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Solmi M, Cobey K, Moher D, Ebrahimzadeh S, Dragioti E, Shin JI, Radua J, Cortese S, Shea B, Veronese N, Hartling L, Pollock M, Egger M, Papatheodorou S, Ioannidis JP, Carvalho AF. Protocol for the development of a reporting guideline for umbrella reviews on epidemiological associations using cross-sectional, case-control and cohort studies: the Preferred Reporting Items for Umbrella Reviews of Cross-sectional, Case-control and Cohort studies (PRIUR-CCC). BMJ Open 2024; 14:e071136. [PMID: 38889936 PMCID: PMC11191798 DOI: 10.1136/bmjopen-2022-071136] [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: 01/03/2023] [Accepted: 02/23/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION Observational studies are fraught with several biases including reverse causation and residual confounding. Overview of reviews of observational studies (ie, umbrella reviews) synthesise systematic reviews with or without meta-analyses of cross-sectional, case-control and cohort studies, and may also aid in the grading of the credibility of reported associations. The number of published umbrella reviews has been increasing. Recently, a reporting guideline for overviews of reviews of healthcare interventions (Preferred Reporting Items for Overviews of Reviews (PRIOR)) was published, but the field lacks reporting guidelines for umbrella reviews of observational studies. Our aim is to develop a reporting guideline for umbrella reviews on cross-sectional, case-control and cohort studies assessing epidemiological associations. METHODS AND ANALYSIS We will adhere to established guidance and prepare a PRIOR extension for systematic reviews of cross-sectional, case-control and cohort studies testing epidemiological associations between an exposure and an outcome, namely Preferred Reporting Items for Umbrella Reviews of Cross-sectional, Case-control and Cohort studies (PRIUR-CCC). Step 1 will be the project launch to identify stakeholders. Step 2 will be a literature review of available guidance to conduct umbrella reviews. Step 3 will be an online Delphi study sampling 100 participants among authors and editors of umbrella reviews. Step 4 will encompass the finalisation of PRIUR-CCC statement, including a checklist, a flow diagram, explanation and elaboration document. Deliverables will be (i) identifying stakeholders to involve according to relevant expertise and end-user groups, with an equity, diversity and inclusion lens; (ii) completing a narrative review of methodological guidance on how to conduct umbrella reviews, a narrative review of methodology and reporting in published umbrella reviews and preparing an initial PRIUR-CCC checklist for Delphi study round 1; (iii) preparing a PRIUR-CCC checklist with guidance after Delphi study; (iv) publishing and disseminating PRIUR-CCC statement. ETHICS AND DISSEMINATION PRIUR-CCC has been approved by The Ottawa Health Science Network Research Ethics Board and has obtained consent (20220639-01H). Participants to step 3 will give informed consent. PRIUR-CCC steps will be published in a peer-reviewed journal and will guide reporting of umbrella reviews on epidemiological associations.
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Affiliation(s)
- Marco Solmi
- Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
- Department of Mental Health, The Ottawa Hospital, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute (OHRI), University of Ottawa, Ottawa, Ontario, Canada
| | - Kelly Cobey
- Open Science and Meta-Research Program, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - David Moher
- Ottawa Methods Centre, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | | | - Elena Dragioti
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linkopings universitet, Linkoping, Sweden
- Research Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Jae Il Shin
- Yonsei University College of Medicine, Seoul, The Republic of Korea
| | - Joaquim Radua
- Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain
- Institut d'Investigacions Biomediques August Pi i Sunyer, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA
- DiMePRe-J-Department of Precision and Rigenerative Medicine-Jonic Area, University of Bari "Aldo Moro", Bari, Italy
| | - Beverley Shea
- Ottawa Health Research Institute, Ottawa, Ontario, Canada
| | | | - Lisa Hartling
- Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | | | - Matthias Egger
- Institute of Social & Preventive Medicine, University of Bern, Bern, Switzerland
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Stefania Papatheodorou
- Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
- Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | | | - Andre F Carvalho
- IMPACT (Innovation in Mental and Physical Health and Clinical Treatment) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
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Camacho-Téllez V, Castro MN, Wainsztein AE, Goldberg X, De Pino G, Costanzo EY, Cardoner N, Menchón JM, Soriano-Mas C, Guinjoan SM, Villarreal MF. Childhood adversity modulates structural brain changes in borderline personality but not in major depression disorder. Psychiatry Res Neuroimaging 2024; 340:111803. [PMID: 38460393 DOI: 10.1016/j.pscychresns.2024.111803] [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: 07/08/2023] [Revised: 11/24/2023] [Accepted: 02/20/2024] [Indexed: 03/11/2024]
Abstract
Adverse childhood experiences (ACEs) negatively affect the function and structure of emotion brain circuits, increasing the risk of various psychiatric disorders. It is unclear if ACEs show disorder specificity with respect to their effects on brain structure. We aimed to investigate whether the structural brain effects of ACEs differ between patients with major depression (MDD) and borderline personality disorder (BPD). These disorders share many symptoms but likely have different etiologies. To achieve our goal, we obtained structural 3T-MRI images from 20 healthy controls (HC), 19 MDD patients, and 18 BPD patients, and measured cortical thickness and subcortical gray matter volumes. We utilized the Adverse Childhood Experiences (ACE) questionnaire to quantify self-reported exposure to childhood trauma. Our findings suggest that individuals with MDD exhibit a smaller cortical thickness when compared to those with BPD. However, ACEs showed a significantly affected relationship with cortical thickness in BPD but not in MDD. ACEs were found to be associated with thinning in cortical regions involved in emotional behavior in BPD, whereas HC showed an opposite association. Our results suggest a potential mechanism of ACE effects on psychopathology involving changes in brain structure. These findings highlight the importance of early detection and intervention strategies.
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Affiliation(s)
- Vicente Camacho-Téllez
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (Grupo INAAC), Instituto de Neurociencias Fleni-CONICET (INEU), Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina; Departamento de Salud Mental, Facultad de Medicina, Universidad de Buenos Aires (UBA), Argentina
| | - Mariana N Castro
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (Grupo INAAC), Instituto de Neurociencias Fleni-CONICET (INEU), Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina; Departamento de Salud Mental, Facultad de Medicina, Universidad de Buenos Aires (UBA), Argentina.
| | - Agustina E Wainsztein
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (Grupo INAAC), Instituto de Neurociencias Fleni-CONICET (INEU), Argentina; Servicio de Psiquiatría, Fleni, Argentina
| | - Ximena Goldberg
- Mental Health Department, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain; ISGlobal, Barcelona, Spain
| | - Gabriela De Pino
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (Grupo INAAC), Instituto de Neurociencias Fleni-CONICET (INEU), Argentina; Laboratorio de Neuroimágenes, Departamento de Imágenes, Fleni, Argentina; Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín, Argentina
| | - Elsa Y Costanzo
- Departamento de Salud Mental, Facultad de Medicina, Universidad de Buenos Aires (UBA), Argentina; Servicio de Psiquiatría, Fleni, Argentina
| | - Narcís Cardoner
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José M Menchón
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - Carles Soriano-Mas
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Social Psychology and Quantitative Psychology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Salvador M Guinjoan
- Laureate Institute for Brain Research, Tulsa, USA; Department of Psychiatry, Health Sciences Center, Oklahoma University, and Oxley College, Tulsa University, Tulsa, Oklahoma, USA
| | - Mirta F Villarreal
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (Grupo INAAC), Instituto de Neurociencias Fleni-CONICET (INEU), Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina; Departamento de Física, Facultad de Ciencias Exactas y Naturales, UBA, Argentina
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Chu Z, Wang X, Cheng Y, Yuan L, Jin M, Lu Y, Shen Z, Xu X. Subcortical neural mechanisms of childhood trauma impacts on personality traits. Asian J Psychiatr 2024; 94:103966. [PMID: 38364748 DOI: 10.1016/j.ajp.2024.103966] [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: 12/01/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/18/2024]
Abstract
This study aims to explore the relationships between childhood trauma (CT), personality traits, and subcortical structures. 171 healthy individuals completed the Childhood Trauma Questionnaire (CTQ), the Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI), and underwent 3D T1-weighted MRI scans. Linear regression analyses indicated the complex relationship between CT, personality traits, and subcortical gray matter volume (GMV). Mediation analyses revealed that the right hippocampal GMV partially mediated the effects of CT on neuroticism. These findings suggest that CT affects the development of the Big Five personality traits, and alterations in subcortical structures are closely related to this process. Altered GMV in the right hippocampus may be a key neural mechanism for CT-induced neuroticism.
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Affiliation(s)
- Zhaosong Chu
- Department of Psychiatry, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Yunnan Province Clinical Research Center for Mental Health, Kunming 650032, China
| | - Xin Wang
- Department of Psychiatry, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Yunnan Province Clinical Research Center for Mental Health, Kunming 650032, China
| | - Yuqi Cheng
- Department of Psychiatry, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Yunnan Province Clinical Research Center for Mental Health, Kunming 650032, China
| | - Lijin Yuan
- Department of Psychiatry, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Yunnan Province Clinical Research Center for Mental Health, Kunming 650032, China
| | - Mengyun Jin
- Department of Psychiatry, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Yunnan Province Clinical Research Center for Mental Health, Kunming 650032, China
| | - Yi Lu
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Zonglin Shen
- Department of Psychiatry, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China.
| | - Xiufeng Xu
- Yunnan Province Clinical Research Center for Mental Health, Kunming 650032, China.
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Muñoz-Negro JE, Gutiérrez B, Rivera M, Molina E, González Díaz M, Jabalera Ruz P, Cervilla JA. An epidemiological survey on personality disorder in Andalusia (the PISMA-ep PD study). Int J Soc Psychiatry 2024; 70:209-217. [PMID: 37840279 DOI: 10.1177/00207640231204216] [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] [Indexed: 10/17/2023]
Abstract
BACKGROUND Despite a significant clinical and social burden, there is a relative scarcity of epidemiological studies on Personality Disorder (PD). AIM To determine the current prevalence of PD and the psychosocial correlates associated with this in the Andalusian population. METHOD We carried out a cross-sectional population mental-health survey in Andalusia, southern Spain. Thus, 4,518 randomly selected participants were interviewed following sampling using different standard stratification levels. We used the Spanish version of the SAPAS to estimate PD prevalence. In addition, a full battery of other instruments was utilized to explore global functionality, childhood abuse, maltreatment, threatening life events, personality traits (neuroticism, impulsivity and paranoia), medical and psychiatric comorbidities, family history of psychological problems and other potential risk factors for PD. RESULTS PD prevalence (10.8%; 95% CI [9.8, 11.7]) and ran two different multivariate models for PD. We obtained the highest PD prevalence in those affected by any mental disorder plus those reporting having suffered childhood abuse, particularly sexual abuse. Additional potential risk factors or correlates of PD identified were: younger age, lower levels of functioning, less social support, poorer general health, having suffered maltreatment, threatening life events, higher suicidal risk scores and higher levels of both neuroticism and impulsivity. CONCLUSIONS This study reports PD prevalence and risk correlates in consonance with similar findings reported in other Western populations. However, longitudinal studies are needed to elicit a more thorough group of prospective determinants of PD.
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Affiliation(s)
| | - Blanca Gutiérrez
- Departament of Psychiatry, University of Granada, Spain
- Institute of Neurosciences, Biomedical Research Centre, University of Granada, Spain
- Instituto de Investigación Biosanitaria ibs Granada, Spain
| | - Margarita Rivera
- Institute of Neurosciences, Biomedical Research Centre, University of Granada, Spain
- Instituto de Investigación Biosanitaria ibs Granada, Spain
- Department of Biochemistry and Molecular Biology II, Faculty of Pharmacy, University of Granada, Spain
| | - Esther Molina
- Institute of Neurosciences, Biomedical Research Centre, University of Granada, Spain
- Instituto de Investigación Biosanitaria ibs Granada, Spain
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain
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Airikka A, Lahti-Pulkkinen M, Tuovinen S, Heinonen K, Lahti J, Girchenko P, Lähdepuro A, Pyhälä R, Czamara D, Villa P, Laivuori H, Kajantie E, Binder EB, Räikkönen K. Maternal exposure to childhood maltreatment and mental and behavioral disorders in children. Eur Child Adolesc Psychiatry 2023; 32:2463-2475. [PMID: 36181574 PMCID: PMC10682113 DOI: 10.1007/s00787-022-02090-8] [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: 03/16/2022] [Accepted: 09/23/2022] [Indexed: 11/24/2022]
Abstract
Exposure to maltreatment in childhood is associated with lifelong risk of mental and behavioral disorders. Whether the effects extend to the next generation remains unclear. We examined whether maternal exposure to childhood abuse and neglect in her own childhood were associated with mental and behavioral disorders and psychiatric symptoms in her children, and whether maternal lifetime mental and behavioral disorders or lower education level mediated or added to the effects. Mothers (n = 2252) of the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction cohort study completed the Childhood Trauma Questionnaire and reported on their education and their 7.0-12.1-year-old children's psychiatric symptoms using the Strengths and Difficulties Questionnaire. We identified lifetime mental and behavioral disorder diagnoses for the mothers and diagnoses for their children from birth (2006-2010) until 8.4-12.8 years (12/31/2018) from Care Register for Health Care. We found that maternal exposure to childhood abuse, but not neglect, was associated with higher hazards of mental and behavioral disorders (hazard ratio 1.20, 95% confidence interval 1.06-1.37) in children. These associations were partially mediated by maternal mental and behavioral disorders and education (proportion of effect size mediated: 23.8% and 15.1%, respectively), which together with maternal exposure to childhood abuse added to the hazard of mental and behavioral disorders in children. Similar associations were found for maternal exposure to childhood abuse and neglect with psychiatric symptoms in children. To conclude, maternal exposure to childhood maltreatment is associated with mental and behavioral disorders and psychiatric symptoms in children. Our findings call for interventions to prevent intergenerational transmission.
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Affiliation(s)
- Aino Airikka
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
- The Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland.
- The Finnish Institute for Health and Welfare, Helsinki, Finland.
- University of Edinburgh, Edinburgh, UK.
| | - Soile Tuovinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
- Welfare Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
- Welfare Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
| | - Polina Girchenko
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
| | - Anna Lähdepuro
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
| | - Riikka Pyhälä
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
| | - Darina Czamara
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Pia Villa
- Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannele Laivuori
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
- Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, Center for Child, Adolescent and Maternal Health Research, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Eero Kajantie
- The Finnish Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Clinical and Molecular Medicine, Norwegian University for Science and Technology, Trondheim, Norway
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
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Solmi M, Cortese S, Vita G, De Prisco M, Radua J, Dragioti E, Köhler-Forsberg O, Madsen NM, Rohde C, Eudave L, Aymerich C, Pedruzo B, Rodriguez V, Rosson S, Sabé M, Hojlund M, Catalan A, de Luca B, Fornaro M, Ostuzzi G, Barbui C, Salazar-de-Pablo G, Fusar-Poli P, Correll CU. An umbrella review of candidate predictors of response, remission, recovery, and relapse across mental disorders. Mol Psychiatry 2023; 28:3671-3687. [PMID: 37957292 PMCID: PMC10730397 DOI: 10.1038/s41380-023-02298-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/21/2023] [Accepted: 10/06/2023] [Indexed: 11/15/2023]
Abstract
We aimed to identify diagnosis-specific/transdiagnostic/transoutcome multivariable candidate predictors (MCPs) of key outcomes in mental disorders. We conducted an umbrella review (protocol link ), searching MEDLINE/Embase (19/07/2022), including systematic reviews of studies reporting on MCPs of response, remission, recovery, or relapse, in DSM/ICD-defined mental disorders. From published predictors, we filtered MCPs, validating MCP criteria. AMSTAR2/PROBAST measured quality/risk of bias of systematic reviews/individual studies. We included 117 systematic reviews, 403 studies, 299,888 individuals with mental disorders, testing 796 prediction models. Only 4.3%/1.2% of the systematic reviews/individual studies were at low risk of bias. The most frequently targeted outcome was remission (36.9%), the least frequent was recovery (2.5%). Studies mainly focused on depressive (39.4%), substance-use (17.9%), and schizophrenia-spectrum (11.9%) disorders. We identified numerous MCPs within disorders for response, remission and relapse, but none for recovery. Transdiagnostic MCPs of remission included lower disease-specific symptoms (disorders = 5), female sex/higher education (disorders = 3), and quality of life/functioning (disorders = 2). Transdiagnostic MCPs of relapse included higher disease-specific symptoms (disorders = 5), higher depressive symptoms (disorders = 3), and younger age/higher anxiety symptoms/global illness severity/ number of previous episodes/negative life events (disorders = 2). Finally, positive trans-outcome MCPs for depression included less negative life events/depressive symptoms (response, remission, less relapse), female sex (response, remission) and better functioning (response, less relapse); for schizophrenia, less positive symptoms/higher depressive symptoms (remission, less relapse); for substance use disorder, marital status/higher education (remission, less relapse). Male sex, younger age, more clinical symptoms and comorbid mental/physical symptoms/disorders were poor prognostic factors, while positive factors included social contacts and employment, absent negative life events, higher education, early access/intervention, lower disease-specific and comorbid mental and physical symptoms/conditions, across mental disorders. Current data limitations include high risk of bias of studies and extraction of single predictors from multivariable models. Identified MCPs can inform future development, validation or refinement of prediction models of key outcomes in mental disorders.
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Affiliation(s)
- Marco Solmi
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
- Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
- DiMePRe-J-Department of Precision and Regenerative Medicine-Jonic Area, University of Bari "Aldo Moro", Bari, Italy
| | - Giovanni Vita
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Michele De Prisco
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Elena Dragioti
- University of Ioannina, Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, Ioannina, Greece
- Linköping University, Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping, Sweden
| | - Ole Köhler-Forsberg
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Nanna M Madsen
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Christopher Rohde
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
| | - Luis Eudave
- Faculty of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Claudia Aymerich
- Biobizkaia Health Research Institute, Basurto University Hospital, OSI Bilbao-Basurto. University of the Basque Country UPV/EHU. Centro de Investigación en Red de Salud Mental. (CIBERSAM), Instituto de Salud Carlos III. Plaza de Cruces 12, 48903, Barakaldo, Bizkaia, Spain
| | - Borja Pedruzo
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | | | - Stella Rosson
- Mental Health Department, Local Health Unit ULSS3 Serenissima, Venice, Italy
| | - Michel Sabé
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226, Thonex, Switzerland
| | - Mikkel Hojlund
- Department of Psychiatry Aabenraa, Mental Health Services Region of Southern Denmark, Aabenraa, Denmark
- Clinical Pharmacology, Pharmacy, and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Child and Adolescent Mental Health Centre, Mental Health Services Capital Region of Denmark, Copenhagen, Denmark
| | - Ana Catalan
- Biobizkaia Health Research Institute, Basurto University Hospital, OSI Bilbao-Basurto. University of the Basque Country UPV/EHU. Centro de Investigación en Red de Salud Mental. (CIBERSAM), Instituto de Salud Carlos III. Plaza de Cruces 12, 48903, Barakaldo, Bizkaia, Spain
| | - Beatrice de Luca
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Michele Fornaro
- Department of Psychiatry, Federico II of Naples, Naples, Italy
| | - Giovanni Ostuzzi
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Gonzalo Salazar-de-Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry and Mental Health. Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Outreach and Support in South London (OASIS) service, NHS South London and Maudsley Foundation Trust, London, UK
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany.
- The Zucker Hillside Hospital, Northwell Health, New York, NY, USA.
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA.
- The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA.
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7
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Mielke EL, Koenig J, Herpertz SC, Steinmann S, Neukel C, Kilavuz P, van der Venne P, Bertsch K, Kaess M. Adverse childhood experiences mediate the negative association between borderline personality disorder symptoms and plasma oxytocin. Prog Neuropsychopharmacol Biol Psychiatry 2023; 125:110749. [PMID: 36924878 DOI: 10.1016/j.pnpbp.2023.110749] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 03/12/2023] [Accepted: 03/12/2023] [Indexed: 03/18/2023]
Abstract
Background Interpersonal dysfunction is a core symptom of borderline personality disorder (BPD) and may be closely linked to adverse childhood experiences. According to a recent model on the pathology of BPD, the neuropeptide oxytocin might play an important role in the development and maintenance of the disorder. However, so far, only few studies with small adult samples have reported reduced baseline oxytocin levels in BPD that may be linked to adverse childhood experiences. Methods We examined baseline plasma oxytocin levels in 131 female patients with BPD and 124 non-BPD female controls across a large age span (12-50 years). Additionally, 113 female patients with less than five DSM-IV BPD features were included to examine the association between plasma oxytocin levels and the number of fulfilled BPD criteria. We also explored associations between plasma oxytocin and adverse childhood experiences as well as depressive symptoms in BPD. Results Patients with BPD had reduced plasma oxytocin levels compared to non-BPD controls and this was independent of age. Plasma oxytocin was negatively associated with the number of fulfilled BPD criteria. The exploratory regression model revealed no association between plasma oxytocin and depressive symptoms but an association between plasma oxytocin and adverse childhood experiences, which in fact mediated the relationship between BPD criteria und plasma oxytocin. Conclusion In a large sample of individuals with BPD across a large age span, our results replicate and extend previous reports of reduced plasma oxytocin levels that might be related to adverse childhood experiences thus providing further evidence for a prominent role of oxytocin in BPD.
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Affiliation(s)
- Emilia L Mielke
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, University of Heidelberg, Voßstraße 4, 69115 Heidelberg, Germany.
| | - Julian Koenig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Robert-Koch-Straße 10, 50931 Cologne, Germany; Department of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, Medical Faculty, University of Heidelberg, Blumenstr. 8, 69115 Heidelberg, Germany; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, University of Heidelberg, Voßstraße 4, 69115 Heidelberg, Germany
| | - Sylvia Steinmann
- Department of Psychosomatics and Psychotherapeutic Medicine, Central Institute of Mental Health Mannheim, University of Heidelberg, J 5, 68159 Mannheim, Germany
| | - Corinne Neukel
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, University of Heidelberg, Voßstraße 4, 69115 Heidelberg, Germany
| | - Pelin Kilavuz
- Department of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, Medical Faculty, University of Heidelberg, Blumenstr. 8, 69115 Heidelberg, Germany
| | - Patrice van der Venne
- Department of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, Medical Faculty, University of Heidelberg, Blumenstr. 8, 69115 Heidelberg, Germany; Institute of Psychology, University of Heidelberg, Hauptstr. 47- 51, 69117 Heidelberg, Germany
| | - Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, University of Heidelberg, Voßstraße 4, 69115 Heidelberg, Germany; Department of Psychology, Ludwig-Maximilians-University Munich, Leopoldstr. 13, 80802 Munich, Germany
| | - Michael Kaess
- Department of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, Medical Faculty, University of Heidelberg, Blumenstr. 8, 69115 Heidelberg, Germany; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
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8
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Turco R, Russo M, Lenta S, Apicella A, Gagliardo T, Savoia F, Corona AM, De Fazio F, Bernardo P, Tipo V. Pediatric emergency care admissions for somatic symptom disorders during the COVID-19 pandemic. Eur J Pediatr 2023; 182:957-964. [PMID: 36459226 PMCID: PMC9716529 DOI: 10.1007/s00431-022-04687-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/25/2022] [Accepted: 10/31/2022] [Indexed: 12/03/2022]
Abstract
During the COVID-19 pandemic, children and adolescents with psychiatric disorders experienced an exacerbation of their symptoms with more access to the emergency department (ED). However, little is known about the experience of somatic symptom disorders (SSDs) during the COVID-19 pandemic in children. Therefore, we aimed to compare the rates of pediatric ED admissions for SSDs before and during the COVID-19 pandemic and to understand whether the relative risk of ED admissions for SSDs changed between the two periods. We retrospectively enrolled all children between 4 and 14 years admitted for SSDs in the pediatric ED of Santobono-Pausilipon Hospital, Naples, Italy, from March 11th, 2020, to March 11th, 2021 (pandemic period), and in the same time period of the previous year (pre-pandemic period). We identified 205/95,743 (0,21%) children with SSDs presenting in ED in the pre-pandemic year and 160/40,165 (0,39%) in the pandemic year (p < 0.05). Considering the accesses for age, we observed a relative decrease of the accesses for SSDs over 12 years old (IRR 0,59; CI 0,39-0,88), while we found no differences under 12 years old (IRR 0,87; CI 0,68-1,10). Conclusion: In this study, we found that despite the massive decrease in pediatric admissions due to the COVID-19 pandemic, somatic symptom disorders' admissions to the pediatric ED increased, suggesting an impact of the pandemic also on pediatric psychiatric disorders. What is Known: • During the COVID -19 pandemic, children and adolescents with a psychiatric disorder experienced exacerbation of their symptoms with more accesses in Emergency Department. What is New: • We found that despite the massive decrease of the pediatric admissions due to the COVID-19 pandemic, somatic symptom disorders admissions in healthy children to the pediatric Emergency Department increased ,suggesting an impact of the pandemic also on the pediatric psychiatric disorders.
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Affiliation(s)
- R. Turco
- grid.415247.10000 0004 1756 8081Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - M. Russo
- grid.415247.10000 0004 1756 8081Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - S. Lenta
- grid.415247.10000 0004 1756 8081Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - A. Apicella
- grid.415247.10000 0004 1756 8081Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - T. Gagliardo
- grid.415247.10000 0004 1756 8081Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - F. Savoia
- grid.415247.10000 0004 1756 8081Childhood Cancer Registry of Campania, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy
| | - A. M. Corona
- grid.415247.10000 0004 1756 8081Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - F. De Fazio
- grid.415247.10000 0004 1756 8081Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - P. Bernardo
- grid.415247.10000 0004 1756 8081Department of Neurosciences, Pediatric Psychiatry and Neurology, Santobono-Pausilipon Children’s Hospital, 80120 Naples, Italy
| | - V. Tipo
- grid.415247.10000 0004 1756 8081Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
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Yuan Y, Lin S, Lin W, Huang F, Zhu P. Modifiable predictive factors and all-cause mortality in the non-hospitalized elderly population: An umbrella review of meta-analyses. Exp Gerontol 2022; 163:111792. [PMID: 35367595 DOI: 10.1016/j.exger.2022.111792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/20/2022] [Accepted: 03/28/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This umbrella review aimed to summarize the association between modifiable predictive factors and all-cause mortality in the non-hospitalized elderly population, and estimated the credibility and strength of the current evidence. METHODS PubMed, Embase, Web of science, and EBSCOhost were searched up to February 28, 2022. Random-effect summary effect sizes and 95% confidence intervals (CIs), heterogeneity, small-study effect, excess significance bias, as well as 95% prediction intervals (PIs) were calculated. Methodological quality was assessed with the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool. The credibility of the included meta-analyses was graded from convincing to weak using established criteria. This umbrella review was registered with PROSPERO, CRD 42021282183. RESULTS In total, 32 predictive factors involving 49 associations extracted from 35 meta-analyses were analyzed. Forty-three of the 49 (87.8%) associations presented nominal significant effects by the random-effect model (P < 0.05), of which 34 had harmful associations and nine had beneficial associations with all-cause mortality. Frailty (FRAIL scale), low short physical performance battery (SPPB) score, and fewer daily steps carried a more than three-fold risk for all-cause mortality. Convincing evidence showed that weight fluctuation, prefrailty and frailty status, sarcopenia, low SPPB score, fewer daily steps, and fatigue increased the risk of all-cause mortality, while daily moderate-to-vigorous physical activity (MVPA) duration and total physical activity participation reduced the risk of death. There were twenty, nine, five, and six associations that yielded highly suggestive, suggestive, weak, and non-significant grades of evidence. Thirty-four (69.4%) of the associations exhibited significant heterogeneity. Twenty-two associations presented 95% PIs excluding the null value, two indicated small-study effects, and three had evidence for excess significance bias, respectively. The methodological quality of most meta-analyses was rated as low (37.1%) or critically low (42.9%). CONCLUSIONS A summary of the currently available meta-analyses suggests that a broad range of modifiable predictive factors are significantly associated with all-cause mortality risk in the non-hospitalized elderly population. The most credible evidence indicates that physical function represented by frailty and sarcopenia, as well as physical activity, are significant predictors for all-cause mortality. This umbrella review may provide prognostic information to direct appropriate diagnostic evaluation and treatment goals in the future. More solid evidence is still needed coming from moderate-to-high quality meta-analyses.
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Affiliation(s)
- Yin Yuan
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, China; Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China; Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China; Fujian Provincial Center of Geriatrics, Fuzhou, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China
| | - Siyang Lin
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, China; Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China; Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China; Fujian Provincial Center of Geriatrics, Fuzhou, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China
| | - Wenwen Lin
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, China; Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China; Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China; Fujian Provincial Center of Geriatrics, Fuzhou, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China
| | - Feng Huang
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, China; Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China; Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China; Fujian Provincial Center of Geriatrics, Fuzhou, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China.
| | - Pengli Zhu
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, China; Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China; Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, China; Fujian Provincial Center of Geriatrics, Fuzhou, China; Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, China.
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10
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Salzmann S, Salzmann-Djufri M, Euteneuer F. Childhood Emotional Neglect and Cardiovascular Disease: A Narrative Review. Front Cardiovasc Med 2022; 9:815508. [PMID: 35198614 PMCID: PMC8858943 DOI: 10.3389/fcvm.2022.815508] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Psychosocial factors predict the incidence and progression of cardiovascular disease (CVD). There is accumulating evidence for the importance of childhood maltreatment for the development and progression of both CVD-related risk factors and CVD. However, past research has predominantly focused on active forms of childhood maltreatment such as emotional abuse, physical abuse, and sexual abuse. At the same time, childhood neglect as a relatively silent form of childhood maltreatment received less attention. Childhood emotional neglect is the most common form of neglect. This narrative review summarizes findings on the association between childhood emotional neglect and CVD and potential underlying mechanisms. These mechanisms may involve biological factors (i.e., elevated inflammation, autonomic dysregulation, dysregulated HPA axis, and altered brain development), psychological variables and mental health (i.e., depression and anxiety), and health behaviors (i.e., eating behavior, smoking, drug use, physical activity) and interpersonal aspects. Evidence suggests that emotional neglect is associated with CVD and CVD risk factors such as obesity, diabetes, inflammation, a dysregulated stress system, altered brain development, depression and other psychological abnormalities (i.e., emotion-regulation difficulties), interpersonal difficulties, and lack of health behaviors. Specific subtypes of childhood maltreatment may be associated with CVD via different mechanisms. This review further encompasses clinical suggestions, identifies research gaps, and has implications for future studies. However, more research with better study designs is desperately needed to identify the exact underlying mechanisms and opportunities for mitigating the negative health consequences of emotional neglect to reduce the prevalence and progression of CVD.
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Affiliation(s)
- Stefan Salzmann
- Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
- *Correspondence: Stefan Salzmann
| | | | - Frank Euteneuer
- Department of Psychology, Clinical Psychology and Psychotherapy, Medical School Berlin, Berlin, Germany
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