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Yu H, Sun Y, Ren J, Qin M, Su H, Zhou Y, Hou D, Zhang W. Factors related to suicidal ideation of schizophrenia patients in China: a study based on decision tree and logistic regression model. PSYCHOL HEALTH MED 2024; 29:1281-1295. [PMID: 38166506 DOI: 10.1080/13548506.2023.2301225] [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: 03/08/2023] [Accepted: 12/26/2023] [Indexed: 01/04/2024]
Abstract
This study aimed to investigate the factors associated with suicidal ideation in schizophrenia patients in China using decision tree and logistic regression models. From October 2020 to March 2022, patients with schizophrenia were chosen from Chifeng Anding Hospital and Daqing Third Hospital in Heilongjiang Province. A total of 300 patients with schizophrenia who met the inclusion criteria were investigated by questionnaire. The questionnaire covered general data, suicidal ideation, childhood trauma, social support, depressive symptoms and psychological resilience. Logistic regression analysis revealed that childhood trauma and depressive symptoms were risk factors for suicidal ideation in schizophrenia (OR = 2.330, 95%CI: 1.177 ~ 4.614; OR = 10.619, 95%CI: 5.199 ~ 21.688), while psychological resilience was a protective factor for suicidal ideation in schizophrenia (OR = 0.173, 95%CI: 0.073 ~ 0.409). The results of the decision tree model analysis demonstrated that depressive symptoms, psychological resilience and childhood trauma were influential factors for suicidal ideation in patients with schizophrenia (p < 0.05). The area under the ROC for the logistic regression model and the decision tree model were 0.868 (95% CI: 0.821 ~ 0.916) and 0.863 (95% CI: 0.814 ~ 0.912) respectively, indicating excellent accuracy of the models. Meanwhile, the logistic regression model had a sensitivity of 0.834 and a specificity of 0.743 when the Youden index was at its maximum. The decision tree model had a sensitivity of 0.768 and a specificity of 0.8. Decision trees in combination with logistic regression models are of high value in the study of factors influencing suicidal ideation in schizophrenia patients.
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Affiliation(s)
- Hong Yu
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
- The Third People's Hospital of Daqing, Daqing, China
| | - Yujing Sun
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
| | - Jiaxin Ren
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
| | - Mengnan Qin
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
| | - Hong Su
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
| | - Yuqiu Zhou
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
| | - Dongyu Hou
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
| | - Weimiao Zhang
- The second Clinical Medical College, Shanxi Medical University, Taiyuan, China
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Hogg B, Radua J, Gardoki-Souto I, Fontana-McNally M, Lupo W, Reinares M, Jiménez E, Madre M, Blanco-Presas L, Cortizo R, Massó-Rodriguez A, Castaño J, Argila I, Castro-Rodriguez JI, Comes M, Macias C, Sánchez-González R, Mur-Mila E, Novo P, Rosa AR, Vieta E, Padberg F, Pérez-Solà V, Valiente-Gómez A, Moreno-Alcázar A, Amann BL. EMDR therapy vs. supportive therapy as adjunctive treatment in trauma-exposed bipolar patients: A randomised controlled trial. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023:S2950-2853(23)00112-6. [PMID: 38061553 DOI: 10.1016/j.sjpmh.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/03/2023] [Accepted: 11/28/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Patients with bipolar disorder (BD) are frequently exposed to traumatic events which worsen disease course, but this study is the first multicentre randomised controlled trial to test the efficacy of a trauma-focused adjunctive psychotherapy in reducing BD affective relapse rates. MATERIALS AND METHODS This multicentre randomised controlled trial included 77 patients with BD and current trauma-related symptoms. Participants were randomised to either 20 sessions of trauma-focused Eye Movement Desensitization and Reprocessing (EMDR) therapy for BD, or 20 sessions of supportive therapy (ST). The primary outcome was relapse rates over 24-months, and secondary outcomes were improvements in affective and trauma symptoms, general functioning, and cognitive impairment, assessed at baseline, post-treatment, and at 12- and 24-month follow-up. The trial was registered prior to starting enrolment in clinical trials (NCT02634372) and carried out in accordance with CONSORT guidelines. RESULTS There was no significant difference between treatment conditions in terms of relapse rates either with or without hospitalisation. EMDR was significantly superior to ST at the 12-month follow up in terms of reducing depressive symptoms (p=0.0006, d=0.969), manic symptoms (p=0.027, d=0.513), and improving functioning (p=0.038, d=0.486). There was no significant difference in dropout between treatment arms. CONCLUSIONS Although the primary efficacy criterion was not met in the current study, trauma-focused EMDR was superior to ST in reducing of affective symptoms and improvement of functioning, with benefits maintained at six months following the end of treatment. Both EMDR and ST reduced trauma symptoms as compared to baseline, possibly due to a shared benefit of psychotherapy. Importantly, focusing on traumatic events did not increase relapses or dropouts, suggesting psychological trauma can safely be addressed in a BD population using this protocol.
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Affiliation(s)
- Bridget Hogg
- Centre Fòrum Research Unit, Hospital del Mar Research Institute, Barcelona, Spain; Mental Health Institute, Hospital del Mar Barcelona, Barcelona, Spain; PhD Programme, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Joaquim Radua
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Department of Clinical Neuroscience, Karolinska Institutet (KI), Sweden; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; Departament de Medicina, Facultat de Medicina i Ciencias de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Itxaso Gardoki-Souto
- Centre Fòrum Research Unit, Hospital del Mar Research Institute, Barcelona, Spain; PhD Programme, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Fontana-McNally
- Centre Fòrum Research Unit, Hospital del Mar Research Institute, Barcelona, Spain; Mental Health Institute, Hospital del Mar Barcelona, Barcelona, Spain
| | - Walter Lupo
- Centre Fòrum Research Unit, Hospital del Mar Research Institute, Barcelona, Spain
| | - María Reinares
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain; Departament de Medicina, Facultat de Medicina i Ciencias de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain; Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Spain
| | - Esther Jiménez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain; Departament de Medicina, Facultat de Medicina i Ciencias de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain; Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
| | - Mercè Madre
- Mental Health, Hospital de la Santa Creu i Sant Pau, IR SANT PAU, Barcelona, Spain; Hospital Benito Menni-CASM, Sant Boi de Llobregat, Barcelona, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Laura Blanco-Presas
- Hospital Benito Menni-CASM, Sant Boi de Llobregat, Barcelona, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Programa TEPT-AGRESX, Instituto de Neurociencias (ICN), Hospital Clinic, Barcelona, Spain
| | - Romina Cortizo
- Centro Salud Mental Adultos Ciutat Vella, Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centro Salud Mental Adultos, Institute of Mental Health, Hosptial del Mar Barcelona, Barcelona, Spain
| | - Anna Massó-Rodriguez
- Centro Salud Mental Infanto-Juvenil, Hospital del Mar Barcelona, Barcelona, Spain
| | - Juan Castaño
- Centro Salud Mental Adultos, Institute of Mental Health, Hosptial del Mar Barcelona, Barcelona, Spain
| | - Isabel Argila
- Hospital Benito Menni-CASM, Sant Boi de Llobregat, Barcelona, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | | | - Mercè Comes
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Cristina Macias
- Centre Fòrum Research Unit, Hospital del Mar Research Institute, Barcelona, Spain; Centro Salud Mental Adultos, Institute of Mental Health, Hosptial del Mar Barcelona, Barcelona, Spain; Centre Emili Mira, Institute of Mental Health, Hospital del Mar Barcelona, Barcelona, Spain
| | - Roberto Sánchez-González
- Mental Health Institute, Hospital del Mar Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain; Centro Salud Mental Adultos, Institute of Mental Health, Hosptial del Mar Barcelona, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Estanislao Mur-Mila
- Mental Health Institute, Hospital del Mar Barcelona, Barcelona, Spain; Centro Salud Mental Adultos, Institute of Mental Health, Hosptial del Mar Barcelona, Barcelona, Spain
| | - Patricia Novo
- Centro Salud Mental Infanto-Juvenil, Hospital del Mar Barcelona, Barcelona, Spain; Day Hospital, Centro de Psicoterapia de Barcelona (CPB), Barcelona, Spain
| | - Adriane R Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Departamento de Farmacologia, Instituto de Ciéncias Básicas de Saúde, Universidade Federal do Rio Grande do Sul, Brazil; Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande doSul (UFRGS), Porto Alegre, RS, Brazil
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain; Departament de Medicina, Facultat de Medicina i Ciencias de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain; Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Victor Pérez-Solà
- Mental Health Institute, Hospital del Mar Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain; Centro Salud Mental Adultos, Institute of Mental Health, Hosptial del Mar Barcelona, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Alicia Valiente-Gómez
- Centre Fòrum Research Unit, Hospital del Mar Research Institute, Barcelona, Spain; Mental Health Institute, Hospital del Mar Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain.
| | - Ana Moreno-Alcázar
- Centre Fòrum Research Unit, Hospital del Mar Research Institute, Barcelona, Spain; Mental Health Institute, Hospital del Mar Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Benedikt L Amann
- Centre Fòrum Research Unit, Hospital del Mar Research Institute, Barcelona, Spain; Mental Health Institute, Hospital del Mar Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
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Kim HJ, Kim J, Yook KH, Choi TK, Lee SH. Early Trauma Subtypes are Differentially Related to Anxiety Symptomatology and Suicidal Ideation in Panic Disorder. Psychiatry Investig 2023; 20:1211-1220. [PMID: 38163660 PMCID: PMC10758330 DOI: 10.30773/pi.2023.0371] [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: 10/22/2023] [Revised: 11/09/2023] [Accepted: 11/12/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE Early trauma significantly affects the severity of panic disorder (PD) symptoms and suicidal ideation. However, few studies have explored the specific effects of different early trauma subtypes on PD. This study analyzed how childhood trauma subtypes, including general, physical, emotional, and sexual, influence panic and phobia levels and suicidal ideation in adults with PD and healthy controls (HCs). METHODS In total, 455 adults with PD and 149 HCs participated in this study. The independent variables were sociodemographic and clinical variables such as coping strategies and early trauma subtypes from the Early Trauma Inventory Self Report-Short Form. The dependent variables were the Albany Panic and Phobia Questionnaire (APPQ), the Panic Disorder Severity Scale, and the Scale for Suicide Ideation (SSI). RESULTS Early emotional trauma significantly influenced the APPQ scores, whereas early physical trauma significantly influenced the SSI scores in patients with PD. However, in HCs, only early emotional trauma was significantly associated with the APPQ and SSI scores. CONCLUSION These findings highlight the influence of early trauma subtypes on the phobic symptom severity of PD and suicidal ideation among patients with PD. Early emotional trauma is associated with the severity of phobic symptoms, whereas early physical trauma is associated with suicidal ideation, suggesting distinct clinical outcomes based on the type of trauma in patients with PD.
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Affiliation(s)
- Hyun-Ju Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Jieun Kim
- Department of Family Environment and Welfare, Chonnam National University, Gwangju, Republic of Korea
| | - Ki-Hwan Yook
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Tai Kiu Choi
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
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Li X, Huang Y, Liu M, Zhang M, Liu Y, Teng T, Liu X, Yu Y, Jiang Y, Ouyang X, Xu M, Lv F, Long Y, Zhou X. Childhood trauma is linked to abnormal static-dynamic brain topology in adolescents with major depressive disorder. Int J Clin Health Psychol 2023; 23:100401. [PMID: 37584055 PMCID: PMC10423886 DOI: 10.1016/j.ijchp.2023.100401] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/24/2023] [Indexed: 08/17/2023] Open
Abstract
Childhood trauma is a leading risk factor for adolescents developing major depressive disorder (MDD); however, the underlying neuroimaging mechanisms remain unclear. This study aimed to investigate the association among childhood trauma, MDD and brain dysfunctions by combining static and dynamic brain network models. We recruited 46 first-episode drug-naïve adolescent MDD patients with childhood trauma (MDD-CT), 53 MDD patients without childhood trauma (MDD-nCT), and 90 healthy controls (HCs) for resting-state functional magnetic resonance imaging (fMRI) scans; all participants were aged 13-18 years. Compared to the HCs and MDD-nCT groups, the MDD-CT group exhibited significantly higher global and local efficiency in static brain networks and significantly higher temporal correlation coefficients in dynamic brain network models at the whole-brain level, and altered the local efficiency of default mode network (DMN) and temporal correlation coefficients of DMN, salience (SAN), and attention (ATN) networks at the local perspective. Correlation analysis indicated that altered brain network features and clinical symptoms, childhood trauma, and particularly emotional neglect were highly correlated in adolescents with MDD. This study may provide new evidence for the dysconnectivity hypothesis regarding the associations between childhood trauma and MDD in adolescents from the perspectives of both static and dynamic brain topology.
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Affiliation(s)
- Xuemei Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Huang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mengqi Liu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Manqi Zhang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yang Liu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Teng Teng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xueer Liu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Yu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuanliang Jiang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuan Ouyang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ming Xu
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Fajin Lv
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yicheng Long
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xinyu Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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González-Castro TB, Juárez-Rojop IE, Tovilla-Zárate CA, Ovando-Ricárdez JA, Hernández-Díaz Y, López-Narváez ML, Genis-Mendoza AD, Rodríguez-Pérez C. Gene-environment interaction between HPA-axis genes and trauma exposure in the suicide behavior: A systematic review. J Psychiatr Res 2023; 164:162-170. [PMID: 37352812 DOI: 10.1016/j.jpsychires.2023.06.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 03/03/2023] [Accepted: 06/15/2023] [Indexed: 06/25/2023]
Abstract
Suicide behavior (SB) emerge from complex interactions among traumatic events and multiple genetic factors. We conducted the first systematic review to assess the evidence of a link among trauma exposure, HPA-axis genes, and SB. A systematic search of PubMed, EBSCO, Science Direct, PsychInfo, and Scopus databases on gene-environment interaction, and susceptibility to SB was carried out until February 2022. Our study was prospectively registered in PROSPERO (CRD42022316141). A total of 13 epidemiological studies (11,756 subjects) were included: eight studies focused on traumatic experiences in the childhood and five studies on lifetime trauma exposure. All studies reported a positive association between the trauma exposure with SB. Gene-environment interaction was reported for CRHR1 (n = 6), CRHR2 (n = 2), FKBP5 (n = 2), and CRHBP (n = 1), however, for CRH, NR3C1, MC2R, and POMC genes no found gene-environment effects on SB. Trauma exposure could be one mechanism that links HPA-axis genes activity with the development of SB.
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Affiliation(s)
- Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, United Mexican States.
| | - Isela Esther Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Tabasco, United Mexican States.
| | - Carlos Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco, Tabasco, United Mexican States.
| | - José Antonio Ovando-Ricárdez
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, United Mexican States.
| | - Yazmin Hernández-Díaz
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, United Mexican States.
| | | | - Alma Delia Genis-Mendoza
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, United Mexican States.
| | - Candelario Rodríguez-Pérez
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, United Mexican States.
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Onofri A. Editorial: Present and future of EMDR in clinical psychology and psychotherapy, volume II. Front Psychol 2023; 14:1138153. [PMID: 36910837 PMCID: PMC9999004 DOI: 10.3389/fpsyg.2023.1138153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/01/2023] [Indexed: 03/14/2023] Open
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Martínez-Levy GA, Bermúdez-Gómez J, Flores-Torres RP, Merlín-García I, Nani A, Cruz-Fuentes CS, Briones-Velasco M. Clinical, environmental, and molecular factors associated to the occurrence and persistence of posttraumatic stress disorder after an earthquake. J Psychiatr Res 2022; 154:102-110. [PMID: 35933853 DOI: 10.1016/j.jpsychires.2022.07.041] [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: 03/30/2022] [Revised: 06/30/2022] [Accepted: 07/20/2022] [Indexed: 11/26/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a common and disabling condition with high incidence after an earthquake. The objective of the present study was to identify risk factors associated with the occurrence and persistence of PTSD. Individuals (18-65 years old) who experienced the earthquake of September 19th, 2017, attended the National Institute of Psychiatry (INPRFM) between October and November 2017 (baseline n = 68). Participants were followed 4-6 (first follow-up, n = 40) and 7-9 (second follow-up n = 41) months after the earthquake. Delay returning to normal activities, a negative emotional valence to a previous earthquake, comorbidity with depression, history of childhood maltreatment, and low expression of Glucocorticoid Receptor (GR) were associated with PTSD in the basal assessment. The earthquake-related variable associated with the persistence of PTSD at the second follow-up was that the earthquake had directly affected the participants, either because they were evicted, had damage to their homes, or suffered some injury. Comorbidity with dysthymia, history of childhood maltreatment, and higher severity of PTSD in the basal assessment were associated with persistent PTSD in the second follow-up. The lower expression of the FK506 binding protein 5 (FKBP5) in participants with persistent PTSD in the second follow-up was better explained by childhood physical abuse than with PTSD severity. These findings suggest that acute exposure to earthquake-related stressful situations is relevant for the initial risk of PTSD, while potential long-term stressful conditions are associated with its persistence. Likewise, molecular markers associated with hypothalamus-pituitary-adrenal-axis dysregulation were differentially associated with PTSD diagnosis at the different assessment times.
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Affiliation(s)
- G A Martínez-Levy
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñíz", Av. Mexico-Xochimilco 101, Huipulco, Tlalpan, Mexico City, 14370, Mexico.
| | - J Bermúdez-Gómez
- Servicios Clínicos, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñíz", Av. Mexico-Xochimilco 101, Huipulco, Tlalpan, Mexico City, 14370, Mexico.
| | - R P Flores-Torres
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñíz", Av. Mexico-Xochimilco 101, Huipulco, Tlalpan, Mexico City, 14370, Mexico.
| | - I Merlín-García
- Servicios Clínicos, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñíz", Av. Mexico-Xochimilco 101, Huipulco, Tlalpan, Mexico City, 14370, Mexico.
| | - A Nani
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñíz", Av. Mexico-Xochimilco 101, Huipulco, Tlalpan, Mexico City, 14370, Mexico.
| | - C S Cruz-Fuentes
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñíz", Av. Mexico-Xochimilco 101, Huipulco, Tlalpan, Mexico City, 14370, Mexico.
| | - M Briones-Velasco
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñíz", Av. Mexico-Xochimilco 101, Huipulco, Tlalpan, Mexico City, 14370, Mexico.
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Schnider M, Jenni R, Ramain J, Camporesi S, Golay P, Alameda L, Conus P, Do KQ, Steullet P. Time of exposure to social defeat stress during childhood and adolescence and redox dysregulation on long-lasting behavioral changes, a translational study. Transl Psychiatry 2022; 12:413. [PMID: 36163247 PMCID: PMC9512907 DOI: 10.1038/s41398-022-02183-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 11/09/2022] Open
Abstract
Traumatic events during childhood/early adolescence can cause long-lasting physiological and behavioral changes with increasing risk for psychiatric conditions including psychosis. Genetic factors and trauma (and their type, degree of repetition, time of occurrence) are believed to influence how traumatic experiences affect an individual. Here, we compared long-lasting behavioral effects of repeated social defeat stress (SD) applied during either peripuberty or late adolescence in adult male WT and Gclm-KO mice, a model of redox dysregulation relevant to schizophrenia. As SD disrupts redox homeostasis and causes oxidative stress, we hypothesized that KO mice would be particularly vulnerable to such stress. We first found that peripubertal and late adolescent SD led to different behavioral outcomes. Peripubertal SD induced anxiety-like behavior in anxiogenic environments, potentiated startle reflex, and increased sensitivity to the NMDA-receptor antagonist, MK-801. In contrast, late adolescent SD led to increased exploration in novel environments. Second, the long-lasting impact of peripubertal but not late adolescent SD differed in KO and WT mice. Peripubertal SD increased anxiety-like behavior in anxiogenic environments and MK-801-sensitivity mostly in KO mice, while it increased startle reflex in WT mice. These suggest that a redox dysregulation during peripuberty interacts with SD to remodel the trajectory of brain maturation, but does not play a significant role during later SD. As peripubertal SD induced persisting anxiety- and fear-related behaviors in male mice, we then investigated anxiety in a cohort of 89 early psychosis male patients for whom we had information about past abuse and clinical assessment during the first year of psychosis. We found that a first exposure to physical/sexual abuse (analogous to SD) before age 12, but not after, was associated with higher anxiety at 6-12 months after psychosis onset. This supports that childhood/peripuberty is a vulnerable period during which physical/sexual abuse in males has wide and long-lasting consequences.
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Affiliation(s)
- Mirko Schnider
- grid.8515.90000 0001 0423 4662Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), 1008 Prilly-Lausanne, Switzerland
| | - Raoul Jenni
- grid.8515.90000 0001 0423 4662Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), 1008 Prilly-Lausanne, Switzerland
| | - Julie Ramain
- grid.8515.90000 0001 0423 4662Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), 1008 Prilly-Lausanne, Switzerland
| | - Sara Camporesi
- grid.8515.90000 0001 0423 4662Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), 1008 Prilly-Lausanne, Switzerland
| | - Philippe Golay
- grid.8515.90000 0001 0423 4662Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), 1008 Prilly-Lausanne, Switzerland
| | - Luis Alameda
- grid.8515.90000 0001 0423 4662Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), 1008 Prilly-Lausanne, Switzerland
| | - Philippe Conus
- grid.8515.90000 0001 0423 4662Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), 1008 Prilly-Lausanne, Switzerland
| | - Kim Q. Do
- grid.8515.90000 0001 0423 4662Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), 1008 Prilly-Lausanne, Switzerland
| | - Pascal Steullet
- Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), 1008, Prilly-Lausanne, Switzerland.
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9
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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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10
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Yang JZ, Kang CY, Yuan J, Zhang Y, Wei YJ, Xu L, Zhou F, Fan X. Effect of adverse childhood experiences on hypothalamic-pituitary-adrenal (HPA) axis function and antidepressant efficacy in untreated first episode patients with major depressive disorder. Psychoneuroendocrinology 2021; 134:105432. [PMID: 34607174 DOI: 10.1016/j.psyneuen.2021.105432] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/07/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
Adverse childhood experiences (ACEs) has been associated not only with an increased vulnerability for stress-related psychiatric disorders but also with distinct alterations of the hypothalamic-pituitary-adrenal (HPA) axis function and the immune system. The aim of this study is to examine differences in the HPA axis between major depressive disorder (MDD) patients with and without ACEs, and to explore differences in efficacy and HPA changes after long term antidepressant treatment between these two groups. A cohort of 803 patients with MDD were recruited. After the determination of cortisol (COR) and adrenocorticotropic hormone (ACTH), Hamilton Rating Scale for Depression (HAMD), Hamilton Rating Scale for Anxiety (HAMA), the Childhood Trauma Questionnaire (CTQ), 403 subjects were recruited for the following treatment study. Finally 330 MDD patients finished the monotherapy treatments of four antidepressants (Fluoxetine, Sertraline, Venlafaxine-extended release (XR), Duloxetine hydrochloride) for 12 weeks. Of 403 patients, 226 (56%) patients reported ACEs. Total score of HAMD in MDD with ACEs were higher than those in MDD without ACEs. There were significant differences for both ACTH and COR between MDD patients with and without ACEs that MDD patients with any types of maltreatment had higher level. Both COR and ACTH was positively and significantly correlated with the total scores of CTQ, HAMD, HAMA. After 12 weeks treatment of antidepressants monotherapy, the mean (SD) changes in HAMD and HAMA total scores was greater in MDD without ACEs than those in MDD with ACEs. At the 12-week end point, response was achieved by 37.2% in the MDD with ACEs group, 59.0% in the MDD without ACEs group respectively, with significant difference. Remission was achieved by 15.2% in the MDD with ACEs group and 32.2% in the MDD without ACEs group, with significant difference. The change in ACTH level in MDD without ACEs was also greater than that in MDD with ACEs, which was positively and significantly correlated with the HAMD total score only in MDD patient without ACEs. Logistic regression analysis showed that the total scores of CTQ, level of COR and ACTH at baseline were significantly associated with the response and remission. These findings indicated that exposure to ACEs for MDD could influence the HPA function and severity of symptoms. ACEs, ACTH and COR could be used as predictors of long term antidepressant treatment, suggested that are poor prognostic signs for antidepressants monotherapy in MDD with ACEs.
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Affiliation(s)
- Jian Zhong Yang
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, China.
| | - Chuan Yuan Kang
- Department of Clinical Psychology, East Hospital Affiliated to Tongji University (Shanghai East Hospital), 150 Jimo Road, Pudong New District, Shanghai 200120, China.
| | - Jing Yuan
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, China
| | - Yan Zhang
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, China
| | - Yu Jun Wei
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, China
| | - Li Xu
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, China
| | - Fang Zhou
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, China
| | - Xinxin Fan
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, China
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11
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Scelles C, Bulnes LC. EMDR as Treatment Option for Conditions Other Than PTSD: A Systematic Review. Front Psychol 2021; 12:644369. [PMID: 34616328 PMCID: PMC8488430 DOI: 10.3389/fpsyg.2021.644369] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 08/24/2021] [Indexed: 12/12/2022] Open
Abstract
Eye Movement Desensitisation and Reprocessing (EMDR) is a treatment for post-traumatic stress disorder (PTSD). The technique is known to facilitate reprocessing of maladaptive memories that are thought to be central to this pathology. Here we investigate if EMDR therapy can be used in other conditions. We conducted a systematic literature search on PubMed, ScienceDirect, Scopus, and Web of Science. We searched for published empirical findings on EMDR, excluding those centred on trauma and PTSD, published up to 2020. The results were classified by psychiatric categories. Ninety articles met our research criteria. A positive effect was reported in numerous pathological situations, namely in addictions, somatoform disorders, sexual dysfunction, eating disorders, disorders of adult personality, mood disorders, reaction to severe stress, anxiety disorders, performance anxiety, Obsessive-Compulsive Disorder (OCD), pain, neurodegenerative disorders, mental disorders of childhood and adolescence, and sleep. Some studies reported that EMDR was successful in usually uncooperative (e.g., Dementia) or unproductive cases (e.g., aphasia). Moreover, in some severe medical conditions, when psychological distress was an obstacle, EMDR allowed the continuation of treatment-as-usual. Furthermore, the effects observed in non-pathological situations invite for translational research. Despite a generally positive outlook of EMDR as an alternative treatment option, more methodologically rigorous studies are needed. We discuss the advantages and limitations and possible implications for the hypothesised mechanisms of action.
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Affiliation(s)
- Charles Scelles
- Adult Psychiatry Department, Université Catholique de Louvain – Saint Luc University Hospital, Brussels, Belgium
- La Métairie Clinic, Nyon, Switzerland
- Adult Psychiatry Department, Geneva University Hospital, Geneva, Switzerland
| | - Luis Carlo Bulnes
- Brain, Body and Cognition Research Group, Vrije Universiteit Brussel, Brussels, Belgium
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12
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Herpers PCM, Neumann JEC, Staal WG. Treatment Refractory Internalizing Behaviour Across Disorders: An Aetiological Model for Severe Emotion Dysregulation in Adolescence. Child Psychiatry Hum Dev 2021; 52:515-532. [PMID: 32748274 PMCID: PMC8113221 DOI: 10.1007/s10578-020-01036-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 05/28/2020] [Accepted: 07/21/2020] [Indexed: 12/17/2022]
Abstract
Auto-aggressive behaviour, especially treatment refractory suicidality in adolescents with psychiatric disorders, may be challenging to clinicians. In search of therapeutic possibilities, we have integrated current opinions regarding causality and interdependency of suicidality and auto-aggressive behaviour across disorders within the HiTOP framework. We propose a developmental model regarding these unsettling behaviours in youths that may help to guide future directions for research and interventions. We argue that the interdependent development of biologic factors, attachment, moral reasoning and emotion regulation in an overprotective environment may lead to social anxiety and later during development to emotion dysregulation and severe internalizing behaviour disorders. To optimize treatment efficacy for both internalizing and externalizing behaviour, we emphasize the importance transdiagnostic interventions, such as addressing non-compliance, restoration of trust between parents and their child, and limitation of avoidance behaviour. These may be seen as higher order interventions within the HiTOP framework.
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Affiliation(s)
- Pierre C M Herpers
- Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, Nijmegen, 6525 GC, The Netherlands.
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands.
| | - Josephine E C Neumann
- Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, Nijmegen, 6525 GC, The Netherlands
| | - Wouter G Staal
- Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, Nijmegen, 6525 GC, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Geert Grooteplein 10, Nijmegen, 6525 GA, The Netherlands
- Faculty of Social Sciences, Leiden Institute for Brain and Cognition, Postzone C2-5, P.O. Box 9600, Leiden, 2300 RC, The Netherlands
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13
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Chaplin AB, Jones PB, Khandaker GM. Sexual and physical abuse and depressive symptoms in the UK Biobank. BMC Psychiatry 2021; 21:248. [PMID: 34001033 PMCID: PMC8127207 DOI: 10.1186/s12888-021-03207-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/07/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The association between sexual and physical abuse and subsequent depression is well-established, but the associations with specific depressive symptoms and sex differences remain relatively understudied. We investigated the associations of sexual and physical abuse with depressive symptoms in men and women in a large population cohort. METHODS Observational study based on 151,396 UK Biobank participants. Exposures included self-reported experiences of childhood physical abuse and sexual abuse. Mid-life outcomes included current depressive symptoms score, individual depressive symptoms, and lifetime depression. We used logistic regression to test associations of childhood sexual/physical abuse with depressive outcomes. RESULTS Recalled childhood sexual and physical abuse were both associated with current depressive symptoms score in adults. Results for individual symptoms-based analyses suggest that sexual and physical abuse are associated with all depressive symptoms, particularly suicidal behaviours. The associations between lifetime depression and sexual/physical abuse were not fully explained by current depressive symptoms score, indicating that these findings may not be fully attributable to recall bias. There was no indication of differential risk for specific depressive symptoms among men and women. CONCLUSIONS Sexual and physical abuse are robust risk factors for depression/depressive symptoms regardless of sex. Higher risk of suicidal behaviours associated with childhood sexual/physical abuse are of particular concern. Longitudinal research into sex-specific associations for individual depressive symptoms is required.
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Affiliation(s)
- Anna B. Chaplin
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Peter B. Jones
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK ,grid.450563.10000 0004 0412 9303Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Golam M. Khandaker
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK ,grid.450563.10000 0004 0412 9303Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK ,grid.5337.20000 0004 1936 7603MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK ,grid.5337.20000 0004 1936 7603Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK ,grid.439418.3Avon and Wiltshire Mental Health Partnership NHS Trust, Bristol, UK
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14
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Zhang Y, Fang X, Tang B, Fan K, Wen N, Zhao K, Xu W, Tang W, Chen Y. Childhood Trauma and Insomnia Increase Suicidal Ideation in Schizophrenia Patients: A Cross-Sectional Study. Front Psychiatry 2021; 12:769743. [PMID: 34858237 PMCID: PMC8631870 DOI: 10.3389/fpsyt.2021.769743] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/19/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives: This study aimed to investigate the effect of childhood trauma, especially its specific dimensions, and clinical risk factors for suicidal ideation in patients with schizophrenia. Methods: A total of 83 inpatients with schizophrenia were enrolled and divided into two groups: with suicidal ideation (n = 33) and without suicidal ideation (n = 50). All participants were administered the Childhood Trauma Questionnaire-Short Form, the Insomnia Severity Index, the Beck Scale for Suicide Ideation, the Modified Overt Aggression Scales, the auditory hallucination rating scale, the Hamilton Rating Scale of Depression and the Positive and Negative Syndrome Scale. Results: In our sample, 39.8% of the subjects had suicidal ideation, and 60.6% of them had suffered from childhood trauma. Patients with suicidal ideation had a higher Insomnia Severity Index score, Physical neglect score, the Childhood Trauma Questionnaire-Short Form total score (all P < 0.05) compared to those without. The logistic regression analysis revealed that physical neglect in Childhood Trauma Questionnaire was significantly associated with suicidal ideation (OR = 5.46, P < 0.05, 95% CI = 0.007-0.483). Further stepwise multiple linear regression identified that insomnia (β = 0.272, P = 0.011) and physical neglect (β = 0.257, P = 0.017) were strong risk factors for the severity of suicidal ideation in patients with schizophrenia. Mediation analysis showed that insomnia played a complete mediating role between physical neglect and suicidal ideation. Conclusion: Our results indicate that childhood maltreatment of physical neglect is a strong independent risk factor for suicidal ideation in schizophrenia. The risk is probably aggravated by the poor quality of sleep. Early screening and psychosocial treatment are recommended for psychotic individuals with a trauma history.
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Affiliation(s)
- Yaoyao Zhang
- Department of Psychiatry, Wenzhou Medical University, Wenzhou, China
| | - Xinyu Fang
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Bei Tang
- Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Kaili Fan
- Department of Psychiatry, Wenzhou Medical University, Wenzhou, China
| | - Na Wen
- Department of Psychiatry, The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ke Zhao
- Department of Psychiatry, Wenzhou Medical University, Wenzhou, China
| | - Weiqian Xu
- Department of Psychiatry, The Second People's Hospital of Taizhou, Taizhou, China
| | - Wei Tang
- Department of Psychiatry, Wenzhou Medical University, Wenzhou, China.,Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Yi Chen
- Department of Psychiatry, The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China
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15
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Paino M, Ordóñez-Camblor N, Fonseca-Pedrero E, García-Álvarez L, Pizarro-Ruiz JP. Development and Validation of an Instrument for the Detection of Early Traumatic Experiences (ExpTra-S) in Patients With Psychosis. Front Psychol 2020; 11:528213. [PMID: 33192770 PMCID: PMC7658315 DOI: 10.3389/fpsyg.2020.528213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 10/06/2020] [Indexed: 11/19/2022] Open
Abstract
The risk of the appearance of psychosis may reflect the existence of an underlying vulnerability, which may be influenced by environmental factors such as early traumatic experiences. This means that in clinical practice, the assessment of and approach to previous traumatic events is important in persons with psychotic disorders. The psychometric assessment of trauma has advanced considerably in recent years; however, there is no instrument that has been constructed and validated specifically for the evaluation of early traumatic experiences in the clinical population with psychosis. The main goal of this study was to present the construction and validation process of the Screening of Early Traumatic Experiences in Patients with Severe Mental Illness (ExpTra-S). The sample consisted of 114 patients who had experienced at least one psychotic episode (M = 35.5 years of age; SD = 9.26) and a comparison group of 153 young adults (M = 20.8 years of age; SD = 1.8). The factor analysis revealed an essentially one-dimensional structure. The ExpTra-S was associated with the positive dimension of the psychosis phenotype but not with the negative or affective dimensions, or subjective experiences. No items displayed differential functioning for sex and age. The ordinal alpha for the total score was 0.96. The patients with psychosis had a higher score for early traumatic experiences in comparison with the non-clinical group. The results obtained showed that the measuring instrument developed, the ExpTra-S, is a brief, simple, and useful measuring instrument for assessing the presence of early traumatic experiences in patients with severe mental illness.
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Affiliation(s)
- Mercedes Paino
- Department of Psychology, University of Oviedo, Oviedo, Spain
| | | | - Eduardo Fonseca-Pedrero
- Educational Sciences, University of La Rioja, Logroño, Spain.,Center for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
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16
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Yin H, Galfalvy H, Zhang B, Tang W, Xin Q, Li E, Xue X, Li Q, Ye J, Yan N, Mann JJ. Interactions of the GABRG2 polymorphisms and childhood trauma on suicide attempt and related traits in depressed patients. J Affect Disord 2020; 266:447-455. [PMID: 32056912 DOI: 10.1016/j.jad.2020.01.126] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/28/2019] [Accepted: 01/20/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Previously, we reported that the longest variant of the GABA A receptor γ2 subunit (GABRG2) was associated with suicidal behavior. The present study therefore aimed to determine whether polymorphisms near the alternatively spliced exon of GABRG2 are associated with suicide attempt (SA) and its related traits, and how these variants might interact with reported childhood trauma (CT) in their association with suicidal behavior. METHODS We examined 5 single nucleotide polymorphisms (SNPs) of GABRG2. Subjects were suicide Attempters (N = 94), non-suicide attempters (N = 168) with MDD or Bipolar depression, and healthy volunteers (N = 100). Data on demographics, depression severity and suicide attempts were collected. Participants also completed a set of instruments assessing CT, and lifetime aggression and impulsivity.. GABRG2 polymorphisms were genotyped using Sanger sequencing. RESULTS Allele A of rs211034 was a protective factor for SA (OR = 0.50 (0.32, 0.80), p = 0.003), and had an interaction effect with emotional neglect (OR = 0.89 (0.82, 0.97), p = 0.006) on depression. One haploblock (consisting of rs211035 and rs211034) was identified within these SNPs, and subjects with haplotype GA (frequency = 7.3%), had lower rate of SA (OR=0.26(0.10, 0.67), p = 0.006). Cognitive impulsivity (OR=1.38)1.24,1.55), p < 0.001), non-planning impulsivity (OR = 1.18 (1.10,1.25), p < 0.001), anger (OR = 1.13 (1.07,1.19), p < 0.001), impulsivity total score (OR = 1.10(1.06,1.15), p < 0.001), hostility (OR = 1.10 (1.04, 1.15), p < 0.001), aggression total score (OR = 1.05 (1.03,1.07), p < 0.001) were associated with depression, meanwhile, hopelessness (OR = 2.18 (1.56, 3.04), p < 0.001) and impulsivity total score (OR = 1.05 (1.02,1.08), p < 0.001) were associated with the risk of SA, adjusted by age and gender. There was no mediation effect in the relationship among CT, gene polymorphisms and SA or depression through increased impulsivity or aggression. LIMITATIONS The main limitation of this study is its modest sample size. More genetic variants as well as epigenetic markers should be examined in future studies. CONCLUSIONS These findings add to evidence for the involvement of GABRG2 and impulsivity and hopelessness in SA independent from their association with depression. More research is needed on possible mediators of the relationship between GABA-related gene and SA.
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Affiliation(s)
- Honglei Yin
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China.
| | - Hanga Galfalvy
- Department of Psychiatry, Columbia University, New York, NY
| | - Bin Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Weiwei Tang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Qianqian Xin
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Enze Li
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Xiang Xue
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Qiyang Li
- Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Junping Ye
- Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - Na Yan
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China
| | - J John Mann
- Department of Psychiatry, Columbia University, New York, NY; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York.
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17
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Normann C, Buttenschøn HN. Gene-environment interactions between HPA-axis genes and childhood maltreatment in depression: a systematic review. Acta Neuropsychiatr 2020; 32:1-11. [PMID: 31902387 DOI: 10.1017/neu.2020.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Gene-environment (GxE) interactions may comprise an important part of the aetiology of depression, and childhood maltreatment (CM), a significant stressor, has consistently been linked to depression. Hence, in this systematic review, we aimed to investigate the interaction between hypothalamus-pituitary-adrenal axis (HPA-axis) genes and CM in depression. METHODS We conducted a literature search using the Pubmed, Embase, and PsychINFO databases in adherence with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. We included studies investigating GxE interactions between HPA-axis genes [Angiotensin Converting Enzyme (ACE), Arginine Vasopressin (AVP), Corticotrophin Releasing Hormone (CRH), Corticotrophin Releasing Hormone Receptor 1 (CRHR1), Corticotrophin Releasing Hormone Receptor 2 (CRHR2), FK506 binding protein (FKBP5), Nuclear Receptor subfamily 3 group C member 1 (NR3C1), Nuclear Receptor subfamily 3 group C member 2 (NR3C2)] and CM in depression. RESULTS The literature search identified 159 potentially relevant studies. Following screening, 138 of these were excluded. Thus, 21 studies, investigating a total of 51 single nucleotide polymorphisms, were included in the final study. The most prevalent genes in the current study were CRHR1 and FKBP5. Significant GxE interactions were reported in seven of eight studies for CRHR1:rs110402 and CM, and in five of eight studies for FKBP5:rs1360780 and CM. In summary, our results suggest possible GxE interactions between CRHR1, FKBP5, NR3C1, and NR3C2 and CM, respectively. For the remaining genes, no relevant literature emerged. CONCLUSIONS We find that genetic variation in four HPA-axis genes may influence the effects of CM in depression.
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Affiliation(s)
- Caroline Normann
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Henriette N Buttenschøn
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- NIDO Denmark, Research and Education in Health, Regional Hospital West Jutland, Herning, Denmark
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18
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Alli S, Tasmim S, Adanty C, Graff A, Strauss J, Zai C, Gerretsen P, Borlido C, De Luca V. Childhood trauma predicts multiple, high lethality suicide attempts in patients with schizophrenia. Psychiatry Res 2019; 281:112567. [PMID: 31586840 DOI: 10.1016/j.psychres.2019.112567] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/12/2019] [Accepted: 09/12/2019] [Indexed: 11/17/2022]
Abstract
Childhood trauma has been shown to increase the risk of suicide attempts in individuals with schizophrenia. However, previous literature has been limited by considerable heterogeneity within the category of suicide attempters. Here we tested the predictive effect of childhood maltreatment on lifetime suicide attempt in a homogeneous sample of 650 patients with schizophrenia spectrum disorders. Childhood trauma was assessed using the Childhood Trauma Questionnaire-Short Form and suicide history was measured using subjective and objective validated scales as well as medical chart reviews. We refined our sample into two homogenous groups: 1) suicide attempters: patients who had attempted suicide multiple times, with highly lethal results (medical hospitalization required) (n = 24); and 2) non-ideators: patients who had no personal history of suicide attempt or ideation, or family history of attempt (n = 25). Binary logistic regression models revealed that total childhood trauma (β = 0.002; OR: 1.07; 95% CI: 1.00-1.14) and emotional abuse (β = 0.04; OR: 1.38; 95% CI: 1.08-1.77), but not other trauma subtypes, significantly predicted lifetime multiple, high lethality suicide attempts after adjusting for demographic and clinical covariates. Thus, childhood trauma is a weak, independent risk factor for extreme suicide attempts in patients with schizophrenia spectrum disorders.
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Affiliation(s)
- Sauliha Alli
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Samia Tasmim
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Ariel Graff
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - John Strauss
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Clement Zai
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Philip Gerretsen
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Carol Borlido
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Vincenzo De Luca
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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19
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Kim Y, Kwon A, Min D, Kim S, Jin MJ, Lee SH. Neurophysiological and Psychological Predictors of Social Functioning in Patients with Schizophrenia and Bipolar Disorder. Psychiatry Investig 2019; 16:718-727. [PMID: 31587532 PMCID: PMC6801316 DOI: 10.30773/pi.2019.07.28] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 07/28/2019] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE The aim of this study is to examine social functioning in patients with schizophrenia and bipolar disorder and explore the psychological and neurophysiological predictors of social functioning. METHODS Twenty-seven patients with schizophrenia and thirty patients with bipolar disorder, as well as twenty-five healthy controls, completed measures of social functioning (questionnaire of social functioning), neurocognition (Verbal fluency, Korean-Auditory Verbal Learning Test), and social cognition (basic empathy scale and Social Attribution Task-Multiple Choice), and the childhood trauma questionnaire (CTQ). For neurophysiological measurements, mismatch negativity and heart rate variability (HRV) were recorded from all participants. Multiple hierarchical regression was performed to explore the impact of factors on social functioning. RESULTS The results showed that CTQ-emotional neglect significantly predicted social functioning in schizophrenia group, while HRV-high frequency significantly predicted social functioning in bipolar disorder patients. Furthermore, emotional neglect and HRV-HF still predicted social functioning in all of the subjects after controlling for the diagnostic criteria. CONCLUSION Our results implicated that even though each group has different predictors of social functioning, early traumatic events and HRV could be important indicators of functional outcome irrespective of what group they are.
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Affiliation(s)
- Yourim Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
| | - Aeran Kwon
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
| | - Dongil Min
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
| | - Sungkean Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea.,Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Min Jin Jin
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea.,Department of Psychiatry, Inje University, Ilsan-Paik Hospital, Goyang, Republic of Korea
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20
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Mohammadzadeh A, Azadi S, King S, Khosravani V, Sharifi Bastan F. Childhood trauma and the likelihood of increased suicidal risk in schizophrenia. Psychiatry Res 2019; 275:100-107. [PMID: 30897391 DOI: 10.1016/j.psychres.2019.03.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 03/13/2019] [Accepted: 03/13/2019] [Indexed: 12/14/2022]
Abstract
The aims of the present study were to investigate the dimensions of childhood trauma (CT) in patients with schizophrenia, and to predict suicidal risk (e.g., current suicidal ideation and lifetime suicide attempts) by CT dimensions and clinical factors (positive and negative symptoms and depression). Eighty-two inpatients with schizophrenia completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Beck Depression Inventory-II (BDI-II), and the Beck Scale for Suicide Ideation (BSSI); they were also administered the Positive and Negative Syndrome Scale (PANSS).The presence of lifetime suicide attempts was assessed by structured diagnostic clinical interview. Patients with lifetime suicide attempts scored higher on sexual abuse than those without attempts after controlling for depression severity. Patients with high suicidal risk had higher scores on physical neglect than those without high risk after controlling for depression severity. Patients with high CT had higher scores on negative and positive symptoms, current suicidal ideation, and depression than those with low CT. Logistic regression analyses indicated that sexual abuse was a unique predictor of lifetime suicide attempts, and that physical neglect and depression were unique predictors of current suicidal ideation. These findings indicate that patients with schizophrenia who have experienced CT may be at increased risk for suicide.
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Affiliation(s)
| | - Shahdokht Azadi
- Department of Psychology, Islamic Azad University, Gachsaran Branch, Gachsaran, Kohgiluyeh and Boyer-Ahmad, Iran
| | - Suzanne King
- Department of Psychiatry, McGill University, Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Vahid Khosravani
- Clinical Research Development Center of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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21
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Räsänen S, Niemelä M, Nordström T, Hakko H, Haapea M, Marshall CA, Miettunen J. Parental hospital-treated somatic illnesses and psychosis of the offspring-The Northern Finland Birth Cohort 1986 study. Early Interv Psychiatry 2019; 13:290-296. [PMID: 28840960 DOI: 10.1111/eip.12479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 05/14/2017] [Accepted: 07/11/2017] [Indexed: 12/19/2022]
Abstract
AIM The aim of this study was to investigate whether parental somatic illnesses during childhood increase the risk for later psychosis in the offspring. In addition, we examined which parental illnesses in particular are associated with increased risk of psychosis in the offspring. METHOD The data of the Northern Finland Birth Cohort 1986 (NFBC 1986), included 9137 children born alive in northern Finland between the July 1, 1985, and the June 30, 1986. Information regarding the parents' somatic morbidity was collected through various healthcare registers up to age 28 of the cohort members. RESULTS Psychosis was diagnosed in 169 (1.8%) of the cohort members between the ages of 16 and 28. Accumulation of parental somatic diseases was related to later psychosis in the offspring. In addition, some specific somatic diagnostic groups of parents were emphasized in relation to psychosis in the offspring. CONCLUSIONS Our study findings indicated that parental somatic illness should be taken into account in the prevention of serious mental health problems in their offspring.
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Affiliation(s)
- Sami Räsänen
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Mika Niemelä
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Children, Adolescents and Families Unit, National Institute for Health and Welfare, Oulu, Finland
| | - Tanja Nordström
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Helinä Hakko
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Marianne Haapea
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Catherine A Marshall
- Department of Disability and Psychoeducational Studies, University of Arizona, Tucson, Arizona
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
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22
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Carvalho CM, Pan PM, Ota VK, Spindola LM, Xavier G, Santoro ML, Mazzotti DR, Pellegrino R, Hakonarson H, Rohde LA, Miguel EC, Gadelha A, Bressan RA, Belangero SI. Effects of the interaction between genetic factors and maltreatment on child and adolescent psychiatric disorders. Psychiatry Res 2019; 273:575-577. [PMID: 30716596 DOI: 10.1016/j.psychres.2019.01.078] [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: 09/18/2018] [Revised: 01/04/2019] [Accepted: 01/19/2019] [Indexed: 11/25/2022]
Abstract
We evaluated the effects of the interaction between child maltreatment (CM) and single nucleotide polymorphisms (SNPs) on development of mental disorders (MD) and psychopathology. We genotyped 720 individuals from a Brazilian community school-based prospective study, focusing on SNPs in 21 genes known to be associated with mental disorders. CM was assessed via a multi-informant-measure, which was previously validated. To test G × CM, we used linear or logistic models depending on variable evaluated (MD or dimensional psychopathology). After Bonferroni multiple comparison correction, we did not find any statistically significant association of G × CM with either MD or psychopathology.
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Affiliation(s)
- Carolina Muniz Carvalho
- Genetics Division of the Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), Brazil; Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), UNIFESP, Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Pedro M Pan
- Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), UNIFESP, Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Vanessa K Ota
- Genetics Division of the Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), Brazil; Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), UNIFESP, Brazil
| | - Letícia M Spindola
- Genetics Division of the Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), Brazil; Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), UNIFESP, Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Gabriela Xavier
- Genetics Division of the Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), Brazil; Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), UNIFESP, Brazil
| | - Marcos L Santoro
- Genetics Division of the Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), Brazil; Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), UNIFESP, Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Diego R Mazzotti
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, USA
| | - Renata Pellegrino
- Laboratory Center for Applied Genomics of Children's Hospital of Philadelphia, Philadelphia, USA
| | - Hakon Hakonarson
- Laboratory Center for Applied Genomics of Children's Hospital of Philadelphia, Philadelphia, USA
| | - Luis Augusto Rohde
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
| | | | - Ary Gadelha
- Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), UNIFESP, Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Rodrigo A Bressan
- Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), UNIFESP, Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Sintia I Belangero
- Genetics Division of the Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), Brazil; Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), UNIFESP, Brazil; Department of Psychiatry, UNIFESP, Brazil.
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23
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Sancassiani F, Carmassi C, Romano F, Balestrieri M, Caraci F, Di Sciascio G, Drago F, Faravelli C, Hardoy MC, Moro MF, Roncone R, Preti A, Dell'Osso L. Impairment of Quality of Life Associated With Lifetime Diagnosis of Post-traumatic Stress Disorder in Women - A National Survey in Italy. Clin Pract Epidemiol Ment Health 2019; 15:38-43. [PMID: 30972141 PMCID: PMC6416466 DOI: 10.2174/1745017901915010038] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 01/28/2019] [Accepted: 02/02/2019] [Indexed: 12/16/2022]
Abstract
Introduction The aim of the study was to measure the lifetime prevalence of Post-Traumatic Stress Disorder (PTSD) among women of an Italian community sample, the comorbidity of PTSD with mood and anxiety disorders and the burden attributable to PTSD in worsening the Quality of Life (QoL). Methods Community survey on a sample of 1961 adult women randomly selected. Tools: psychiatric clinical interview ANTAS partially derived from the SCID-DSM-IV, administered by psychologists or medical doctors; Short Form Health Survey (SF-12); Mood Disorder Questionnaire (MDQ). Results Lifetime prevalence of PTSD in women was 1.3%, (1.4% in<45 years aged, 1.3% in >44 years aged; p=0.8). In order of risk of comorbidity, PTSD was associated with: Bipolar Spectrum Disorders (MDQ+), Panic Disorders (PD) and Major Depressive Disorder (MDD). People with PTSD showed an SF-12 mean score lower than women of the same sample without PTSD (standardized by gender and age), with a mean difference (attributable burden) of 3.9±0.9 similarly to MDD and Eating Disorders and higher than PD. Among the analyzed nonpsychiatric diseases, Multiple Sclerosis and Carotid Atherosclerosis showed a higher burden in impairing QoL than PTSD; Wilson's Disease showed a similar burden and Celiac Disease was found less impairing on QoL than PTSD. Conclusion The attributable burden in worsening women' perceived QoL due to a lifetime diagnosis of PTSD was found comparable to those caused by MDD, Eating Disorders or by neurological condition such as Wilson's Disease. The comorbidity of PTSD with Bipolar Spectrum Disorders was remarkable, even further studies are needed to clarify the direction of causality.
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Affiliation(s)
- Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | | | | | | | | | | | | | - Maria Carolina Hardoy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Maria Francesca Moro
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Mailman School of Public Health Columbia University, New York, NY 10027, USA
| | | | - Antonio Preti
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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24
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Devi F, Shahwan S, Teh WL, Sambasivam R, Zhang YJ, Lau YW, Ong SH, Fung D, Gupta B, Chong SA, Subramaniam M. The prevalence of childhood trauma in psychiatric outpatients. Ann Gen Psychiatry 2019; 18:15. [PMID: 31428182 PMCID: PMC6694480 DOI: 10.1186/s12991-019-0239-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 07/27/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The aim of this present study was to compare the prevalence and type of trauma experienced by community sample with the outpatient sample with mental disorders. METHODS A total of 354 outpatients, aged 14-35 years old, with mood disorders, schizophrenia and other psychotic disorders, adjustment disorder and anxiety disorder were recruited from a tertiary psychiatric hospital. A total of 100 healthy controls were recruited from the Singapore general population by snowballing. The Childhood Trauma Questionnaire-Short Form (CTQ-SF) designed to measure childhood trauma and the severity (e.g., physical abuse, emotional abuse, sexual abuse, physical neglect and emotional neglect) was administered to participants. Socio-demographic and clinical characteristics were obtained from interviews with the participants and from outpatients' medical records, respectively. Independent sample t tests and Chi-square tests were used to investigate the differences between the outpatient and community samples. RESULTS Overall the CTQ-SF total and domain scores indicated that outpatient sample experienced higher rate of traumatic life events in childhood than community sample. Two most reported trauma types were emotional abuse (n = 81, 59.1%) and physical neglect (n = 74, 54%) reported by the mood disorder group. In the community sample, emotional neglect (n = 46, 46%) and physical neglect (n = 18, 18%) were the most commonly reported trauma type. Overall outpatient sample (n = 80, 22.6%) and community sample (n = 28, 28%) reported at least one type of trauma. CONCLUSION The findings indicate higher rates of CTQ-SF total and domain scores in outpatient sample demonstrating a higher rate of traumatic life events in childhood compared to community sample. Further research in childhood trauma is needed to improve the knowledge in psychiatric clinic practices.
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Affiliation(s)
- Fiona Devi
- 1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Shazana Shahwan
- 1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Wen Lin Teh
- 1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Rajeswari Sambasivam
- 1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Yun Jue Zhang
- 1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Ying Wen Lau
- 1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Say How Ong
- 3Department of Developmental Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Daniel Fung
- 3Department of Developmental Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Bhanu Gupta
- 2Department of Mood & Anxiety, Institute of Mental Health, Singapore, Singapore
| | - Siow Ann Chong
- 1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Mythily Subramaniam
- 1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
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25
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Menke A, Lehrieder D, Fietz J, Leistner C, Wurst C, Stonawski S, Reitz J, Lechner K, Busch Y, Weber H, Deckert J, Domschke K. Childhood trauma dependent anxious depression sensitizes HPA axis function. Psychoneuroendocrinology 2018; 98:22-29. [PMID: 30086534 DOI: 10.1016/j.psyneuen.2018.07.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/04/2018] [Accepted: 07/25/2018] [Indexed: 12/12/2022]
Abstract
Anxious depression is a common subtype of major depressive disorder (MDD) and is associated with greater severity and poorer outcome. Alterations of the hypothalamic-pituitary-adrenal (HPA) axis, especially of the glucocorticoid receptor (GR) function, are often observed in MDD, but evidence lacks for anxious depression. Childhood adversity is known to influence both the HPA axis and risk of MDD. Therefore, we investigated GR-function in anxious depression dependent on childhood adversity. We enrolled 144 depressed in-patients (49.3% females). Anxious depression was defined using the Hamilton Depression Rating Scale (HAM-D) anxiety/somatization factor score ≥7. Blood draws were performed at 6 pm before and 3 h after 1.5 mg dexamethasone ingestion for measurement of cortisol, ACTH and blood count to assess GR-function and the immune system. In a subgroup of n = 60 FKBP5 mRNA controlled for FKBP5 genotype was measured before and after dexamethasone. Childhood adversity was evaluated using the Childhood Trauma Questionnaire (CTQ). We identified 78 patients (54.2%) with anxious depression who showed a greater severity and worse outcome. These patients were more often exposed to sexual abuse (30% vs. 16%/p = 0.04) and emotional neglect (76% vs. 58%/p = 0.02) than patients with non-anxious depression. Anxious depressed patients showed an enhanced GR-induced FKBP5 mRNA expression (F = 5.128; p = 0.03) and reduced cortisol levels, partly dependent on sexual abuse (F = 7.730; p = 0.006). Additionally, the GR-induced leukocyte response was enhanced in patients with sexual abuse (F = 7.176; p = 0.008). Anxious depression in dependence of childhood trauma is associated with heightened sensitivity of the HPA axis and the immune system which should be considered for treatment algorithms and targets.
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Affiliation(s)
- Andreas Menke
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, Wuerzburg, 97080, Germany; Comprehensive Heart Failure Center, University Hospital of Wuerzburg, Am Schwarzenberg 15, Wuerzburg, 97080, Germany; Interdisciplinary Center for Clinical Research, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080, Wuerzburg, Germany.
| | - Dominik Lehrieder
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, Wuerzburg, 97080, Germany
| | - Jasmin Fietz
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, Wuerzburg, 97080, Germany
| | - Carolin Leistner
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, Wuerzburg, 97080, Germany
| | - Catherina Wurst
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, Wuerzburg, 97080, Germany
| | - Saskia Stonawski
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, Wuerzburg, 97080, Germany
| | - Jannika Reitz
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, Wuerzburg, 97080, Germany
| | - Karin Lechner
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, Wuerzburg, 97080, Germany
| | - Yasmin Busch
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, Wuerzburg, 97080, Germany
| | - Heike Weber
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, Wuerzburg, 97080, Germany; Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Frankfurt, Heinrich-Hoffmann-Straße 10, 60528, Frankfurt am Main, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, Wuerzburg, 97080, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstrasse 5, 79104, Freiburg, Germany
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26
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Jaworska-Andryszewska P, Rybakowski JK. Childhood trauma in mood disorders: Neurobiological mechanisms and implications for treatment. Pharmacol Rep 2018; 71:112-120. [PMID: 30544098 DOI: 10.1016/j.pharep.2018.10.004] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 08/01/2018] [Accepted: 10/08/2018] [Indexed: 01/30/2023]
Abstract
A contemporary model for the pathogenesis of mood disorders (bipolar and depressive disorders) involves gene-environmental interaction, with genetic predisposition, epigenetic regulation, and environmental effects. Among multiple environmental factors, the experience of childhood trauma can be connected with the pathogenesis, course and the treatment of mood disorders. Patients with mood disorders have the greater frequency of childhood trauma compared with the general population, and adverse childhood experiences can exert a negative impact on their clinical course. In this article, the neurobiological mechanisms of childhood trauma are presented. The influence of negative childhood experiences on the central nervous system can result in many structural and functional changes of the brain, including such structures as hippocampus and amygdala, associated with the development of bipolar and depressive illnesses. Interaction of several genes with childhood trauma to produce pathological, clinical phenomena in adulthood has been demonstrated, the most important in this respect being the serotonin transporter gene and the FKBP5 gene playing an important role in the pathogenesis of mood disorders. Neurobiological effects can also involve epigenetic mechanisms such as DNA methylation which can exert an effect on brain function over long-term periods. Somatic effects of childhood trauma include disturbances of stress axis and immune-inflammatory mechanisms as well as metabolic dysregulation. Negative childhood experiences may also bear implications for the treatment of mood disorders. In the article, the impact of such experiences on the treatment of mood disorders will be discussed, especially in the context of treatment -resistance to antidepressants and mood-stabilizing drugs.
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Affiliation(s)
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznań, Poland.
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27
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Halonen JI, Koskinen A, Varje P, Kouvonen A, Hakanen JJ, Väänänen A. Mental health by gender-specific occupational groups: Profiles, risks and dominance of predictors. J Affect Disord 2018; 238:311-316. [PMID: 29902735 DOI: 10.1016/j.jad.2018.06.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 05/15/2018] [Accepted: 06/01/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND We defined gender-specific profiles of mental ill-health for the main occupational groups using three outcomes; antidepressant use, sickness absence (SA) due to depression, and suicides. We also examined which occupational groups had the highest risk of the outcomes, and compared the importance of their predictors. METHODS From a random register cohort of Finnish working age population, individuals in the six largest occupational groups in 2004 for men and women were included (N = 414 357). We used register data to define the first antidepressant purchase (i.e. use), the first long-term SA spell for depression, and suicide between Jan 1st 2005 and Dec 31st 2014. We assessed the risk of each outcome by occupational group with logistic regression models, and used dominance analysis to compare the relative importance of predictors. RESULTS In all six occupational groups for women, the prevalence of antidepressant use and SA for depression was higher than in the men's occupational groups. The opposite was observed for suicides. The risk of antidepressant use was lower, but the risk of suicide was 2-times higher among men in low vs. high-skilled occupations. Among women, a lower skill-level was associated with a higher risk of SA due to depression. Gender was the most important predictor of all outcomes. LIMITATIONS We lacked information on history of medication use or health problems prior to follow-up. CONCLUSIONS Gendered occupational status was an underlying factor explaining distinctive mental health profiles in the working population. Occupational class-dependent behavioural patterns related to mental health existed among men.
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Affiliation(s)
- Jaana I Halonen
- Finnish Institute of Occupational Health, Helsinki/Kuopio, Finland.
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Helsinki/Kuopio, Finland
| | - Pekka Varje
- Finnish Institute of Occupational Health, Helsinki/Kuopio, Finland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland; SWPS University of Social Sciences and Humanities in Wroclaw, Wroclaw, Poland; Administrative Data Research Centre (Northern Ireland), Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Jari J Hakanen
- Finnish Institute of Occupational Health, Helsinki/Kuopio, Finland
| | - Ari Väänänen
- Finnish Institute of Occupational Health, Helsinki/Kuopio, Finland; School of Social Policy, Sociology and Social Research, University of Kent, United Kingdom
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28
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McIntyre RS, Young AH, Haddad PM. Rethinking the spectrum of mood disorders: implications for diagnosis and management - Proceedings of a symposium presented at the 30th Annual European College of Neuropsychopharmacology Congress, 4 September 2017, Paris, France. Ther Adv Psychopharmacol 2018; 8:1-16. [PMID: 29977518 PMCID: PMC6022880 DOI: 10.1177/2045125318762911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 02/09/2018] [Indexed: 12/17/2022] Open
Abstract
The simultaneous occurrence of manic and depressive features has been recognized since classical times, but the term 'mixed state' was first used by Kraepelin at the end of the 19th century. From the 1980s, until the advent of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), psychiatric disorders were classified using a categorical approach. However, it was recognized that such an approach was too rigid to encompass the range of symptomatology encountered in clinical practice. Therefore, a dimensional approach was adopted in DSM-5, in which affective states are considered to be distributed across a continuum ranging from pure mania to pure depression. In addition, the copresence of symptoms of the opposite pole are captured using a 'with mixed features' specifier, applied when three or more nonoverlapping subthreshold symptoms of the opposite pole are present. Mixed features are common in patients with mood episodes, complicating the course of illness, reducing treatment response and worsening outcomes. However, research in this area is scarce and treatment options are limited. Current evidence indicates that antidepressants should be avoided for the treatment of bipolar mixed states. Evidence for bipolar mixed states supports the use of several second-generation antipsychotics, valproate and electroconvulsive therapy. One randomized controlled trial has demonstrated the efficacy of lurasidone, compared with placebo, in patients with major depressive disorder with mixed features, and there is limited evidence supporting the use of ziprasidone in such patients. Further research is required to determine whether other antipsychotic agents, or additional therapeutic approaches, might also be effective in this setting.
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Affiliation(s)
- Roger S McIntyre
- UHN-Toronto Western Hospital, Mood Disorders Psychopharmacology Unit, University of Toronto, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada
| | - Allan H Young
- Department of Psychological Medicine, King's College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - Peter M Haddad
- Neuroscience and Psychiatry Unit, University of Manchester, Manchester, UK
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Wang Q, Shelton RC, Dwivedi Y. Interaction between early-life stress and FKBP5 gene variants in major depressive disorder and post-traumatic stress disorder: A systematic review and meta-analysis. J Affect Disord 2018; 225:422-428. [PMID: 28850857 PMCID: PMC5626653 DOI: 10.1016/j.jad.2017.08.066] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 08/10/2017] [Accepted: 08/20/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Gene-environment interaction contributes to the risks of psychiatric disorders. Interactions between FKBP5 gene variants and early-life stress may enhance the risk not only for mood disorder, but also for a number of other behavioral phenotypes. The aim of the present study was to review and conduct a meta-analysis on the results from published studies examining interaction between FKBP5 gene variants and early-life stress and their associations with stress-related disorders such as major depression and PTSD. METHODS A literature search was conducted using PsychINFO and PubMed databases until May 2017. A total of 14 studies with a pooled total of 15109 participants met the inclusion criteria, the results of which were combined and a meta-analysis was performed using the differences in correlations as the effect measure. Based on literature, rs1360780, rs3800373, and rs9470080 SNPs were selected within the FKBP5 gene and systematic review was conducted. RESULTS Based on the Comprehensive Meta-Analysis software, no publication bias was detected. Sensitivity analysis and credibility of meta-analysis results also indicated that the analyses were stable. The meta-analysis showed that individuals who carry T allele of rs1360780, C-allele of rs3800373 or T-allele of rs9470080 exposed to early-life trauma had higher risks for depression or PTSD. LIMITATIONS The effects of ethnicity, age, sex, and different stress measures were not examined due to limited sample size. CONCLUSIONS These results provide strong evidence of interactions between FKBP5 genotypes and early-life stress, which could pose a significant risk factor for stress-associated disorders such as major depression and PTSD.
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Affiliation(s)
- Qingzhong Wang
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Richard C Shelton
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Yogesh Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
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Kim S, Kim JS, Jin MJ, Im CH, Lee SH. Dysfunctional frontal lobe activity during inhibitory tasks in individuals with childhood trauma: An event-related potential study. Neuroimage Clin 2017; 17:935-942. [PMID: 29527497 PMCID: PMC5842757 DOI: 10.1016/j.nicl.2017.12.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 12/19/2017] [Accepted: 12/22/2017] [Indexed: 11/17/2022]
Abstract
Background Individuals who experience childhood trauma are vulnerable to various psychological and behavioral problems throughout their lifetime. This study aimed to investigate whether individuals with childhood trauma show altered frontal lobe activity during response inhibition tasks. Methods In total, 157 healthy individuals were recruited and instructed to perform a Go/Nogo task during electroencephalography recording. Source activities of N2 and P3 of Nogo event-related potentials (ERP) were analyzed. The Childhood Trauma Questionnaire (CTQ) and Barratt Impulsivity Scale (BIS) were applied. Individuals were divided into three groups based on their total CTQ score: low CTQ, middle CTQ, and high CTQ groups. Results The high CTQ group exhibited significantly higher BIS scores than the low CTQ group. P3 amplitudes of the differences between Nogo and Go ERP waves exhibited higher mean values in the low CTQ than the high CTQ group, with trending effects. In Nogo-P3, the source activities of the right anterior cingulate cortex, bilateral medial frontal cortex (MFC), bilateral superior frontal gyrus (SFG), and right precentral gyrus were significantly lower in the high CTQ than the low CTQ group. Motor impulsivity showed a significant negative correlation with activities of the bilateral MFC and SFG in Nogo-P3 conditions. Conclusions Our study revealed that individuals with childhood trauma have inhibitory failure and frontal lobe dysfunction in regions related to Nogo-P3.
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Affiliation(s)
- Sungkean Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea; Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Ji Sun Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea; Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, 31151, Republic of Korea
| | - Min Jin Jin
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea; Department of Psychology, Chung-Ang University, Seoul, Republic of Korea
| | - Chang-Hwan Im
- Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea.
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea; Department of Psychiatry, Inje University, Ilsan-Paik Hospital, Goyang, Republic of Korea.
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31
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An overview of posttraumatic stress disorder genetic studies by analyzing and integrating genetic data into genetic database PTSDgene. Neurosci Biobehav Rev 2017; 83:647-656. [DOI: 10.1016/j.neubiorev.2017.08.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 07/08/2017] [Accepted: 08/30/2017] [Indexed: 01/08/2023]
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Valiente-Gómez A, Moreno-Alcázar A, Treen D, Cedrón C, Colom F, Pérez V, Amann BL. EMDR beyond PTSD: A Systematic Literature Review. Front Psychol 2017; 8:1668. [PMID: 29018388 PMCID: PMC5623122 DOI: 10.3389/fpsyg.2017.01668] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 09/11/2017] [Indexed: 12/18/2022] Open
Abstract
Background: Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapeutic approach that has demonstrated efficacy in the treatment of Post-traumatic Stress Disorder (PTSD) through several randomized controlled trials (RCT). Solid evidence shows that traumatic events can contribute to the onset of severe mental disorders and can worsen their prognosis. The aim of this systematic review is to summarize the most important findings from RCT conducted in the treatment of comorbid traumatic events in psychosis, bipolar disorder, unipolar depression, anxiety disorders, substance use disorders, and chronic back pain. Methods: Using PubMed, ScienceDirect, and Scopus, we conducted a systematic literature search of RCT studies published up to December 2016 that used EMDR therapy in the mentioned psychiatric conditions. Results: RCT are still scarce in these comorbid conditions but the available evidence suggests that EMDR therapy improves trauma-associated symptoms and has a minor effect on the primary disorders by reaching partial symptomatic improvement. Conclusions: EMDR therapy could be a useful psychotherapy to treat trauma-associated symptoms in patients with comorbid psychiatric disorders. Preliminary evidence also suggests that EMDR therapy might be useful to improve psychotic or affective symptoms and could be an add-on treatment in chronic pain conditions.
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Affiliation(s)
- Alicia Valiente-Gómez
- Centre Emili Mira, Institute of Neuropsychiatry and Addictions, Parc de Salut Mar, Barcelona, Spain.,Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addictions, Parc de Salut Mar, Barcelona, Spain.,Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain
| | - Ana Moreno-Alcázar
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addictions, Parc de Salut Mar, Barcelona, Spain.,Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Devi Treen
- Institute of Neuropsychiatry and Addictions Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - Carlos Cedrón
- Institute of Neuropsychiatry and Addictions Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - Francesc Colom
- Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain.,Institute of Neuropsychiatry and Addictions Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Víctor Pérez
- Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain.,Institute of Neuropsychiatry and Addictions Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Benedikt L Amann
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addictions, Parc de Salut Mar, Barcelona, Spain.,Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain.,Institute of Neuropsychiatry and Addictions Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
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Kim JS, Jin MJ, Jung W, Hahn SW, Lee SH. Rumination as a Mediator between Childhood Trauma and Adulthood Depression/Anxiety in Non-clinical Participants. Front Psychol 2017; 8:1597. [PMID: 28993746 PMCID: PMC5622198 DOI: 10.3389/fpsyg.2017.01597] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 08/31/2017] [Indexed: 11/25/2022] Open
Abstract
Objective: Although there is strong evidence that childhood trauma is associated with the development of depression and anxiety, relatively few studies have explored potential mediating factors for this relationship. The present study aimed to evaluate the mediating role of rumination in the link between childhood trauma and mood status such as depression, anxiety and affective lability. Materials and Methods: Two hundred and seven non-clinical participants completed the Childhood Trauma Questionnaire, the Ruminative Response Scale, the Beck Depression Inventory, the State Anxiety Inventory, and the Affective Lability Scale. Structural equation modeling was used to evaluate the results. Results: Our results supported that rumination is a meaningful mediator between childhood trauma and depression/anxiety in non-clinical participants. The mediation model indicated that childhood trauma and its subtypes are linked to depression and anxiety through three subtypes of rumination, thereby supporting a significant indirect relationship (Standardized coefficient [SC] = 0.56, p < 0.001 for the path from trauma to rumination; SC = 0.67, p < 0.001, from rumination to mood). The direct relationship between childhood trauma and mood symptoms was also significant in a model including rumination (SC = 0.68, p < 0.001). The mediation effect of rumination in the relationship between childhood trauma and mood was more predominant in female participants. Conclusions: The present study found that rumination mediates the influence of childhood trauma on the development of mood symptoms in non-clinical participants. Childhood trauma appears to be a critical determinant for developing symptoms of depression and anxiety.
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Affiliation(s)
- Ji S Kim
- Clinical Emotion and Cognition Research Laboratory, Inje UniversityGoyang, South Korea.,Department of Psychiatry, Soonchunhyang University of College of MedicineChunan, South Korea
| | - Min J Jin
- Clinical Emotion and Cognition Research Laboratory, Inje UniversityGoyang, South Korea.,Department of Psychology, Chung-Ang UniversitySeoul, South Korea
| | - Wookyoung Jung
- Clinical Emotion and Cognition Research Laboratory, Inje UniversityGoyang, South Korea
| | - Sang W Hahn
- Department of Psychiatry, Soonchunhyang University of College of MedicineSeoul, South Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje UniversityGoyang, South Korea.,Department of Psychiatry, Inje University, Ilsan-Paik HospitalGoyang, South Korea
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Kim YK. Can we cope with treatment refractoriness in psychiatric disorders? Prog Neuropsychopharmacol Biol Psychiatry 2016; 70:101-2. [PMID: 27345157 DOI: 10.1016/j.pnpbp.2016.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Yong-Ku Kim
- Department of Psychiatry, College of Medicine, Korea University, Republic of Korea.
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