy
| | - Alessandro Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 28, Milano, Italy; MoMiLab Research Unit, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Andrea Boscutti
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, 20122 Milano, Italy
| | - Carolina Bonivento
- Scientific Institute IRCCS 'Eugenio Medea', Polo FVG, Via della Bontà 7, 33078 San Vito al Tagliamento, Pordenone, Italy
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy
| | - Roberta Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, via Pilastroni 4, 25125, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 28, Milano, Italy; Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, 20122 Milano, Italy
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Wrobel A, Russell SE, Dean OM, Cotton S, Berk M, Turner A. Influence of childhood trauma on the treatment outcomes of pharmacological and/or psychological interventions for adolescents and adults with bipolar disorder: protocol for a systematic review and meta-analysis. BMJ Open 2021; 11:e044569. [PMID: 33926981 PMCID: PMC8094386 DOI: 10.1136/bmjopen-2020-044569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/14/2020] [Accepted: 03/23/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Despite available pharmacological and psychological treatments, remission rates for bipolar disorder remain relatively low. Current research implicates the experience of childhood trauma as a potential moderator of poor treatment outcomes among individuals with bipolar disorder. To date, the evidence reporting the influence of childhood trauma on the treatment outcomes of pharmacological and/or psychological interventions for adolescents and adults with bipolar disorder has not been systematically reviewed. METHOD AND ANALYSIS MEDLINE Complete, Embase, PsycINFO and the Cochrane Central Register of Controlled Trials will be searched to identify randomised and nonrandomised studies of pharmacological and/or psychological interventions for bipolar disorder, which also assessed childhood trauma. To be eligible for inclusion, studies must have been conducted with adolescents or adults (≥10 years). Data will be screened and extracted by two independent reviewers. The methodological quality of the included studies will be assessed with the Cochrane Collaboration's Risk of Bias tool and the Newcastle-Ottawa Scale. If deemed viable, a meta-analysis will be conducted using a random effects model. Heterogeneity of evidence will be estimated with the I² statistics. ETHICS AND DISSEMINATION This systematic review will use only previously published data. Therefore, ethical approval is not required. The results will be written in concordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, published in peer-reviewed journals and presented at relevant conferences. PROSPERO REGISTRATION NUMBER CRD42020201891.
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Affiliation(s)
- Anna Wrobel
- IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
| | - Samantha E Russell
- IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Olivia M Dean
- IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
- Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sue Cotton
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Michael Berk
- IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
- Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
- Department of Psychiatry, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Alyna Turner
- IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
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Palagini L, Miniati M, Marazziti D, Sharma V, Riemann D. Association among early life stress, mood features, hopelessness and suicidal risk in bipolar disorder: The potential contribution of insomnia symptoms. J Psychiatr Res 2021; 135:52-59. [PMID: 33445061 DOI: 10.1016/j.jpsychires.2020.12.069] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 12/18/2020] [Accepted: 12/29/2020] [Indexed: 12/16/2022]
Abstract
AIM The study aimed to investigate the potential pathways mediating early exposure to stressful events and the clinical manifestations of bipolar disorder (BD), such as severity of mood symptoms, hopelessness and suicidal ideation, focusing on the potential role of insomnia symptoms. METHOD A sample of 162 adult participants with BD I or II were assessed during depressed phase using the Structural Clinical Interview for DSM-5 (SCID-5), the Beck Depression Inventory-II (BDI-II), the Young Mania Rating Scale (YMRS), the Early Trauma Inventory Self Report-Short Form (ETISR-SF), the Beck Hopelessness Scale (BHS), the Insomnia Severity Index (ISI) and the Scale for Suicide Ideation (SSI). Participants with or without clinically significant insomnia were compared and we carried out correlations, regression and mediation analyses. RESULTS Participants with insomnia showed a greater severity of depressive symptoms,of suicidal risk, of the cognitive component of hopelessness and of early life stressors. Insomnia symptoms mediated the association among early life stress and depressive symptoms (Z = 2.72, p = 0.0006), the cognitive component of hopelessness (Z = 3.02, p = 0.0001) and suicidal ideation and plans (Z = 2.07 p = 0.0006). CONCLUSION Insomnia may mediate the relationship between early life stress and clinical manifestations of BD. Assessing the evolution of insomnia symptoms could offer an approach to characterize BD and to formulate treatment strategies. In particular targeting insomnia symptoms might potentially modify the clinical features of BD in response to early life stressful events.
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Affiliation(s)
- Laura Palagini
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy.
| | - Mario Miniati
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy
| | - Verinder Sharma
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada
| | - Dieter Riemann
- Department of Clinical Psychology and Psychophysiology/ Sleep Medicine, Center for Mental Disorders, University of Freiburg, Freiburg, Germany
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Lopizzo N, Mazzelli M, Zonca V, Begni V, D'Aprile I, Cattane N, Pariante CM, Riva MA, Cattaneo A. Alterations in 'inflammatory' pathways in the rat prefrontal cortex as early biological predictors of the long-term negative consequences of exposure to stress early in life. Psychoneuroendocrinology 2021; 124:104794. [PMID: 33429258 DOI: 10.1016/j.psyneuen.2020.104794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 12/17/2022]
Abstract
Early life stress, especially when experienced during the first period of life, affects the brain developmental trajectories leading to an enhanced vulnerability for stress-related psychiatric disorders later in life. Although both clinical and preclinical studies clearly support this association, the biological pathways deregulated by such exposure, and the effects in shaping the neurodevelopmental trajectories, have so far been poorly investigated. By using the prenatal stress (PNS) model, a well-established rat model of early life stress, we performed transcriptomic analyses in the prefrontal cortex of rats exposed or not to PNS and sacrificed at different postnatal days (PNDs 21, 40, 62). We first investigated the long-lasting mechanisms and pathways affected in the PFC. We have decided to focus on the prefrontal cortex because we have previously shown that this brain region is highly sensitive to PNS exposure. We found that adult animals exposed to PNS show alterations in 389 genes, mainly involved in stress and inflammatory signalling. We then wanted to establish whether PNS exposure could also affect the neurodevelopmental trajectories in order to identify the most critical temporal window. We found that PNS rats show the most significant changes during adolescence (between PND 40 versus PND 21), with alterations of several pathways related to stress, inflammation and metabolism, which were maintained until adulthood.
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Affiliation(s)
- Nicola Lopizzo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Department of Pharmacological and Biomolecular Sciences, University of Milan, Italy
| | - Monica Mazzelli
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Department of Pharmacological and Biomolecular Sciences, University of Milan, Italy
| | - Valentina Zonca
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Veronica Begni
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Italy
| | - Ilari D'Aprile
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Nadia Cattane
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Carmine M Pariante
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Marco A Riva
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Italy
| | - Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Department of Pharmacological and Biomolecular Sciences, University of Milan, Italy.
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50
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Huang C, Yuan Q, Zhang L, Wang L, Cui S, Zhang K, Zhou X. Associations Between Childhood Trauma and the Age of First-Time Drug Use in Methamphetamine-Dependent Patients. Front Psychiatry 2021; 12:658205. [PMID: 33868060 PMCID: PMC8044866 DOI: 10.3389/fpsyt.2021.658205] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/03/2021] [Indexed: 01/03/2023] Open
Abstract
Childhood trauma is related to substance use disorder; however, few studies have examined the relationship between childhood trauma and the age at which the drug was first used. The aim of this study was to investigate the relationship between childhood trauma and the age of first-time drug use among methamphetamine-dependent patients. Moreover, we analyzed the characteristics of adverse family environment associated with severe childhood trauma and the risk factors for starting drugs in minors. A baseline interview was conducted with 110 participants who were in detoxification, including demographic information, past substance use, and age of first-time drug use. The participants' childhood trauma experience before 18 years of age was evaluated using the simplified version of the Childhood Trauma Questionnaire (CTQ-SF). The Chinese version of the Family Environment Scale (FES-CV) was used to assess the family environment of methamphetamine-dependent patients. Among 110 non-injecting methamphetamine-dependent patients, nearly half (n = 48, 43.6%) had moderate and severe childhood trauma. Correlation analysis showed that the age of first-time drug use negatively correlated with emotional abuse (r = -0.32, p < 0.01) and physical abuse (r = -0.27, p < 0.01). The age of first-time drug use negatively correlated with conflict (r = -0.20, p < 0.05) and independence (r = -0.22, p < 0.05) of family environment, but positively correlated with intellectual-cultural orientation (r = 0.28, p < 0.01). Additionally, childhood trauma factors significantly correlated with many indexes of family environment, especially cohesion (r = -0.45, p < 0.01), conflict (r = 0.49, p < 0.01), and independence (r = 0.33, p < 0.01). Additionally, the regression model showed that when emotional abuse increased by one point, the age of first-time drug use was 0.69 years earlier. These findings suggest that a detrimental family environment can aggravate childhood trauma, and the experience of childhood emotional or physical abuse may be an effective predictor of early drug use among methamphetamine-dependent patients.
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Affiliation(s)
- Cui Huang
- Chaohu Hospital, Anhui Medical University, Hefei, China.,School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Qiuyu Yuan
- Chaohu Hospital, Anhui Medical University, Hefei, China.,School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Ling Zhang
- Chaohu Hospital, Anhui Medical University, Hefei, China.,School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Lei Wang
- Chaohu Hospital, Anhui Medical University, Hefei, China.,School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Shu Cui
- Chaohu Hospital, Anhui Medical University, Hefei, China.,School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Kai Zhang
- Chaohu Hospital, Anhui Medical University, Hefei, China.,School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Xiaoqin Zhou
- Chaohu Hospital, Anhui Medical University, Hefei, China.,School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
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