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Santaguida E, Bergamasco M. A perspective-based analysis of attachment from prenatal period to second year postnatal life. Front Psychol 2024; 15:1296242. [PMID: 38840732 PMCID: PMC11150629 DOI: 10.3389/fpsyg.2024.1296242] [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: 09/18/2023] [Accepted: 05/08/2024] [Indexed: 06/07/2024] Open
Abstract
Attachment is one of the foundational themes in the history of the psychological development of human beings. For this reason, we assume that it must be approached by taking into account multiple scientific perspectives. The present review aims at analyzing the state of the art regarding the genetic, neurobiological and cognitive mechanisms underlying the development of attachment bonding, considering the child as the frame of reference. We hypothesize that attachment may be present in prototypical forms even in the prenatal period, thus our analysis has a temporal origin in the intrauterine period preceding birth. The intrauterine period is assumed to be a period of maximum sensitivity to stimuli and in particular to those coming from a potential primary caregiver: the biological mother. We conclude with a reframing of the state of the art and propose that future research work would benefit from a superordinate model of attachment, capable of containing and regulating all its components and variables.
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Affiliation(s)
- Erica Santaguida
- Institute of Mechanical Intelligence, Scuola Superiore Sant’Anna, Pisa, Italy
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2
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DeMairo J, Rimsky L, Moses A, Birndorf C, Bellenbaum P, Van Nortwick N, Osborne LM, Robakis TK. Outcomes at the Motherhood Center: A Comparison of Virtual and On-Site Versions of a Specialized Perinatal Partial Hospitalization Program. Matern Child Health J 2024; 28:828-835. [PMID: 37964152 DOI: 10.1007/s10995-023-03836-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVES Remotely administered mental health care is becoming increasingly common for treatment of a range of psychiatric disorders; however, there is a dearth of literature overviewing direct comparisons between remote and in-person interventions for treatment of Perinatal Mood and Anxiety Disorders (PMADs). The sudden advent of the Covid-19 pandemic in New York City forced an abrupt conversion for an intensive day treatment program for new mothers with PMADs, from an on-site to a remote program. METHODS The current report compares outcomes of 81 women who completed the program in-person to those of 60 women who completed the program remotely. RESULTS Improvement in depression scores was statistically superior in the remote program, and improvement in mother-infant bonding was statistically equivalent between the on-site and remote programs. DISCUSSION These findings indicate that specialized partial hospitalization treatment for individuals with moderate to severe psychiatric illness can be effectively provided via telehealth, thus offering improved convenience, accessibility, and safety without compromising care. We conclude that remotely administered group psychotherapy is an effective intervention for women with moderate to severe PMADs.
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Affiliation(s)
- Jeana DeMairo
- The Motherhood Center of New York, New York, NY, USA
| | - Liza Rimsky
- The Motherhood Center of New York, New York, NY, USA
| | - Ada Moses
- The Motherhood Center of New York, New York, NY, USA
| | | | | | | | | | - Thalia K Robakis
- The Motherhood Center of New York, New York, NY, USA.
- Women's Mental Health Program, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, Rm L4-45, New York, NY, USA.
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3
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Tomoda A, Nishitani S, Takiguchi S, Fujisawa TX, Sugiyama T, Teicher MH. The neurobiological effects of childhood maltreatment on brain structure, function, and attachment. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01779-y. [PMID: 38466395 DOI: 10.1007/s00406-024-01779-y] [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: 09/01/2023] [Accepted: 02/16/2024] [Indexed: 03/13/2024]
Abstract
Childhood maltreatment is a risk factor for psychopathologies, and influences brain development at specific periods, particularly during early childhood and adolescence. This narrative review addresses phenotypic alterations in sensory systems associated with specific types of childhood maltreatment exposure, periods of vulnerability to the neurobiological effects of maltreatment, and the relationships between childhood maltreatment and brain structure, function, connectivity, and network architecture; psychopathology; and resilience. It also addresses neurobiological alterations associated with maternal communication and attachment disturbances, and uses laboratory-based measures during infancy and case-control studies to elucidate neurobiological alterations in reactive attachment disorders in children with maltreatment histories. Moreover, we review studies on the acute effects of oxytocin on reactive attachment disorder and maltreatment and methylation of oxytocin regulatory genes. Epigenetic changes may play a critical role in initiating or producing the atypical structural and functional brain alterations associated with childhood maltreatment. However, these changes could be reversed through psychological and pharmacological interventions, and by anticipating or preventing the emergence of brain alterations and subsequent psychopathological risks.
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Affiliation(s)
- Akemi Tomoda
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Fukui, Japan.
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan.
| | - Shota Nishitani
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Fukui, Japan
| | - Shinichiro Takiguchi
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Fukui, Japan
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
| | - Takashi X Fujisawa
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Fukui, Japan
| | - Toshiro Sugiyama
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Fukui, Japan
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
| | - Martin H Teicher
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, USA
- Department of Psychiatry, Harvard Medical School, Boston, USA
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4
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Weinstein SR, Erickson EN, Molina R, Bell AF. Maternal outcomes related to Genetic and epigenetic Variation in the oxytocin system: A scoping review. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2023; 16:100209. [PMID: 38108031 PMCID: PMC10724832 DOI: 10.1016/j.cpnec.2023.100209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 12/19/2023] Open
Abstract
Purpose In this scoping review, we synthesize the literature on oxytocin and oxytocin receptor genetic and epigenetic variation in relationship to breastfeeding, maternal caregiving behavior, and maternal mental health. Methods A literature search was conducted in early 2022, and updated in 2023, utilizing the PRISMA scoping review reporting method, using the following MeSH headings and key terms: oxytocin, oxytocin receptor, genetics, epigenetics, methylation, pregnancy, postnatal, breastfeeding, lactation, mother-infant relations and perinatal outcomes. The search was conducted using PubMed, EMBASE, CINAHL, Google Scholar, SCOPUS, and the Cochrane Library. Inclusion criteria included: human literature which was peer reviewed and found in primary sources, printed in the English language. In addition, the study must have reported genetic/epigenetic data in either the oxytocin or oxytocin receptor gene (maternal or infant up to 12 months after birth) in relation to a breastfeeding, maternal caregiving behavior or a maternal mental health outcome. There was no date limitation. Four authors reviewed studies for eligibility. Data was extracted using a structured data extraction form. Results A total of 23 studies met inclusion criteria for this review (breastfeeding n = 4, maternal caregiving behavior n = 7, and maternal mental health n = 16). Seventeen papers reported on oxytocin or oxytocin receptor genotype and nine reported epigenetic associations (namely DNA methylation). These totals are greater than 23, as studies reported on multiple outcomes. One paper assessed the interaction between genotype and methylation. While a number of genotype variations were reported, the single nucleotide polymorphism rs53576 on the oxytocin receptor gene was the most studied. Overall, variation in this polymorphism was related to postnatal depression symptoms. Among numerous epigenetic markers, site -934 was the most studied methylation site, and methylation status was associated with maternal depression and maternal caregiving behavior outcomes. Results suggest that early life experiences impact adult maternal caregiving behaviors and mental health outcomes, and vary based on genetic vulnerability. Breastfeeding outcomes were minimally studied. Conclusion This scoping review found that genetic and epigenetic variation at the oxytocin and oxytocin receptor genes were associated with maternal caregiving behavior and mental health, likely through complex gene and environment interactions. The findings suggest that maternal early life experiences and stress impact later caregiving behaviors and mental health in the postnatal period. The findings highlight potential pathways by which environment, experiences, and genes interact to impact maternal caregiving behavior and maternal mental health.
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Affiliation(s)
| | | | - Rodin Molina
- Frontier Nursing University, Hyden, KY, USA
- BabyMoon Inn Birth Center, Tucson, AZ, USA
| | - Aleeca F. Bell
- University of Arizona College of Nursing, Tucson, AZ, USA
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5
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Müller S, Sicorello M, Moser D, Frach L, Limberg A, Gumpp AM, Ramo-Fernandez L, Köhler-Dauner F, Fegert JM, Waller C, Kumsta R, Kolassa IT. The DNA methylation landscape of the human oxytocin receptor gene (OXTR): data-driven clusters and their relation to gene expression and childhood adversity. Transl Psychiatry 2023; 13:265. [PMID: 37479681 PMCID: PMC10362059 DOI: 10.1038/s41398-023-02548-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/23/2023] [Accepted: 06/27/2023] [Indexed: 07/23/2023] Open
Abstract
The oxytocin receptor gene (OXTR) is of interest when investigating the effects of early adversity on DNA methylation. However, there is heterogeneity regarding the selection of the most promising CpG sites to target for analyses. The goal of this study was to determine functionally relevant clusters of CpG sites within the OXTR CpG island in 113 mother-infant dyads, with 58 of the mothers reporting childhood maltreatment (CM). OXTR DNA methylation was analyzed in peripheral/umbilical blood mononuclear cells. Different complexity reduction approaches were used to reduce the 188 CpG sites into clusters of co-methylated sites. Furthermore, associations between OXTR DNA methylation (cluster- and site-specific level) and OXTR gene expression and CM were investigated in mothers. Results showed that, first, CpG sections differed strongly regarding their statistical utility for research of individual differences in DNA methylation. Second, cluster analyses and Partial Least Squares (PLS) suggested two clusters consisting of intron1/exon2 and the protein-coding region of exon3, respectively, as most strongly associated with outcome measures. Third, cross-validated PLS regression explained 7% of variance in CM, with low cross-validated variance explained for the prediction of gene expression. Fourth, substantial mother-child correspondence was observed in correlation patterns within the identified clusters, but only modest correspondence outside these clusters. This study makes an important contribution to the mapping of the DNA methylation landscape of the OXTR CpG island by highlighting clusters of CpG sites that show desirable statistical properties and predictive value. We provide a Companion Web Application to facilitate the choice of CpG sites.
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Affiliation(s)
- Svenja Müller
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
- Department of Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, 89081, Ulm, Germany
| | - Maurizio Sicorello
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - Dirk Moser
- Department of Genetic Psychology, Faculty of Psychology, Ruhr Universität Bochum, 44801, Bochum, Germany
| | - Leonard Frach
- Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, WC1H 0AP, United Kingdom
| | - Alicia Limberg
- Department of Genetic Psychology, Faculty of Psychology, Ruhr Universität Bochum, 44801, Bochum, Germany
| | - Anja M Gumpp
- Department of Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, 89081, Ulm, Germany
| | - Laura Ramo-Fernandez
- Department of Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, 89081, Ulm, Germany
| | - Franziska Köhler-Dauner
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, 89075, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, 89075, Ulm, Germany
| | - Christiane Waller
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, 89075, Ulm, Germany
- Department of Psychosomatics and Psychotherapeutic Medicine, Paracelsus Medical Private University of Nueremberg, 90419, Nueremberg, Germany
| | - Robert Kumsta
- Department of Genetic Psychology, Faculty of Psychology, Ruhr Universität Bochum, 44801, Bochum, Germany.
- Department of Behavioural and Cognitive Sciences, Laboratory for Stress and Gene-Environment Interplay, University of Luxemburg, Porte des Sciences L-4366, Esch-sur-Alzette, Luxemburg.
| | - Iris-Tatjana Kolassa
- Department of Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, 89081, Ulm, Germany.
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6
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Ray M, Wallace MK, Grayson SC, Cummings MH, Davis JA, Scott J, Belcher SM, Davis TS, Conley YP. Epigenomic Links Between Social Determinants of Health and Symptoms: A Scoping Review. Biol Res Nurs 2023; 25:404-416. [PMID: 36537264 PMCID: PMC10404910 DOI: 10.1177/10998004221147300] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Social determinants of health (SDoH) impact health and wellness. The link between SDoH and adverse health outcomes, including symptom occurrence and severity, may be explained by an individual's physiologic response to one or more SDoH. One potential mechanism underlying this physiologic response linking SDoH and symptoms is the dynamic epigenome. The purpose of this scoping review of the literature was to examine differential susceptibility for symptoms by identifying and summarizing research linking SDoH and symptoms through epigenomic mechanisms. PubMed was searched to identify empirical research where at least one SDoH was an independent or dependent variable, at least one symptom was investigated, and the investigation included an epigenomic measure. Of the 484 articles initially retrieved, after thorough vetting, 41 articles met eligibility. The most studied symptom was depressive symptoms followed by anxiety, cognitive function, sleep dysfunction, and pain. The most frequently studied SDoH were: 1) stress, particularly early life stress and acculturative stress; and 2) trauma, predominantly childhood trauma. DNA methylation and telomere length were the most studied epigenomic measures. Four genes (SLC6A4, BDNF, NR3C1, OXTR) had evidence from multiple studies and across methodological approaches linking SDoH to symptoms. This review supports the inclusion of epigenomic approaches to better understand the link between SDoH and symptoms and provides evidence that SDoH impact telomere length and the methylation of genes involved in neurotransmitter signaling, neuronal survival, behavior, inflammation and stress response.
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Affiliation(s)
- Mitali Ray
- Health Promotion and Development, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | | | - Susan C. Grayson
- Health Promotion and Development, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Meredith H. Cummings
- Health Promotion and Development, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Jessica A. Davis
- Health Promotion and Development, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Jewel Scott
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - Sarah M. Belcher
- Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Tara S. Davis
- Health Promotion and Development, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Yvette P. Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
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7
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Altamura M, Leccisotti I, De Masi L, Gallone F, Ficarella L, Severo M, Biancofiore S, Denitto F, Ventriglio A, Petito A, Maruotti G, Nappi L, Bellomo A. Coping as a Mediator between Attachment and Depressive Symptomatology Either in Pregnancy or in the Early Postpartum Period: A Structural Equation Modelling Approach. Brain Sci 2023; 13:1002. [PMID: 37508934 PMCID: PMC10377438 DOI: 10.3390/brainsci13071002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Peripartum depression (PPD) is a major complication of pregnancy, and numerous risk factors have been associated with its onset, including dysfunctional coping strategies and insecure attachment styles, both during pregnancy and postpartum. The aim of our study was to investigate the role of coping strategies in mediating the relationship between women's attachment style and depressive symptomatology in pregnancy and one week after giving birth in a large sample of women (N = 1664). Our hypothesis was that the relationship between anxious and avoidant attachment and depressive symptomatology would be mediated by use of maladaptive coping strategies. The assessment instruments were Edinburgh Postnatal Depression Scale (EPDS), Brief Coping Orientation for Problem Experiences (COPE), and Experiences in Close Relationship Scale (ECR). The results indicated that the effect of insecure attachment styles (anxious and avoidant attachment) on antepartum depressive symptomatology was partially mediated by dysfunctional coping styles. Anxious attachment also has an indirect significant effect on postpartum depressive symptomatology through emotional coping; however, avoidant attachment does not seem to be significantly related to postpartum depressive symptoms. Our findings revealed that not only is it important to consider attachment in understanding peripartum depressive symptomatology, but also that coping plays an important role in these relationships. These findings would help a preventive coping-based intervention strategy to enhance the capacity of women with insecure attachment styles to use more adaptive coping during and after pregnancy.
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Affiliation(s)
- Mario Altamura
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Ivana Leccisotti
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Laura De Masi
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Fiammetta Gallone
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Livia Ficarella
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Melania Severo
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Simona Biancofiore
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Francesca Denitto
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Annamaria Petito
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Giuseppe Maruotti
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Luigi Nappi
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
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8
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Luo F, Zhu Z, Du Y, Chen L, Cheng Y. Risk Factors for Postpartum Depression Based on Genetic and Epigenetic Interactions. Mol Neurobiol 2023; 60:3979-4003. [PMID: 37004608 DOI: 10.1007/s12035-023-03313-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 03/09/2023] [Indexed: 04/04/2023]
Abstract
Postpartum depression (PPD) is a serious mood disorder that tends to occur after the delivery, which may bring lifelong consequences to women and their families in terms of family relationships, social relationships, and mental health. Currently, various risk factors including environmental factors and genetic factors that may induce postpartum depression have been extensively studied. In this review, we suggest that postpartum women's susceptibility to postpartum depression may be the result of the interaction between the genes associated with postpartum depression as well as the interaction between genetic and environmental factors. We reviewed the genes that have been studied in postpartum depression, including genes related to the synthesis, metabolism, and transport of monoamine neurotransmitters, key molecules of the HPA axis, and the kynurenine pathway. These studies have found more or less gene-gene and gene-environment interactions, so we will discuss these issues in more detail. However, so far, the conclusions of these risk factors, especially genetic factors, are not completely consistent in the occurrence and exacerbation of symptoms in postpartum depression, and it is not clear how these risk factors specifically participate in the pathological mechanism of the disease and play a role. We conclude that the role of genetic polymorphisms, including genetic and epigenetic processes, in the occurrence and development of postpartum depression, is complex and ambiguous. We also note that interactions between multiple candidate genes and the environment have been suggested as causes of depression, suggesting that more definitive research is needed to understand the heritability and susceptibility of PPD. Overall, our work supports the hypothesis that postpartum depression is more likely to be caused by a combination of multiple genetic and environmental factors than by a single genetic or environmental influence.
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Affiliation(s)
- Fan Luo
- NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
- Center on Translational Neuroscience, College of Life and Environmental Sciences, Minzu University of China, Beijing, China
| | - Zimo Zhu
- Center on Translational Neuroscience, College of Life and Environmental Sciences, Minzu University of China, Beijing, China
| | - Yang Du
- Center on Translational Neuroscience, College of Life and Environmental Sciences, Minzu University of China, Beijing, China
| | - Lei Chen
- Center on Translational Neuroscience, College of Life and Environmental Sciences, Minzu University of China, Beijing, China
| | - Yong Cheng
- NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China.
- Center on Translational Neuroscience, College of Life and Environmental Sciences, Minzu University of China, Beijing, China.
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9
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The Mother-Baby Bond: Role of Past and Current Relationships. CHILDREN 2023; 10:children10030421. [PMID: 36979979 PMCID: PMC10046950 DOI: 10.3390/children10030421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/13/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023]
Abstract
During the perinatal period, up to 25% of women experience difficulties in relating to their child. The mother-child bond promotes the transition to motherhood, protects the woman from depression, and protects the child from the intergenerational transmission of the disease. This study prospectively investigated if the relationship with the co-parent, the attachment style, and the bond that women had with their parents influenced the mother-fetus and then mother-child bond. We also explored the role of depression and anxiety. One hundred nineteen pregnant women were enrolled. We administered clinical interviews and psychometric tools. A telephone interview was conducted at 1, 3, and 6 months of follow-up. Maternal insecure attachment style (r = −0.253, p = 0.006) and women’s dyadic adjustment in the couple’s relationships (r = 0.182, p = 0.049) were correlated with lower maternal–fetal attachment. Insecure attachment styles and depression correlate with bottle-feeding rather than breastfeeding. The bond women had with their mothers, not their fathers, was associated with breastfeeding. Depression (OR = 0.243, p = 0.008) and anxiety (OR = 0.185, p = 0.004; OR = 0.304, p < 0.0001) were related to mother-infant bonding. Close relationships, past and present, affect the bond with the fetus and the child differently. Psychotherapy can provide reassuring and restorative intersubjective experiences.
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10
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Merrill SM, Gladish N, Fu MP, Moore SR, Konwar C, Giesbrecht GF, MacIssac JL, Kobor MS, Letourneau NL. Associations of peripheral blood DNA methylation and estimated monocyte proportion differences during infancy with toddler attachment style. Attach Hum Dev 2023; 25:132-161. [PMID: 34196256 DOI: 10.1080/14616734.2021.1938872] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Attachment is a motivational system promoting felt security to a caregiver resulting in a persistent internal working model of interpersonal behavior. Attachment styles are developed in early social environments and predict future health and development outcomes with potential biological signatures, such as epigenetic modifications like DNA methylation (DNAm). Thus, we hypothesized infant DNAm would associate with toddler attachment styles. An epigenome-wide association study (EWAS) of blood DNAm from 3-month-old infants was regressed onto children's attachment style from the Strange Situation Procedure at 22-months at multiple DNAm Cytosine-phosphate-Guanine (CpG) sites. The 26 identified CpGs associated with proinflammatory immune phenotypes and cognitive development. In post-hoc analyses, only maternal cognitive-growth fostering, encouraging intellectual exploration, contributed. For disorganized children, DNAm-derived cell-type proportions estimated higher monocytes -cells in immune responses hypothesized to increase with early adversity. Collectively, these findings suggested the potential biological embedding of both adverse and advantageous social environments as early as 3-months-old.
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Affiliation(s)
- Sarah M Merrill
- BC Children's Hospital Research Institute Vancouver, British Columbia, Canada; Department of Medical Genetics, University of British Columbia, Vancouver, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, Canada
| | - Nicole Gladish
- BC Children's Hospital Research Institute Vancouver, British Columbia, Canada; Department of Medical Genetics, University of British Columbia, Vancouver, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, Canada
| | - Maggie P Fu
- BC Children's Hospital Research Institute Vancouver, British Columbia, Canada; Department of Medical Genetics, University of British Columbia, Vancouver, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, Canada
| | - Sarah R Moore
- BC Children's Hospital Research Institute Vancouver, British Columbia, Canada; Department of Medical Genetics, University of British Columbia, Vancouver, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, Canada
| | - Chaini Konwar
- BC Children's Hospital Research Institute Vancouver, British Columbia, Canada; Department of Medical Genetics, University of British Columbia, Vancouver, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, Canada
| | - Gerald F Giesbrecht
- Department of Pediatrics, University of Calgary, Calgary, Canada.,Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Julia L MacIssac
- BC Children's Hospital Research Institute Vancouver, British Columbia, Canada; Department of Medical Genetics, University of British Columbia, Vancouver, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, Canada
| | - Michael S Kobor
- BC Children's Hospital Research Institute Vancouver, British Columbia, Canada; Department of Medical Genetics, University of British Columbia, Vancouver, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, Canada.,Program in Child and Brain Development, CIFAR, Toronto, Canada
| | - Nicole L Letourneau
- Department of Pediatrics, University of Calgary, Calgary, Canada.,Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada.,Department of Psychiatry, University of Calgary, Calgary, Canada.,Faculty of Nursing, University of Calgary, Calgary, Canada
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11
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Sumner JA, Cleveland S, Chen T, Gradus JL. Psychological and biological mechanisms linking trauma with cardiovascular disease risk. Transl Psychiatry 2023; 13:25. [PMID: 36707505 PMCID: PMC9883529 DOI: 10.1038/s41398-023-02330-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death and disability worldwide, and experiences of psychological trauma have been associated with subsequent CVD onset. Identifying key pathways connecting trauma with CVD has the potential to inform more targeted screening and intervention efforts to offset elevated cardiovascular risk. In this narrative review, we summarize the evidence for key psychological and biological mechanisms linking experiences of trauma with CVD risk. Additionally, we describe various methodologies for measuring these mechanisms in an effort to inform future research related to potential pathways. With regard to mechanisms involving posttraumatic psychopathology, the vast majority of research on psychological distress after trauma and CVD has focused on posttraumatic stress disorder (PTSD), even though posttraumatic psychopathology can manifest in other ways as well. Substantial evidence suggests that PTSD predicts the onset of a range of cardiovascular outcomes in trauma-exposed men and women, yet more research is needed to better understand posttraumatic psychopathology more comprehensively and how it may relate to CVD. Further, dysregulation of numerous biological systems may occur after trauma and in the presence of posttraumatic psychopathology; these processes of immune system dysregulation and elevated inflammation, oxidative stress, mitochondrial dysfunction, renin-angiotensin system dysregulation, and accelerated biological aging may all contribute to subsequent cardiovascular risk, although more research on these pathways in the context of traumatic stress is needed. Given that many of these mechanisms are closely intertwined, future research using a systems biology approach may prove fruitful for elucidating how processes unfold to contribute to CVD after trauma.
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Affiliation(s)
- Jennifer A Sumner
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Shiloh Cleveland
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Tiffany Chen
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jaimie L Gradus
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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12
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Chen XY, Lo CKM, Chan KL, Leung WC, Ip P. Association between Childhood Exposure to Family Violence and Telomere Length: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912151. [PMID: 36231453 PMCID: PMC9566190 DOI: 10.3390/ijerph191912151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/17/2022] [Accepted: 09/22/2022] [Indexed: 05/12/2023]
Abstract
The aims of this meta-analysis were to examine the association between childhood exposure to family violence and telomere length and the moderating variables that influence this association. Relevant works published on or before 1st September 2022 were identified through a search in five major databases in English and 19 articles (N = 18,977) finally met the inclusion criteria. A meta-analysis was conducted to compute the pooled effect size (correlation; r), and moderator analyses were performed using a random effects meta-analytic model. The studies yielded a significant inverse association between childhood exposure to family violence and telomere length, with a small effect size (r = -0.038, 95% CI [-0.070, -0.005], p = 0.025). Furthermore, the strength of this association was stronger in studies examining the co-occurrence of multiple types of violence than in those examining just one type (Q = 8.143, p = 0.004). These findings suggested that victims' telomere length may be negatively influenced by childhood exposure to family violence and that such impairment appears to be stronger for those who are exposed to multiple types of violence. Future studies are necessary to examine the moderating and mediating factors underlying the association between childhood exposure to family violence and telomere length.
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Affiliation(s)
- Xiao Yan Chen
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Camilla K. M. Lo
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Correspondence: (C.K.M.L.); (K.L.C.); Tel.: +852-2766-5760 (C.K.M.L.); +852-2766-5709 (K.L.C.)
| | - Ko Ling Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Correspondence: (C.K.M.L.); (K.L.C.); Tel.: +852-2766-5760 (C.K.M.L.); +852-2766-5709 (K.L.C.)
| | - Wing Cheong Leung
- Department of Obstetrics & Gynaecology, Kwong Wah Hospital, Kowloon, Hong Kong
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Pokfulam, Hong Kong
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13
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Kazantseva AV, Davydova YD, Enikeeva RF, Mustafin RN, Lobaskova MM, Malykh SB, Khusnutdinova EK. Individual Differences in Relative Telomere Length in Mentally Healthy Subjects: The Effect of TERT Gene Polymorphism and Urban Residency. RUSS J GENET+ 2022; 58:1135-1144. [PMID: 36119151 PMCID: PMC9470233 DOI: 10.1134/s1022795422090101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/17/2022] [Accepted: 04/04/2022] [Indexed: 11/23/2022]
Abstract
The changes in the telomere length caused by the terminal underreplication in the existing literature are related to depressive disorders. However, the use of the telomere length as a biomarker of depressive states is ambiguous, which is due to the effect of various environmental factors on both the psychoemotional state and cellular aging of an organism. In order to identify the possible use of the relative telomere length (RTL) measured in peripheral blood leukocytes as a biomarker of enhanced liability to depression prior to the clinical symptoms, as well as to determine the link between telomere length, sociodemographic factors, allelic variants of the genes involved in the regulation of telomere elongation, and depression level, the association analysis of reverse transcriptase (TERT rs7726159), telomerase RNA component (TERC rs1317082), and the CST complex encoding protein (OBFC1 rs2487999) gene polymorphisms was performed with RTL and depression level in mentally healthy individuals (N = 1065) aged 18-25 years. Together with genetic variants, the examined regression models included various sociodemographic parameters as predictors. As a result of statistical analysis, we failed to observe the association between RTL and individual differences in depression level in the studied sample. Nevertheless, multiple regression analysis allowed us to construct a statistically significant model of individual variance in RTL (P = 4.3е-4; r 2 = 0.018), which included rs7726159 in the TERT gene (P = 0.020; β = 0.078) and such environmental predictors as age (P = 0.001; β = -0.027) and place of residence in childhood (urban/rural area) (P = 0.048; β = 0.063). The data obtained confirm the involvement of TERT gene variants and age in telomere length in mentally healthy individuals aged 18-25 years and indicate a negative effect of urban residency on telomere length shortening, which reflects the cellular aging of an organism.
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Affiliation(s)
- A V Kazantseva
- Institute of Biochemistry and Genetics-Subdivision of the Ufa Federal Research Centre, Russian Academy of Sciences, 450054 Ufa, Russia.,Bashkir State University, 450076 Ufa, Russia.,Ufa State Petroleum Technical University, 450064 Ufa, Russia
| | - Yu D Davydova
- Institute of Biochemistry and Genetics-Subdivision of the Ufa Federal Research Centre, Russian Academy of Sciences, 450054 Ufa, Russia.,Bashkir State University, 450076 Ufa, Russia
| | - R F Enikeeva
- Institute of Biochemistry and Genetics-Subdivision of the Ufa Federal Research Centre, Russian Academy of Sciences, 450054 Ufa, Russia.,Bashkir State University, 450076 Ufa, Russia
| | - R N Mustafin
- Bashkir State Medical University, 450008 Ufa, Russia
| | - M M Lobaskova
- Psychological Institute, Russian Academy of Education, 125009 Moscow, Russia
| | - S B Malykh
- Psychological Institute, Russian Academy of Education, 125009 Moscow, Russia.,Moscow State University, 119991 Moscow, Russia
| | - E K Khusnutdinova
- Institute of Biochemistry and Genetics-Subdivision of the Ufa Federal Research Centre, Russian Academy of Sciences, 450054 Ufa, Russia.,Bashkir State University, 450076 Ufa, Russia.,Moscow State University, 119991 Moscow, Russia
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14
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Robakis TK, Roth MC, King LS, Humphreys KL, Ho M, Zhang X, Chen Y, Li T, Rasgon NL, Watson KT, Urban AE, Gotlib IH. Maternal attachment insecurity, maltreatment history, and depressive symptoms are associated with broad DNA methylation signatures in infants. Mol Psychiatry 2022; 27:3306-3315. [PMID: 35577912 PMCID: PMC9666564 DOI: 10.1038/s41380-022-01592-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 04/05/2022] [Accepted: 04/19/2022] [Indexed: 11/08/2022]
Abstract
The early environment, including maternal characteristics, provides many cues to young organisms that shape their long-term physical and mental health. Identifying the earliest molecular events that precede observable developmental outcomes could help identify children in need of support prior to the onset of physical and mental health difficulties. In this study, we examined whether mothers' attachment insecurity, maltreatment history, and depressive symptoms were associated with alterations in DNA methylation patterns in their infants, and whether these correlates in the infant epigenome were associated with socioemotional and behavioral functioning in toddlerhood. We recruited 156 women oversampled for histories of depression, who completed psychiatric interviews and depression screening during pregnancy, then provided follow-up behavioral data on their children at 18 months. Buccal cell DNA was obtained from 32 of their infants for a large-scale analysis of methylation patterns across 5 × 106 individual CpG dinucleotides, using clustering-based significance criteria to control for multiple comparisons. We found that tens of thousands of individual infant CpGs were alternatively methylated in association with maternal attachment insecurity, maltreatment in childhood, and antenatal and postpartum depressive symptoms, including genes implicated in developmental patterning, cell-cell communication, hormonal regulation, immune function/inflammatory response, and neurotransmission. Density of DNA methylation at selected genes from the result set was also significantly associated with toddler socioemotional and behavioral problems. This is the first report to identify novel regions of the human infant genome at which DNA methylation patterns are associated longitudinally both with maternal characteristics and with offspring socioemotional and behavioral problems in toddlerhood.
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Affiliation(s)
- Thalia K Robakis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Marissa C Roth
- Department of Psychology and Human Development, Peabody College of Vanderbilt University, Nashville, TN, USA
| | - Lucy S King
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Kathryn L Humphreys
- Department of Psychology and Human Development, Peabody College of Vanderbilt University, Nashville, TN, USA
| | - Marcus Ho
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Xianglong Zhang
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | | | | | - Natalie L Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Kathleen T Watson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Alexander E Urban
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, CA, USA
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15
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Koire A, Nong YH, Cain CM, Greeley CS, Puryear LJ, Van Horne BS. Longer wait time after identification of peripartum depression symptoms is associated with increased symptom burden at psychiatric assessment. J Psychiatr Res 2022; 152:360-365. [PMID: 35785579 DOI: 10.1016/j.jpsychires.2022.06.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 06/07/2022] [Accepted: 06/24/2022] [Indexed: 11/26/2022]
Abstract
Untreated peripartum depression (PD) affects one in seven women and is associated with negative maternal outcomes. This retrospective observational study used health record data from an integrated health system in Texas to assess the extent to which time to access reproductive psychiatry influences the mental health of peripartum women. Women with at least one screening for depression symptoms conducted in obstetric or pediatric settings between May 2014 and October 2019 and subsequently seen by the reproductive psychiatry clinic (n=490) were included. Descriptive and inferential statistics were used to assess timing and factors related to psychiatry follow-up. Findings from this study demonstrated that the average time between a positive screen and a psychiatry assessment was 5 weeks. At psychiatry referral appointments, 85% of women continued to screen positive for PD symptoms. Depression symptom scores at the psychiatry appointment were significantly higher than scores precipitating the referral (p = 0.002). Wait time between initial positive screen and referral appointment was positively correlated with clinically meaningful increases in depression symptom scores (p < 0.001). Each week spent waiting for an appointment produced a 13% increase in odds of clinically meaningful worsening of PD scores and 9% increase in odds of developing new self-harm ideation. Given the findings that a longer period between primary care referral and subspecialty appointment has a negative impact on the mental health of women, this study supports the need for earlier psychiatric assessment to minimize decompensation. Expansion of reproductive psychiatry services are needed to support peripartum women and improve maternal outcomes.
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Affiliation(s)
- Amanda Koire
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Yen H Nong
- Department of Pediatrics, Baylor College of Medicine, 6621 Fannin Street, MC A2275, Houston, TX, 77030, USA; Division of Public Health Pediatrics, Texas Children's Hospital, 6621 Fannin Street, MC A2275, Houston, TX, USA
| | - Cary M Cain
- Department of Pediatrics, Baylor College of Medicine, 6621 Fannin Street, MC A2275, Houston, TX, 77030, USA; Division of Public Health Pediatrics, Texas Children's Hospital, 6621 Fannin Street, MC A2275, Houston, TX, USA
| | - Christopher S Greeley
- Department of Pediatrics, Baylor College of Medicine, 6621 Fannin Street, MC A2275, Houston, TX, 77030, USA; Division of Public Health Pediatrics, Texas Children's Hospital, 6621 Fannin Street, MC A2275, Houston, TX, USA
| | - Lucy J Puryear
- Obstetrics and Gynecology, Menninger Department of Psychiatry, Baylor College of Medicine, 6651 Main Street, Houston, TX, 77030, USA
| | - Bethanie S Van Horne
- Department of Pediatrics, Baylor College of Medicine, 6621 Fannin Street, MC A2275, Houston, TX, 77030, USA; Division of Public Health Pediatrics, Texas Children's Hospital, 6621 Fannin Street, MC A2275, Houston, TX, USA.
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16
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Zhang Y, Liu C. Evaluating the challenges and reproducibility of studies investigating DNA methylation signatures of psychological stress. Epigenomics 2022; 14:405-421. [PMID: 35170363 PMCID: PMC8978984 DOI: 10.2217/epi-2021-0190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 01/27/2022] [Indexed: 12/15/2022] Open
Abstract
Psychological stress can increase the risk of a wide range of negative health outcomes. Studies have been completed to determine if DNA methylation changes occur in the human brain because of stress and are associated with long-term effects and disease, but results have been inconsistent. Human candidate gene studies (150) and epigenome-wide association studies (67) were systematically evaluated to assess how DNA methylation is impacted by stress during the prenatal period, early childhood and adulthood. The association between DNA methylation of NR3C1 exon 1F and child maltreatment and early life adversity was well demonstrated, but other genes did not exhibit a clear association. The reproducibility of individual CpG sites in epigenome-wide association studies was also poor. However, biological pathways, including stress response, brain development and immunity, have been consistently identified across different stressors throughout the life span. Future studies would benefit from the increased sample size, longitudinal design, standardized methodology, optimal quality control, and improved statistical procedures.
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Affiliation(s)
- Yun Zhang
- Medical Department, Northwest Minzu University, Lanzhou, Gansu, 730000, China
- Key Laboratory of Environmental Ecology and Population Health in Northwest Minority Areas, Northwest Minzu University, Lanzhou, Gansu, 730000, China
| | - Chunyu Liu
- Center for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, 410078, China
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY 13210, USA
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17
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Thumfart KM, Jawaid A, Bright K, Flachsmann M, Mansuy IM. Epigenetics of childhood trauma: Long term sequelae and potential for treatment. Neurosci Biobehav Rev 2021; 132:1049-1066. [PMID: 34742726 DOI: 10.1016/j.neubiorev.2021.10.042] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 10/17/2021] [Accepted: 10/29/2021] [Indexed: 12/17/2022]
Abstract
Childhood trauma (CT) can have persistent effects on the brain and is one of the major risk factors for neuropsychiatric diseases in adulthood. Recent advances in the field of epigenetics suggest that epigenetic factors such as DNA methylation and histone modifications, as well as regulatory processes involving non-coding RNA are associated with the long-term sequelae of CT. This narrative review summarizes current knowledge on the epigenetic basis of CT and describes studies in animal models and human subjects examining how the epigenome and transcriptome are modified by CT in the brain. It discusses psychological and pharmacological interventions that can counteract epigenetic changes induced by CT and the need to establish longitudinal assessment after CT for developing more effective diagnostics and treatment strategies based on epigenetic targets.
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Affiliation(s)
- Kristina M Thumfart
- Laboratory of Neuroepigenetics, Brain Research Institute, University of Zürich and Institute for Neuroscience of the Swiss Federal Institute of Technology, Winterthurerstrasse 190, CH-8057, Zürich, Switzerland
| | - Ali Jawaid
- Laboratory of Neuroepigenetics, Brain Research Institute, University of Zürich and Institute for Neuroscience of the Swiss Federal Institute of Technology, Winterthurerstrasse 190, CH-8057, Zürich, Switzerland; Laboratory for Translational Research in Neuropsychiatric Disorders (TREND), BRAINCITY: Center of Excellence for Neural Plasticity and Brain Disorders, Nencki Institute of Experimental Biology, Ludwika Pasteura 3, Warsaw, 02-093, Poland
| | - Kristina Bright
- Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Marc Flachsmann
- Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Isabelle M Mansuy
- Laboratory of Neuroepigenetics, Brain Research Institute, University of Zürich and Institute for Neuroscience of the Swiss Federal Institute of Technology, Winterthurerstrasse 190, CH-8057, Zürich, Switzerland.
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18
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Gerra ML, Gerra MC, Tadonio L, Pellegrini P, Marchesi C, Mattfeld E, Gerra G, Ossola P. Early parent-child interactions and substance use disorder: An attachment perspective on a biopsychosocial entanglement. Neurosci Biobehav Rev 2021; 131:560-580. [PMID: 34606823 DOI: 10.1016/j.neubiorev.2021.09.052] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 12/19/2022]
Abstract
This review aims to elucidate environmental and genetic factors, as well as their epigenetic and neuroendocrine moderators, that may underlie the association between early childhood experiences and Substance Use Disorders (SUD), through the lens of parental attachment. Here we review those attachment-related studies that examined the monoaminergic systems, the hypothalamic pituitary adrenal stress response system, the oxytoninergic system, and the endogenous opioid system from a genetic, epigenetic, and neuroendocrine perspective. Overall, the selected studies point to a moderating effect of insecure attachment between genetic vulnerability and SUD, reasonably through epigenetic modifications. Preliminary evidence suggests that vulnerability to SUDs is related with hypo-methylation (e.g. hyper-expression) of high-risk polymorphisms on the monoaminergic and hypothalamic pituitary adrenal system and hyper-methylation (e.g. hypo-expressions) of protective polymorphisms on the opioid and oxytocin system. These epigenetic modifications may induce a cascade of neuroendocrine changes contributing to the subclinical and behavioural manifestations that precede the clinical onset of SUD. Protective and supportive parenting could hence represent a key therapeutic target to prevent addiction and moderate insecure attachment.
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Affiliation(s)
| | - Maria Carla Gerra
- Center for Neuroplasticity and Pain (CNAP), SMI®, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
| | | | | | - Carlo Marchesi
- Psychiatry Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Elizabeth Mattfeld
- Drug Prevention and Health Branch, Prevention Treatment and Rehabilitation Section, United Nations Office on Drugs and Crime, Vienna, Austria.
| | - Gilberto Gerra
- Department of Mental Health, AUSL of Parma, Parma, Italy.
| | - Paolo Ossola
- Center for Neuroplasticity and Pain (CNAP), SMI®, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
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19
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Schroder JD, de Araújo JB, de Oliveira T, de Moura AB, Fries GR, Quevedo J, Réus GZ, Ignácio ZM. Telomeres: the role of shortening and senescence in major depressive disorder and its therapeutic implications. Rev Neurosci 2021; 33:227-255. [PMID: 34388328 DOI: 10.1515/revneuro-2021-0070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 07/17/2021] [Indexed: 11/15/2022]
Abstract
Major depressive disorder (MDD) is one of the most prevalent and debilitating psychiatric disorders, with a large number of patients not showing an effective therapeutic response to available treatments. Several biopsychosocial factors, such as stress in childhood and throughout life, and factors related to biological aging, may increase the susceptibility to MDD development. Included in critical biological processes related to aging and underlying biological mechanisms associated with MDD is the shortening of telomeres and changes in telomerase activity. This comprehensive review discusses studies that assessed the length of telomeres or telomerase activity and function in peripheral blood cells and brain tissues of MDD individuals. Also, results from in vitro protocols and animal models of stress and depressive-like behaviors were included. We also expand our discussion to include the role of telomere biology as it relates to other relevant biological mechanisms, such as the hypothalamic-pituitary-adrenal (HPA) axis, oxidative stress, inflammation, genetics, and epigenetic changes. In the text and the discussion, conflicting results in the literature were observed, especially considering the size of telomeres in the central nervous system, on which there are different protocols with divergent results in the literature. Finally, the context of this review is considering cell signaling, transcription factors, and neurotransmission, which are involved in MDD and can be underlying to senescence, telomere shortening, and telomerase functions.
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Affiliation(s)
- Jessica Daniela Schroder
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Rodovia SC 484 - Km 02, Fronteira Sul, Postal Code: 89815-899Chapecó, SC, Brazil
| | - Julia Beatrice de Araújo
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Rodovia SC 484 - Km 02, Fronteira Sul, Postal Code: 89815-899Chapecó, SC, Brazil
| | - Tacio de Oliveira
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Rodovia SC 484 - Km 02, Fronteira Sul, Postal Code: 89815-899Chapecó, SC, Brazil
| | - Airam Barbosa de Moura
- Laboratory of Translational Psychiatry, Graduate Program in Health Sciences, University of Southern Santa Catarina, Av. Universitária, 1105 - Bairro Universitário Postal Code: 88806-000Criciúma, SC, Brazil
| | - Gabriel Rodrigo Fries
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, Translational Psychiatry Program, The University of Texas Health Science Center at Houston (UTHealth), 1941 East Road BBSB 3142, Houston77054, TX, USA.,Neuroscience Graduate Program, Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston (UTHealth), 1941 East Road, BBSB 3142, Houston77054, TX, USA.,Center for Precision Health, School of Biomedical Informatics, The University of Texas Health Science Center at Houston, 1941 East Road, BBSB 3142, Houston77054, TX, USA
| | - João Quevedo
- Laboratory of Translational Psychiatry, Graduate Program in Health Sciences, University of Southern Santa Catarina, Av. Universitária, 1105 - Bairro Universitário Postal Code: 88806-000Criciúma, SC, Brazil.,Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, Translational Psychiatry Program, The University of Texas Health Science Center at Houston (UTHealth), 1941 East Road BBSB 3142, Houston77054, TX, USA.,Neuroscience Graduate Program, Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston (UTHealth), 1941 East Road, BBSB 3142, Houston77054, TX, USA.,Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, Center of Excellence on Mood Disorders, The University of Texas Health Science Center at Houston (UTHealth), 1941 East Road, BBSB 3142, Houston77054, TX, USA
| | - Gislaine Zilli Réus
- Laboratory of Translational Psychiatry, Graduate Program in Health Sciences, University of Southern Santa Catarina, Av. Universitária, 1105 - Bairro Universitário Postal Code: 88806-000Criciúma, SC, Brazil
| | - Zuleide Maria Ignácio
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Rodovia SC 484 - Km 02, Fronteira Sul, Postal Code: 89815-899Chapecó, SC, Brazil.,Laboratory of Translational Psychiatry, Graduate Program in Health Sciences, University of Southern Santa Catarina, Av. Universitária, 1105 - Bairro Universitário Postal Code: 88806-000Criciúma, SC, Brazil
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20
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Womersley JS, Nothling J, Toikumo S, Malan-Müller S, van den Heuvel LL, McGregor NW, Seedat S, Hemmings SMJ. Childhood trauma, the stress response and metabolic syndrome: A focus on DNA methylation. Eur J Neurosci 2021; 55:2253-2296. [PMID: 34169602 DOI: 10.1111/ejn.15370] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 05/13/2021] [Accepted: 06/12/2021] [Indexed: 12/12/2022]
Abstract
Childhood trauma (CT) is well established as a potent risk factor for the development of mental disorders. However, the potential of adverse early experiences to exert chronic and profound effects on physical health, including aberrant metabolic phenotypes, has only been more recently explored. Among these consequences is metabolic syndrome (MetS), which is characterised by at least three of five related cardiometabolic traits: hypertension, insulin resistance/hyperglycaemia, raised triglycerides, low high-density lipoprotein and central obesity. The deleterious effects of CT on health outcomes may be partially attributable to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, which coordinates the response to stress, and the consequent fostering of a pro-inflammatory environment. Epigenetic tags, such as DNA methylation, which are sensitive to environmental influences provide a means whereby the effects of CT can be biologically embedded and persist into adulthood to affect health and well-being. The methylome regulates the transcription of genes involved in the stress response, metabolism and inflammation. This narrative review examines the evidence for DNA methylation in CT and MetS in order to identify shared neuroendocrine and immune correlates that may mediate the increased risk of MetS following CT exposure. Our review specifically highlights differential methylation of FKBP5, the gene that encodes FK506-binding protein 51 and has pleiotropic effects on stress responding, inflammation and energy metabolism, as a central candidate to understand the molecular aetiology underlying CT-associated MetS risk.
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Affiliation(s)
- Jacqueline S Womersley
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jani Nothling
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Sylvanus Toikumo
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Stefanie Malan-Müller
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Leigh L van den Heuvel
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Nathaniel W McGregor
- Systems Genetics Working Group, Department of Genetics, Faculty of Agriculture, Stellenbosch University, Stellenbosch, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sîan M J Hemmings
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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21
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Craig F, Tenuta F, Rizzato V, Costabile A, Trabacca A, Montirosso R. Attachment-related dimensions in the epigenetic era: A systematic review of the human research. Neurosci Biobehav Rev 2021; 125:654-666. [PMID: 33727029 DOI: 10.1016/j.neubiorev.2021.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 03/04/2021] [Accepted: 03/07/2021] [Indexed: 12/16/2022]
Abstract
In recent years, an increasing number of studies documented potential links between parental care and epigenetic mechanisms. The present systematic review focuses on the potential association and interrelationship between attachment-related dimensions and DNA methylation in human studies. We performed a literature review using electronic databases such as PubMed, Scopus, Web of Science, and EBSCOhost. Thirteen papers were included in the review. Findings support significant associations between attachment-related dimensions and epigenetic status in studies which considered different populations, age ranges, attachment measures and peripheral tissues. Although research in this area is still under investigation, available results suggest that DNA methylation associated with attachment-related dimensions might affect the development of stress regulation system and social-emotional capacities, thus contributing to the emerging phenotypic outcomes. However, identifying mediator and moderator effects in the interrelationship between these parameters was problematic owing to heterogeneous methodologies. Finally, we discuss clinical implications, unanswered questions, and future directions for human development in epigenetics research.
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Affiliation(s)
- Francesco Craig
- Scientific Institute, IRCCS E. Medea, Unit for Severe Disabilities in Developmental Age and Young Adults, Brindisi, Italy
| | - Flaviana Tenuta
- Department of Culture, Education and Society, University of Calabria, Cosenza, Italy
| | - Veronica Rizzato
- Scientific Institute, IRCCS E. Medea, Unit for Severe Disabilities in Developmental Age and Young Adults, Brindisi, Italy
| | - Angela Costabile
- Department of Culture, Education and Society, University of Calabria, Cosenza, Italy
| | - Antonio Trabacca
- Scientific Institute, IRCCS E. Medea, Unit for Severe Disabilities in Developmental Age and Young Adults, Brindisi, Italy.
| | - Rosario Montirosso
- Scientific Institute, IRCCS Eugenio Medea, 0-3 Center for the at-Risk Infant, Bosisio Parini, Italy
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22
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Parade SH, Huffhines L, Daniels TE, Stroud LR, Nugent NR, Tyrka AR. A systematic review of childhood maltreatment and DNA methylation: candidate gene and epigenome-wide approaches. Transl Psychiatry 2021; 11:134. [PMID: 33608499 PMCID: PMC7896059 DOI: 10.1038/s41398-021-01207-y] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 12/18/2020] [Accepted: 01/07/2021] [Indexed: 01/31/2023] Open
Abstract
Childhood maltreatment is a major risk factor for chronic and severe mental and physical health problems across the lifespan. Increasing evidence supports the hypothesis that maltreatment is associated with epigenetic changes that may subsequently serve as mechanisms of disease. The current review uses a systematic approach to identify and summarize the literature related to childhood maltreatment and alterations in DNA methylation in humans. A total of 100 empirical articles were identified in our systematic review of research published prior to or during March 2020, including studies that focused on candidate genes and studies that leveraged epigenome-wide data in both children and adults. Themes arising from the literature, including consistent and inconsistent patterns of results, are presented. Several directions for future research, including important methodological considerations for future study design, are discussed. Taken together, the literature on childhood maltreatment and DNA methylation underscores the complexity of transactions between the environment and biology across development.
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Affiliation(s)
- Stephanie H Parade
- Initiative on Stress, Trauma, and Resilience, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA.
- Bradley/Hasbro Children's Research Center, E. P. Bradley Hospital, East Providence, RI, USA.
| | - Lindsay Huffhines
- Initiative on Stress, Trauma, and Resilience, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Bradley/Hasbro Children's Research Center, E. P. Bradley Hospital, East Providence, RI, USA
| | - Teresa E Daniels
- Initiative on Stress, Trauma, and Resilience, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - Laura R Stroud
- Initiative on Stress, Trauma, and Resilience, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Nicole R Nugent
- Initiative on Stress, Trauma, and Resilience, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Audrey R Tyrka
- Initiative on Stress, Trauma, and Resilience, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
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23
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Carnevali GS, Buoli M. The role of epigenetics in perinatal depression: Are there any candidate biomarkers? J Affect Disord 2021; 280:57-67. [PMID: 33221608 DOI: 10.1016/j.jad.2020.11.056] [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: 07/28/2020] [Revised: 11/03/2020] [Accepted: 11/08/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Approximately 12% of all women will be affected by Perinatal Depression (PD), a condition associated with an increased risk for low birth weight, preterm birth, preeclampsia, maternal suicide and infanticide. The identification of biomarkers for PD could be useful for early identification and for the development of new treatments. Purpose of the present manuscript is to review the potential epigenetic biomarkers which were associated with PD. METHODS We performed a bibliographic research on PubMed, in order to find studies that proposed epigenetic biomarkers for PD. A total of 9 studies met our inclusion criteria. RESULTS Most available data are concordant in showing that women affected by PD have epigenetic alterations versus Healthy Controls (HC), especially with regard to Hypothalamic Pituitary Adrenal (HPA) axis, oxytocin system, inflammatory response, neuronal differentiation and circadian rhythms. PD might be characterized by specific epigenetic changes; however, the available data are preliminary. LIMITATIONS Many articles report results obtained on a limited sample size, in different cell types or tissues. Furthermore, sometimes the studies selected a restricted number of genes. As a result, most available data have not been replicated. CONCLUSIONS Epigenetic changes of different biological systems could be involved in the etiology of PD. However, until now data are too scanty to draw definitive conclusions. Future studies with larger samples can confirm the results and hypothesis presented in this review.
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Affiliation(s)
- Greta Silvia Carnevali
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
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24
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Johnson MW, Maitland E, Torday J. Covid-19 and the Epigenetics of Learning. POSTDIGITAL SCIENCE AND EDUCATION 2020. [PMCID: PMC7518093 DOI: 10.1007/s42438-020-00190-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Covid-19 is a natural phenomenon that has rapidly upended much of the cultural infrastructure of societies across the globe. Education, which in recent years increasingly tied itself to notions of global culture and markets, is deeply threatened by these changes to the natural environment. This paper makes the case that the relationship between nature and culture in education requires a deep level analysis of the biological and physical substrate of human learning. Only with a sufficiently fundamental level of analysis can society reorganise its systems of learning and scientific inquiry to this rapidly changing environment. Drawing on evolutionary biology, we argue that institutional and individual structures and processes are recapitulations of evolutionary cellular development. Understanding the impact of Covid-19 on cells presents an invitation to consider the larger-scale cultural recapitulations of similar mechanisms and structures, and this has implications for the ways education might most effectively deploy technology. Whilst universities seek to maintain their existing structures, practices and business models, a cellular evolutionary approach points to the necessity for fundamental rethinking of intellectual life and learning. We consider the parameters of effective educational organisation in a post-Covid-19 world. As the richness and variety of the physical campus is removed, viable educational relationships will necessitate deeper intellectual connections and personal inquiries than are currently permitted in the transactional processes of education.
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25
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Bianciardi E, Vito C, Betrò S, De Stefano A, Siracusano A, Niolu C. The anxious aspects of insecure attachment styles are associated with depression either in pregnancy or in the postpartum period. Ann Gen Psychiatry 2020; 19:51. [PMID: 32944057 PMCID: PMC7488240 DOI: 10.1186/s12991-020-00301-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 08/27/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Perinatal depression (PND) is a major complication of pregnancy and many risk factors have been associated with its development both during pregnancy and postpartum. The transition to motherhood activates the attachment system. The aim of our study was to investigate the relationship between women's attachment style (AS) and PND in pregnancy, and 1 month after childbirth, in a large cohort of women. We hypothesized that different patterns of AS were associated with either antenatal or postnatal depression. We, further, explored the role of other possible risk factors such as life-stress events. METHODS A final sample of 572 women was enrolled. At the third trimester of pregnancy, clinical data sheet and self-report questionnaires (ASQ, PSS, LTE-Q, and EPDS) were administered. One month after delivery, EPDS was administered by telephone interview. RESULTS We found 10.1% of the women with depression during pregnancy and 11.1% in the postpartum period. The first logistic regression showed that ASQ-CONF subscale (OR = 0.876, p < 0.0001), ASQ-NFA subscale (OR = 1.097, p = 0.002), foreign nationality (OR = 2.29, p = 0.040), low education levels (OR = 0.185, p = 0.012), PSS total score (OR = 1.376, p = 0.010), and recent life adversities (OR = 3.250, p = 0.012) were related to EPDS ≥ 14 during pregnancy.The second logistic regression showed that ASQ-PRE subscale (OR = 1.077, p < 0.001) and foreign nationality (OR = 2.88, p = 0.010) were related to EPDS ≥ 12 in the postpartum period. CONCLUSIONS Different dimensions of anxious insecure AS were, respectively, associated with either antenatal or postnatal depression. These findings support the literature investigating subtypes of perinatal depression. The PND may be heterogeneous in nature, and the comprehension of psychopathological trajectories may improve screening, prevention, and treatment of a disorder which has a long-lasting disabling impact on the mental health of mother and child. We provided a rationale for targeting an attachment-based intervention in this group of women.
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Affiliation(s)
- Emanuela Bianciardi
- Psychiatric Chair, Department of Systems Medicine, University of Rome “Tor Vergata”, Via Cracovia, 50, 00133 Rome, Italy
| | - Cristina Vito
- Psychiatric Chair, Department of Systems Medicine, University of Rome “Tor Vergata”, Via Cracovia, 50, 00133 Rome, Italy
| | - Sophia Betrò
- Psychiatric Chair, Department of Systems Medicine, University of Rome “Tor Vergata”, Via Cracovia, 50, 00133 Rome, Italy
| | - Alberto De Stefano
- Volunteers Association of Fondazione Policlinico “Tor Vergata”, Rome, Italy
| | - Alberto Siracusano
- Psychiatric Chair, Department of Systems Medicine, University of Rome “Tor Vergata”, Via Cracovia, 50, 00133 Rome, Italy
| | - Cinzia Niolu
- Psychiatric Chair, Department of Systems Medicine, University of Rome “Tor Vergata”, Via Cracovia, 50, 00133 Rome, Italy
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