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Lewis P, Gottlieb JF, Morfeld P, Hellmich M, Erren TC. Perinatal photoperiod associations with bipolar disorder and depression: A systematic literature review and cross-sectional analysis of the UK Biobank database. Psychiatry Res 2024; 335:115878. [PMID: 38581863 DOI: 10.1016/j.psychres.2024.115878] [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: 11/06/2023] [Revised: 03/07/2024] [Accepted: 03/24/2024] [Indexed: 04/08/2024]
Abstract
Season-of-birth associations with psychiatric disorders point to environmental (co-)aetiological factors such as natural photoperiod that, if clarified, may allow interventions toward prevention. We systematically reviewed the literature concerning season-of-birth and bipolar disorder and depression and explored associations between the perinatal natural photoperiod and these outcomes in a cross-sectional analysis of the UK Biobank database. We used mean daily photoperiod and relative photoperiod range (relative to the mean) in the 3rd trimester and, separately, in the first 3 months post birth as metrics. From review, increased risk of depression with late spring birth is compatible with increased odds of probable single episode-, probable recurrent-, and diagnosed depression (OR 2.85 95 %CI 1.6-5.08, OR 2.20 95 %CI 1.57-3.1, and OR 1.48 95 %CI 1.11-1.97, respectively) with increasing 3rd trimester relative photoperiod range for participants who experienced relatively non-extreme daily photoperiods. Risk of bipolar disorder with winter-spring birth contrasted with no consistent patterns of perinatal photoperiod metric associations with bipolar disorder in the UK Biobank. As natural photoperiod varies by both time-of-year and latitude, perinatal natural photoperiods (and a hypothesized mechanism of action via the circadian timing system and/or serotonergic circuitry associated with the dorsal raphe nucleus) may reconcile inconsistencies in season-of-birth associations. Further studies are warranted.
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Affiliation(s)
- Philip Lewis
- Institute and Policlinic for Occupational Medicie, Environmental Medicine, and Prevention Research, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany.
| | - John F Gottlieb
- Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Peter Morfeld
- Institute and Policlinic for Occupational Medicie, Environmental Medicine, and Prevention Research, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Thomas C Erren
- Institute and Policlinic for Occupational Medicie, Environmental Medicine, and Prevention Research, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
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2
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Robinson N, Ploner A, Leone M, Lichtenstein P, Kendler KS, Bergen SE. Impact of Early-Life Factors on Risk for Schizophrenia and Bipolar Disorder. Schizophr Bull 2023; 49:768-777. [PMID: 36946500 PMCID: PMC10154720 DOI: 10.1093/schbul/sbac205] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND AND HYPOTHESIS Schizophrenia (SCZ) and bipolar disorder (BD) have shared genetic risk and clinical symptoms, yet the extent to which environmental risk factors are shared is not well known. We aimed to examine the associations of early-life environmental exposures with the risk of SCZ and BD. STUDY DESIGN We conducted a Swedish register-based nested case-control study using 4184 SCZ and 18 681 BD cases diagnosed 1988-2013, individually matched to 5 population-based controls by birth year, sex and birthplace. Conditional logistic regression was used to evaluate the risk of SCZ and BD by seasonality, severe prenatal infections, and perinatal factors. STUDY RESULTS Seasonality had similar patterns of risk for both disorders: Higher risk for births November-December; lower risk April-June. Experiencing any perinatal factor was associated with a significantly higher risk of SCZ (incidence rate ratio [IRR] 1.19, 95%CI 1.11-1.63) and to a lesser extent BD (IRR 1.08, 95%CI 1.05-1.12). Prenatal infections were only associated with a greater risk of SCZ (IRR 1.30, 95%CI 1.04-1.63). In the mutually adjusted model, only perinatal factors were associated with outcomes. Several perinatal factors were associated with both disorders, but estimates were significantly higher for SCZ for low birth weight, low APGAR, and high parity. Congenital malformations were only associated with risk of SCZ, and jaundice with BD. CONCLUSIONS Adverse perinatal factors and winter birth were the risk factors for both disorders, while severe prenatal infections were only risk a factor for SCZ. Early-life exposures were associated with a higher risk of both disorders, but may play a larger role in the development of SCZ than BD.
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Affiliation(s)
- Natassia Robinson
- Department of Medical Epidemiologiy and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Alexander Ploner
- Department of Medical Epidemiologiy and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Marica Leone
- Department of Medical Epidemiologiy and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Janssen Pharmaceutical Companies of Johnson & Johnson, Solna, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiologiy and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Sarah E Bergen
- Department of Medical Epidemiologiy and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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3
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Zhou H, Peng-Li D, Chen J, Sun D, Wan B. Early life climate and adulthood mental health: how birth seasonality influences depressive symptoms in adults. BMC Public Health 2023; 23:209. [PMID: 36721129 PMCID: PMC9887737 DOI: 10.1186/s12889-023-15145-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 12/11/2022] [Accepted: 01/27/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Early life in-utero can have long-term influence on the mental health status of individuals in adulthood, such as depression. Age, gender, socio-economic status, education, and geography are demographic factors shown to be particularly vulnerable towards the development of depressive symptoms. In addition, climate risks on depression include sunlight, rain, and temperature. However, whether climate factors in early life have a long-term influence on depression related to demographic vulnerability remains unknown. Here, the present study explored the association between birth seasonality and adulthood depressive symptoms. METHODS We employed data from the project of Chinese Labour-forces Dynamic Survey (CLDS) 2016, containing the epidemiological data of depressive symptoms with a probability proportional to size cluster and random cluster sampling method in 29 provinces of China. A final sample size of 16,185 participants was included. Birth seasonality included spring (March, April, and May), summer (June, July, and August), autumn (September, October, and November), and winter (December, January, and February). RESULTS We found that born in Autumn peaked lowest rate of having depressive symptoms (16.8%) and born in Summer (vs. Autumn) had a significant higher ratio (OR = 1.14, 95%CI = 1.02, 1.29) when controlling for demographic variables. In addition, demographic odds ratio of having depressive symptoms differed between people born in different seasons, particular for age and geography. CONCLUSION Our findings suggest that birth seasonality influences the sensitive link of depressive symptoms with age and geography. It implicates early life climate environment may play a role in the development of adulthood depressive symptoms.
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Affiliation(s)
- Hao Zhou
- grid.416271.70000 0004 0639 0580Stem Cell Transplantation Laboratory, Ningbo First Hospital, Ningbo, China
| | - Danni Peng-Li
- grid.9227.e0000000119573309Institute of Psychology, Chinese Academy of Sciences, Beijing, China ,grid.410726.60000 0004 1797 8419Sino-Danish College (SDC), University of Chinese Academy of Sciences, Beijing, China ,grid.7048.b0000 0001 1956 2722Department of Food Science, Aarhus University, Aarhus, Denmark
| | - Juan Chen
- grid.43169.390000 0001 0599 1243Department of Occupational and Environmental Health, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China ,grid.11135.370000 0001 2256 9319School of Public Health, Peking University, Beijing, China
| | - Dong Sun
- grid.12981.330000 0001 2360 039XSchool of Public Health, Sun Yat-sen University, Guangzhou, China ,grid.11135.370000 0001 2256 9319School of Public Health, Peking University, Beijing, China
| | - Bin Wan
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany. .,International Max Planck Research School on Neuroscience of Communication: Function, Structure, and Plasticity (IMPRS NeuroCom), Leipzig, Germany. .,School of Public Health, Sun Yat-sen University, Guangzhou, China.
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4
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Csajbók Z, Kagstrom A, Cermakova P. Season of birth has no effect on symptoms of depression and anxiety in older adults. Sci Rep 2022; 12:6823. [PMID: 35474329 PMCID: PMC9042812 DOI: 10.1038/s41598-022-10892-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 04/01/2022] [Indexed: 01/21/2023] Open
Abstract
There remains a lack of conclusive evidence as to the merit of season of birth as a predictor of mental illness across contexts. We studied 72,370 individuals (55% women; mean age 66) from the Survey on Health, Ageing and Retirement in Europe. Depressive symptoms were assessed with EURO-D scale and symptoms of anxiety with modified Beck Anxiety Inventory. Multilevel modeling was used to assess the association of season of birth as well as month of birth with symptoms of depression and anxiety, by sex and region. Adjusting for sex and age, month of birth explained only 0.01% to 0.07% of anxiety and depressive symptoms with non-significant improvement in the overall models; using season of birth instead of month of birth added 0.00% to 0.04% of explained variance. When stratified by sex and European region, age explained 0.23% to 5.19% of anxiety and depressive symptoms; the addition of month of birth or season of birth improved the models by negligible amount. Season of birth and month of birth are not reliable predictors of anxiety and depression across the life course.
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Affiliation(s)
- Zsófia Csajbók
- Second Faculty of Medicine, Charles University Prague, V Úvalu 84, 15006, Prague 5, Czechia
- Faculty of Humanities, Charles University Prague, Prague, Czechia
| | - Anna Kagstrom
- Second Faculty of Medicine, Charles University Prague, V Úvalu 84, 15006, Prague 5, Czechia
- National Institute of Mental Health, Klecany, Czechia
| | - Pavla Cermakova
- Second Faculty of Medicine, Charles University Prague, V Úvalu 84, 15006, Prague 5, Czechia.
- National Institute of Mental Health, Klecany, Czechia.
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5
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Piqué-Fandiño L, Gallois S, Pavard S, Ramirez Rozzi FV. Reproductive seasonality in the Baka Pygmies, environmental factors and climatic changes. PLoS One 2022; 17:e0264761. [PMID: 35259192 PMCID: PMC8903253 DOI: 10.1371/journal.pone.0264761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 02/16/2022] [Indexed: 12/03/2022] Open
Abstract
Reproductive seasonality is a phenomenon common to human and animal populations and driven by, among others, climatic variables. Given the currently changing climate and its impacts on both the environment and human lives, the question arises of its potential effects on reproductive seasonality. Few studies have specifically explored the seasonality of reproduction among hunter-gatherers and anyone investigated how current climate change might affect this phenomenon. In this study we addressed reproductive seasonality in the Baka Pygmy living in African rain forests. Since reproductive seasonality can be linked to weather patterns, we explore this possibility. However, climatic variables driving weather patterns have changed over the years, so we assessed whether this has influenced the Baka reproductive pattern. Based on 34 years of written birth records and oral questionnaires from 13 years of systematic fieldwork, we observed a bimodal birth pattern with two birth peaks at 6-month intervals. Our results demonstrate that precipitation at conception or at birth potentially has effects, respectively negative and positive on the monthly number of births; and temperature has a role in controlling other variables that do affect the reproductive pattern. Changing weather patterns appear to be affecting the reproductive seasonality in the Baka, suggesting that attention needs to be given to the influence of global climate change on forager societies.
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Affiliation(s)
- Laura Piqué-Fandiño
- Eco-anthropologie (EA), Muséum national d’Histoire naturelle, CNRS, Université de Paris, Musée de l’Homme, Paris, France
| | | | - Samuel Pavard
- Eco-anthropologie (EA), Muséum national d’Histoire naturelle, CNRS, Université de Paris, Musée de l’Homme, Paris, France
| | - Fernando V. Ramirez Rozzi
- Eco-anthropologie (EA), Muséum national d’Histoire naturelle, CNRS, Université de Paris, Musée de l’Homme, Paris, France
- EA 2496, Faculté de Chirurgie Dentaire, Université de Paris, Montrouge, France
- * E-mail:
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6
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Davis GE, Davis MJ, Lowell WE. The effect of ultraviolet radiation on the incidence and severity of major mental illness using birth month, birth year, and sunspot data. Heliyon 2022; 8:e09197. [PMID: 35368522 PMCID: PMC8969152 DOI: 10.1016/j.heliyon.2022.e09197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/06/2021] [Accepted: 03/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background and objectives The evaluation of the severity of patients afflicted with major mental illness (MMI) has been problematic because of confounding variables and genetic variability. There have been multiple studies that suggest several human diseases, especially schizophrenia, are predisposed to be born in certain months or seasons. This observation implied an epigenetic effect of sunlight, likely ultraviolet radiation (UVR), which is damaging to DNA, especially in an embryo. This paper outlines a method to evaluate the severity of schizophrenia (SZ), bipolar disorder (BPD), and schizoaffective disorder (SZ-AFF) using the month/year of birth of those affected compared to the month/year of birth of the general population (GP). Relevance Our previous research found that more intense UVR (equal to or greater than 90 sunspot number (SSN)) had a negative effect on the average human lifespan. Also, human birth rates vary in frequency by month of birth reflecting variables like availability of food, sunlight, and other unknown epigenetic factors. We wanted to see if the patient month of birth varied from the average birth months of the general population and if UVR has an epigenetic effect promoting these diseases. Methods We obtained the month and year of birth of 1,233 patients admitted over a 15-year period to Maine's largest state psychiatric hospital and counted the months of birth for each diagnosis of SZ, BPD, and SZ-AFF, and compared these results to the general population's birth months of 4,265,555 persons from U. S. Census Year 2006. The number of patients in each month was normalized to August and compared with the normalized birth months of the general population (GP). Plots of the normalized months were considered rates of change (e.g., derivatives) and their respective integrals gave domains of each mental illness relative to the GP. Normalizing the GP to unity was then related to the factor 1.28, e.g., 28% more entropy, deduced from the Sun's fractal dimension imprinted on biological organisms. Results The percent of patients meeting our criterion for severity: SZ = 27%; BPD = 26%; SZ-AFF = 100%. Conclusions High UVR intensity or a rapid increase in UVR in early gestation are likely epigenetic triggers of major mental illness. BPD is more epigenetically affected than SZ or SZ-AFF disorders. We found that 52% of 1,233 patients comprised the core function of a tertiary-care psychiatric hospital. Also, mental illness exacerbated when the median SSN doubled. This work also validates the Kraeplinian dichotomy. What is new in this research This paper offers a new paradigm for evaluating the severity of MMI and supports significant epigenetic effects from UVR.
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Affiliation(s)
- George E Davis
- Riverview Psychiatric Center, 250 Arsenal Street, State House Station #11, Augusta, Maine, 04333-0011, USA
| | - Matthew J Davis
- Riverview Psychiatric Center, 250 Arsenal Street, State House Station #11, Augusta, Maine, 04333-0011, USA
| | - Walter E Lowell
- Riverview Psychiatric Center, 250 Arsenal Street, State House Station #11, Augusta, Maine, 04333-0011, USA
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7
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Howard DM, Pain O, Arathimos R, Barbu MC, Amador C, Walker RM, Jermy B, Adams MJ, Deary IJ, Porteous D, Campbell A, Sullivan PF, Evans KL, Arseneault L, Wray NR, Meaney M, McIntosh AM, Lewis CM. Methylome-wide association study of early life stressors and adult mental health. Hum Mol Genet 2021; 31:651-664. [PMID: 34523677 PMCID: PMC8863421 DOI: 10.1093/hmg/ddab274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 09/08/2021] [Accepted: 09/11/2021] [Indexed: 12/25/2022] Open
Abstract
The environment and events that we are exposed to in utero, during birth and in early childhood influence our future physical and mental health. The underlying mechanisms that lead to these outcomes are unclear, but long-term changes in epigenetic marks, such as DNA methylation, could act as a mediating factor or biomarker. DNA methylation data were assayed at 713 522 CpG sites from 9537 participants of the Generation Scotland: Scottish Family Health Study, a family-based cohort with extensive genetic, medical, family history and lifestyle information. Methylome-wide association studies of eight early life environment phenotypes and two adult mental health phenotypes (major depressive disorder and brief resilience scale) were conducted using DNA methylation data collected from adult whole blood samples. Two genes involved with different developmental pathways (PRICKLE2, Prickle Planar Cell Polarity Protein 2 and ABI1, Abl-Interactor-1) were annotated to CpG sites associated with preterm birth (P < 1.27 × 10−9). A further two genes important to the development of sensory pathways (SOBP, Sine Oculis Binding Protein Homolog and RPGRIP1, Retinitis Pigmentosa GTPase Regulator Interacting Protein) were annotated to sites associated with low birth weight (P < 4.35 × 10−8). The examination of methylation profile scores and genes and gene-sets annotated from associated CpGs sites found no evidence of overlap between the early life environment and mental health conditions. Birth date was associated with a significant difference in estimated lymphocyte and neutrophil counts. Previous studies have shown that early life environments influence the risk of developing mental health disorders later in life; however, this study found no evidence that this is mediated by stable changes to the methylome detectable in peripheral blood.
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Affiliation(s)
- David M Howard
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - Oliver Pain
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ryan Arathimos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Trust, London, UK
| | - Miruna C Barbu
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - Carmen Amador
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Rosie M Walker
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK.,Chancellor's Building, 49 Little France Crescent, University of Edinburgh, Edinburgh, UK
| | - Bradley Jermy
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Trust, London, UK
| | - Mark J Adams
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - Ian J Deary
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - David Porteous
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK.,Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Patrick F Sullivan
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Genetics, University of North Carolina, Chapel Hill, NC, USA.,Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Kathryn L Evans
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Louise Arseneault
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Naomi R Wray
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Michael Meaney
- Douglas Mental Health University Institute, McGill University, Montréal, QC, Canada.,Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montréal, QC, Canada.,Singapore Institute for Clinical Sciences, Singapore, Singapore
| | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK.,Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Cathryn M Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Trust, London, UK
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8
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Hsu C, Tseng P, Tu Y, Lin P, Hung C, Liang C, Hsieh Y, Yang Y, Wang L, Kao H. Month of birth and mental disorders: A population-based study and validation using global meta-analysis. Acta Psychiatr Scand 2021; 144:153-167. [PMID: 33930177 PMCID: PMC8360113 DOI: 10.1111/acps.13313] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 04/27/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Month of birth (MOB) is associated with specified mental disorders (MDs). However, whether these relationships extend to all MDs remains unclear. We investigate the association using a population-based cohort study and a meta-analysis. METHODS First, we examined patients with 34 DSM-5-classified MDs in the Taiwan national database. We estimated the relative risk ratios (RR) of each illness in each MOB relative to that in the general population and assessed the periodicity, with six further sensitivity analyses. Second, we searched PubMed, Embase, and Cochrane for related articles through 31 December 2020. We used a random-effects model, pooled RRs with 95% confidence intervals of each MOB from the identified studies, and transformed them from MOB to relative age in a year or season. RESULTS The cohort included 1,951,777 patients. Except for posttraumatic stress disorder, dissociative disorders, feeding/eating disorders, gender dysphoria, and paraphilic disorders, the other MDs had significant MOB periodicity. The meta-analysis included 51 studies investigating 10 MDs. The youngest age at the start of school owing to MOB was associated with the highest RRs of intellectual disability (1.13), autism (1.05), attention-deficit/hyperactivity disorder (1.13). Winter births had significant risks of schizophrenia (1.04), bipolar I disorder (1.02), and major depressive disorder (1.01), and autumn births had a significant risk of alcohol use disorder (1.02). No significant associations between season of birth and Alzheimer's disease, or eating disorders were found. CONCLUSIONS MOB is related to the risks of certain MDs. This finding provides a reference for future research on the etiology of MDs.
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Affiliation(s)
- Chih‐Wei Hsu
- Department of PsychiatryKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiungTaiwan,Department of Computer Science and Information EngineeringNational Cheng Kung UniversityTainanTaiwan
| | - Ping‐Tao Tseng
- Prospect Clinic for Otorhinolaryngology & NeurologyKaohsiungTaiwan,Institute of Biomedical SciencesNational Sun Yat‐sen UniversityKaohsiungTaiwan,Department of PsychologyCollege of Medical and Health Science, Asia UniversityTaichungTaiwan
| | - Yu‐Kang Tu
- Institute of Epidemiology & Preventive MedicineCollege of Public HealthNational Taiwan UniversityTaipeiTaiwan,Department of DentistryNational Taiwan University HospitalTaipeiTaiwan
| | - Pao‐Yen Lin
- Department of PsychiatryKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiungTaiwan,Institute for Translational Research in Biomedical SciencesKaohsiung Chang Gung Memorial HospitalKaohsiungChina
| | - Chi‐Fa Hung
- Department of PsychiatryKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiungTaiwan
| | - Chih‐Sung Liang
- Department of Psychiatry, Beitou BranchTri‐Service General HospitalSchool of MedicineNational Defense Medical CenterTaipeiTaiwan,Graduate Institute of Medical SciencesNational Defense Medical CenterTaipeiTaiwan
| | - Yun‐Yu Hsieh
- Department of PsychiatryKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiungTaiwan
| | - Yao‐Hsu Yang
- Health Information and Epidemiology LaboratoryChang Gung Memorial HospitalChiayi CountyTaiwan,Department of Traditional Chinese MedicineChang Gung Memorial HospitalChiayi CountyTaiwan,School of Traditional Chinese MedicineCollege of MedicineChang Gung UniversityTaoyuanTaiwan
| | - Liang‐Jen Wang
- Department of Child and Adolescent PsychiatryKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiungTaiwan,Department of Chinese MedicineCollege of MedicineChang Gung UniversityTaoyuanTaiwan
| | - Hung‐Yu Kao
- Department of Computer Science and Information EngineeringNational Cheng Kung UniversityTainanTaiwan
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9
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Wang MQ, Wang RR, Hao Y, Xiong WF, Han L, Qiao DD, He J. Clinical characteristics and sociodemographic features of psychotic major depression. Ann Gen Psychiatry 2021; 20:24. [PMID: 33771161 PMCID: PMC8004453 DOI: 10.1186/s12991-021-00341-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 03/07/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Psychotic major depression (PMD) is a subtype of depression with a poor prognosis. Previous studies have failed to find many differences between patients with PMD and those with non-psychotic major depression (NMD) or schizophrenia (SZ). We compared sociodemographic factors (including season of conception) and clinical characteristics between patients with PMD, NMD, and schizophrenia. Our aim was to provide data to help inform clinical diagnoses and future etiology research. METHODS This study used data of all patients admitted to Shandong Mental Health Center from June 1, 2016 to December 31, 2017. We analyzed cases who had experienced an episode of PMD (International Classification of Diseases, Tenth Revision codes F32.3, F33.3), NMD (F32.0-2/9, F33.0-2/9), and SZ (F20-20.9). Data on sex, main discharge diagnosis, date of birth, ethnicity, family history of psychiatric diseases, marital status, age at first onset, education, allergy history, and presence of trigger events were collected. Odds ratios (OR) were calculated using logistic regression analyses. Missing values were filled using the k-nearest neighbor method. RESULTS PMD patients were more likely to have a family history of psychiatric diseases in their first-, second-, and third-degree relatives ([OR] 1.701, 95% confidence interval [CI] 1.019-2.804) and to have obtained a higher level of education (OR 1.451, 95% CI 1.168-1.808) compared with depression patients without psychotic features. Compared to PMD patients, schizophrenia patients had lower education (OR 0.604, 95% CI 0.492-0.741), were more often divorced (OR 3.087, 95% CI 1.168-10.096), had a younger age of onset (OR 0.934, 95% CI 0.914-0.954), less likely to have a history of allergies (OR 0.604, 95% CI 0.492-0.741), and less likely to have experienced a trigger event 1 year before first onset (OR 0.420, 95% CI 0.267-0.661). Season of conception, ethnicity, and sex did not differ significantly between PMD and NMD or schizophrenia and PMD. CONCLUSIONS PMD patients have more similarities with NMD patients than SZ patients in terms of demographic and clinical characteristics. The differences found between PMD and SZ, and PMD and NMD correlated with specificity of the diseases. Furthermore, allergy history should be considered in future epidemiological studies of psychotic disorders.
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Affiliation(s)
- Meng-Qi Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No 11, Bei San Huan East Road, Chaoyang District, Beijing, 100029, China
| | - Ran-Ran Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No 11, Bei San Huan East Road, Chaoyang District, Beijing, 100029, China
| | - Yu Hao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No 11, Bei San Huan East Road, Chaoyang District, Beijing, 100029, China
| | - Wei-Feng Xiong
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No 11, Bei San Huan East Road, Chaoyang District, Beijing, 100029, China
| | - Ling Han
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No 11, Bei San Huan East Road, Chaoyang District, Beijing, 100029, China
| | - Dong-Dong Qiao
- Shandong Provincial Mental Health Hospital, No 49, Wenhua East Road, Jinan, 250014, Shandong, China.
| | - Juan He
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No 11, Bei San Huan East Road, Chaoyang District, Beijing, 100029, China.
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10
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Season-of-birth phenomenon in health and longevity: epidemiologic evidence and mechanistic considerations. J Dev Orig Health Dis 2020; 12:849-858. [PMID: 33298226 DOI: 10.1017/s2040174420001221] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In many human populations, especially those living in regions with pronounced climatic differences between seasons, the most sensitive (prenatal and neonatal) developmental stages occur in contrasting conditions depending on the season of conception. The difference in prenatal and postnatal environments may be a factor significantly affecting human development and risk for later life chronic diseases. Factors potentially contributing to this kind of developmental programming include nutrition, outdoor temperature, infectious exposures, duration of sunlight, vitamin D synthesis, etc. Month of birth is commonly used as a proxy for exposures which vary seasonally around the perinatal period. Season-of-birth patterns have been identified for many chronic health outcomes. In this review, the research evidence for the seasonality of birth in adult-life disorders is provided and potential mechanisms underlying the phenomenon of early life seasonal programming of chronic disease and longevity are discussed.
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11
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Nichols CR, Cohen AK. Preventing maternal mortality in the United States: lessons from California and policy recommendations. J Public Health Policy 2020; 42:127-144. [PMID: 33268845 DOI: 10.1057/s41271-020-00264-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2020] [Indexed: 11/21/2022]
Abstract
Maternal mortality remains a large concern in the United States (US), although other Western countries are making progress. In this scoping review, we identify four problems that may contribute to the maternal mortality burden in the US: inadequately investing in women's health, poor quality of care, increasing disparities, and poor data collection and monitoring of maternal health issues. Because maternal mortality is decreasing in California, we identify strategies implemented there that could improve maternal health outcomes nationwide: funding programs to address social determinants of maternal health; supporting health care strategies to improve maternal health (including national standards and goals for health care systems); and investing in maternal health monitoring and surveillance (including use of technology). We encourage researchers, practitioners, and policymakers to work together to develop evidence-based policies and practices to improve maternal health and reduce maternal. We conclude with recommendations for the United States and globally.
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Affiliation(s)
- Chloe R Nichols
- Department of Public and Nonprofit Management, School of Management, University of San Francisco, San Francisco, USA
| | - Alison K Cohen
- Department of Epidemiology & Population Health, School of Medicine, Stanford University, Stanford, USA.
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12
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Root A, Brown JP, Forbes HJ, Bhaskaran K, Hayes J, Smeeth L, Douglas IJ. Association of Relative Age in the School Year With Diagnosis of Intellectual Disability, Attention-Deficit/Hyperactivity Disorder, and Depression. JAMA Pediatr 2019; 173:1068-1075. [PMID: 31545342 PMCID: PMC6763997 DOI: 10.1001/jamapediatrics.2019.3194] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 06/17/2019] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Young relative age within the school year has previously been associated with attention-deficit/hyperactivity disorder (ADHD) diagnosis and, based on limited evidence, diagnosis of intellectual disability. No study to date has examined the association between relative age and diagnosis of depression. OBJECTIVES To estimate the associations with intellectual disability and ADHD and investigate a potential novel association between relative age and childhood depression. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study of 1 042 106 children aged 4 to 15 years used electronic record data collected before January 3, 2017, from more than 700 general practices contributing to the UK Clinical Practice Research Datalink. Multivariable Cox proportional hazards regression modeling was used to explore the association between relative age and the incidence of intellectual disability, ADHD, and depression before age 16 years. Data were analyzed between July 2017 and January 2019. EXPOSURES Relative age within school year determined by month of birth and categorized into four 3-month groups. MAIN OUTCOMES AND MEASURES Intellectual disability, ADHD, and depression. RESULTS In the total cohort of 1 042 106 children, 532 876 were male (51.1%) and the median age at study entry was 4.0 years (interquartile range, 4.0-5.0). There was evidence that being born in the last quarter of the school year (ie, being the youngest group in a school year) was associated with diagnosis of intellectual disability (adjusted hazard ratio [aHR], 1.30; 95% CI, 1.18-1.42), ADHD (aHR, 1.36; 95% CI, 1.28-1.45), and depression (aHR, 1.31; 95% CI, 1.08-1.59) compared with being born in the first quarter. A graded association was seen with intermediate age groups at a smaller increased risk of each diagnosis compared with the oldest group, with aHRs for intellectual disability for those born in the second quarter of 1.06 (95% CI, 0.96-1.17) and for those born in the third quarter of 1.20 (95% CI, 1.09-1.32); aHRs for ADHD for those born in the second quarter of 1.15 (95% CI, 1.08-1.23) and for those born in the third quarter of 1.31 (95% CI, 1.23-1.40); and aHRs for depression for those born in the second quarter of 1.05 (95% CI, 0.85-1.29) and for those born in the third quarter of 1.13 (95% CI, 0.92-1.38). CONCLUSIONS AND RELEVANCE In this study, relative youth status in the school year is associated with an increased risk of diagnosis of ADHD, intellectual disability, and depression in childhood. Further research into clinical and policy interventions to minimize these associations appears to be needed.
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Affiliation(s)
- Adrian Root
- Electronic Health Records Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jeremy P. Brown
- Electronic Health Records Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Harriet J. Forbes
- Electronic Health Records Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Krishnan Bhaskaran
- Electronic Health Records Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Joseph Hayes
- UCL Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington National Health Service Foundation Trust, St Pancras Hospital, London, United Kingdom
| | - Liam Smeeth
- Electronic Health Records Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ian J. Douglas
- Electronic Health Records Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
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13
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Devore EE, Chang SC, Okereke OI, McMahon DG, Schernhammer ES. Photoperiod during maternal pregnancy and lifetime depression in offspring. J Psychiatr Res 2018; 104:169-175. [PMID: 30092556 PMCID: PMC6104842 DOI: 10.1016/j.jpsychires.2018.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/09/2018] [Accepted: 08/02/2018] [Indexed: 12/18/2022]
Abstract
Experimental studies indicate that perinatal light exposure has enduring effects on affective behaviors in rodents; however, insufficient research has explored this hypothesis in humans. We examined photoperiod (i.e., day length) metrics during maternal pregnancy in relation to lifetime depression in the longitudinal Nurses' Health Study (NHS) and NHS II. 160,723 participants reported birth date and birth state (used to derive daily photoperiod based on published mathematical equations), and clinician-diagnosed depression and antidepressant use throughout adulthood. Logistic regression was used to estimate odds ratios (OR) (and 95% confidence intervals [CI]) for depression (defined as clinician diagnosis and antidepressant use) across quintiles of two exposures during maternal pregnancy: 1) total photoperiod (total number of daylight hours) and 2) differences between minimum/maximum photoperiod; each trimester of pregnancy was examined separately. Total photoperiod during maternal pregnancy was not associated with depression overall or by trimester of pregnancy. However, larger differences between minimum/maximum photoperiod during maternal pregnancy were related to lower odds of depression (multivariable [MV]-adjusted OR: 0.86, 95% CI: 0.83, 0.90 comparing extreme quintiles of exposure; p-trend<0.0001); this association appeared specific to the second trimester of pregnancy (MV-adjusted p-trends = 0.03, <0.0001, and 0.3 across the three trimesters, respectively). In addition, birth at higher latitude (where larger differences in minimum/maximum photoperiod exist) was associated with a significant reduction in the lifetime risk of depression. These findings are consistent with an emerging hypothesis in which perinatal light exposure may influence risk of depression, and they might be understood through the conceptual framework of adaptive developmental plasticity.
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Affiliation(s)
- Elizabeth E Devore
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.
| | - Shun-Chiao Chang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Olivia I Okereke
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, 02144, USA; Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Douglas G McMahon
- Department of Biological Sciences, Vanderbilt University, Box 351634 Station B, Nashville, TN, 37235-1634, USA; Neuroscience Graduate Program, Vanderbilt University, 465 21st Avenue South, Nashville, TN, USA
| | - Eva S Schernhammer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA; Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA; Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/ 1. Stock, 1090, Vienna, Austria
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