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Basedow LA, Zerth SF, Salzmann S, Uecker C, Bauer N, Elsenbruch S, Rief W, Langhorst J. Pre-treatment expectations and their influence on subjective symptom change in Crohn's disease. J Psychosom Res 2024; 176:111567. [PMID: 38100897 DOI: 10.1016/j.jpsychores.2023.111567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Treatment expectations reportedly shape treatment outcomes, but have not been studied in the context of multimodal therapy in Crohn's disease (CD). Therefore, the current study investigated the role of treatment expectations for subjective symptom changes in CD patients who have undergone an integrative multimodal therapy program. METHODS Validated questionnaires were completed at the start of the treatment program and post intervention. Pre-treatment expectations and experienced symptom change were assessed with the Generic Rating Scale for Previous Treatment Experiences, Treatment Expectations, and Treatment Effects (GEEE); stress levels were quantified with the Perceived Stress Scale (PSS-10) and disease specific quality of life was quantified with the disease-specific Inflammatory Bowel Disease Questionnaire (IBDQ). We performed multiple linear and Bayesian regression to determine how expectations related to symptom change. RESULTS N = 71 CD patients (66.2% female) were included. Stronger expectations regarding symptom improvement (b = 0.422, t = 3.70, p < .001) were associated with higher experienced symptom improvement. Additionally, Bayesian analysis provided strong evidence for including improvement expectations as a predictor of improvement experience (BFinclusion = 13.78). CONCLUSIONS In line with research in other disorders, we found that positive treatment expectations were associated with experienced symptom improvement. In contrast, we found no indication that an experience of symptom worsening was associated with positive or negative baseline treatment expectations. Induction of positive expectations might be a potential avenue for improving treatment outcomes in CD therapy.
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Affiliation(s)
- Lukas Andreas Basedow
- Philipps-Universität Marburg, Department of Clinical Psychology and Psychotherapy, 35037 Marburg, Germany.
| | - Simon Felix Zerth
- Philipps-Universität Marburg, Department of Clinical Psychology and Psychotherapy, 35037 Marburg, Germany.
| | - Stefan Salzmann
- Philipps-Universität Marburg, Department of Clinical Psychology and Psychotherapy, 35037 Marburg, Germany; Health and Medical University, Medical Psychology, 99084 Erfurt, Germany.
| | - Christine Uecker
- Sozialstiftung Bamberg, Department of Internal and Integrative Medicine, 96049 Bamberg, Germany; University of Duisburg Essen, Medicinal Faculty, Department of Integrative Medicine, 96049 Bamberg, Germany.
| | - Nina Bauer
- Sozialstiftung Bamberg, Department of Internal and Integrative Medicine, 96049 Bamberg, Germany; University of Duisburg Essen, Medicinal Faculty, Department of Integrative Medicine, 96049 Bamberg, Germany
| | - Sigrid Elsenbruch
- Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, 44789 Bochum, Germany; Department of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany.
| | - Winfried Rief
- Philipps-Universität Marburg, Department of Clinical Psychology and Psychotherapy, 35037 Marburg, Germany.
| | - Jost Langhorst
- Sozialstiftung Bamberg, Department of Internal and Integrative Medicine, 96049 Bamberg, Germany; University of Duisburg Essen, Medicinal Faculty, Department of Integrative Medicine, 96049 Bamberg, Germany.
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Basedow LA, Wiedmann MF, Kuitunen-Paul S, Roessner V, Golub Y. Attenuated psychotic symptoms, substance use and self-reported PTSD in adolescence. Eur J Psychotraumatol 2023; 14:2193327. [PMID: 37010565 PMCID: PMC10071952 DOI: 10.1080/20008066.2023.2193327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
Background: The occurrence of attenuated psychotic symptoms (APS) is a major concern in populations with substance use disorders (SUDs). However, APS also frequently develop in the course of Post-Traumatic Stress Disorder (PTSD). This study explores how the prevalence of APS differs between adolescent patients with only SUD, SUD with a history of traumatic experiences (TEs), and with SUD and self-reported PTSD.Methods: We recruited n = 120 treatment-seeking adolescents at a German outpatient clinic for adolescents with SUD. All participants filled out questionnaires assessing APS (PQ-16, YSR schizoid scale), trauma history, PTSD symptoms (both UCLA PTSD Index), and SUD severity (DUDIT) next to an extensive substance use interview. We performed a multivariate analysis of co-variance with the four PQ-16 scales and the YSR scale as outcomes and PTSD status as predictor. Additionally, we performed five linear regressions predicting each PQ-16 score and YSR score based on tobacco, alcohol, cannabis, ecstasy, amphetamine, and methamphetamine use.Results: Participants with co-occurring SUD and self-reported PTSD showed significantly higher APS prevalence rates (PQ-16 score, p = .00002), more disturbed thought content (p = .000004), more perceptual disturbances (p = .002), more negative symptoms (p = .004) and more thought problems (p = .001) compared to adolescents with SUD and a history of trauma and adolescents with only SUD. Past-year substance use was not predictive for APS prevalence (F(75) = 0.42; p = .86; R2 = .04).Conclusion: Our data suggests that the occurrence of APS in adolescents with SUD is better explained by co-occurring self-reported PTSD than by substance use frequency or substance class. This finding might indicate that APS might be reduced through treating PTSD or focusing on TEs in SUD therapy.
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Affiliation(s)
- Lukas Andreas Basedow
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | | | - Sören Kuitunen-Paul
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
- Clinical Psychology and Psychotherapy, TU Chemnitz, Chemnitz, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Yulia Golub
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
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Basedow LA, Wiedmann MF, Roessner V, Golub Y, Kuitunen-Paul S. Coping motives mediate the relationship between PTSD and MDMA use in adolescents with substance use disorders. Addict Sci Clin Pract 2022; 17:46. [PMID: 36057623 PMCID: PMC9441101 DOI: 10.1186/s13722-022-00329-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 08/17/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) and substance use disorders (SUDs) often co-occur in adolescent patients. Previous research has shown that these patients differ from SUD patients without PTSD in terms of their substance use patterns. In this study, we aimed to test whether substance use in this population is related to an attempt to self-medicate PTSD-related symptoms. METHODS German adolescent patients (aged 13-18 years) at an outpatient clinic for SUD treatment, n = 111 (43% female), completed a self-designed questionnaire on use motives, a measure of PTSD-related experiences, and underwent a standardized psychiatric interview including structured substance use questions. Participants were subsequently classified as 'no traumatic experiences ('noTEs' but SUD), 'traumatic experiences but no current PTSD diagnosis' ('TEs' with SUD), and 'PTSD' with SUD. After establishing a self-designed motive measurement through exploratory and confirmatory factor analyses, we calculated non-parametric group differences and a mediation analysis in a linear regression framework. RESULTS The past-year frequency of MDMA use was highest in the PTSD group and lowest in the noTE group (H (2) = 7.2, p = .027, η2 = .058), but no differences were found for frequencies of tobacco, alcohol, cannabis, or stimulant use (all H ≤ 4.9, p ≥ .085, η2 ≤ .033). While controlling for sex, the three groups showed a similar pattern (highest in the PTSD group and lowest in the noTE group) for coping scores (F (103) = 5.77, p = .004, η2 = .101). Finally, mediation analyses revealed an indirect effect of coping score (b = 0.61, 95% CI [0.29, 1.58], p = .145) on the association between group membership and MDMA use frequency. CONCLUSIONS In adolescent SUD patients, we found an association of current PTSD and lifetime traumatic experiences with higher MDMA use that could be partially explained by substance use being motivated by an attempt to cope with mental health symptoms. This indicates a coping process involved specifically in MDMA use compared to the use of other psychoactive substances, possibly due to unique psychoactive effects of MDMA.
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Affiliation(s)
- Lukas Andreas Basedow
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
- Division of Clinical Psychology and Psychotherapy, Dept. of Psychology, Philipps-University of Marburg, Marburg, Germany.
| | - Melina Felicitas Wiedmann
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Yulia Golub
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Sören Kuitunen-Paul
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Chair for Clinical Psychology and Psychotherapy, Technische Universität Chemnitz, Chemnitz, Germany
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Wiedmann M, Kuitunen-Paul S, Basedow LA, Wolff M, DiDonato N, Franzen J, Wagner W, Roessner V, Golub Y. DNA methylation changes associated with cannabis use and verbal learning performance in adolescents: an exploratory whole genome methylation study. Transl Psychiatry 2022; 12:317. [PMID: 35933470 PMCID: PMC9357061 DOI: 10.1038/s41398-022-02025-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 06/02/2022] [Accepted: 06/09/2022] [Indexed: 11/09/2022] Open
Abstract
The association between extent of chronic cannabis use (CCU-extent) and cognitive impairment among adolescents has been the subject of controversial debate. Linking DNA methylation to CCU-extent could help to understand cannabis associated changes in cognitive performance. We analyzed cognitive task performances, CpG methylation in peripheral whole-blood samples and self-reported past-year CCU-extent of n = 18 adolescents (n = 9 psychiatric outpatients with chronic cannabis use (CCU), n = 9 without) who were matched for age, gender and psychiatric disorders. Patients with CCU were at least 24 h abstinent when cognitive tasks were performed. A Principal Component Analysis (PCA) was carried out to identify group differences in whole genome DNA methylation. Mediation analyses were performed between CCU-extent associated CpG sites and CCU-extent associated variables of cognitive tasks. PCA results indicated large differences in whole genome DNA methylation levels between the groups that did not reach statistical significance. Six CpG sites revealed reduced methylation associated with CCU-extent. Furthermore, CCU-extent was associated with lower scores in verbal learning. All six CpG sites mediated the effects between CCU-extent and verbal learning free recall. Our results indicate that CCU is associated with certain patterns in the methylome. Furthermore, CCU-extent associated impairments in memory function are mediated via differential methylation of the six CCU-associated CpG sits. Six identified CpG are located in genes previously described in the context of neurodegeneration, hippocampus-dependent learning and neurogenesis. However, these results have to be carefully interpreted due to a small sample size. Replication studies are warranted.
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Affiliation(s)
- Melina Wiedmann
- Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Faculty of Medicine, 01307, Dresden, Germany.
| | - Sören Kuitunen-Paul
- grid.4488.00000 0001 2111 7257Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Faculty of Medicine, 01307 Dresden, Germany ,grid.6810.f0000 0001 2294 5505Technische Universität Chemnitz, Chair for Clinical Psychology and Psychotherapy, Chemnitz, Germany
| | - Lukas Andreas Basedow
- grid.4488.00000 0001 2111 7257Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Faculty of Medicine, 01307 Dresden, Germany
| | - Max Wolff
- grid.6363.00000 0001 2218 4662Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Berlin, Germany
| | - Nataliya DiDonato
- grid.4488.00000 0001 2111 7257Technische Universität Dresden, University Hospital, Institute for Clinical Genetics, Dresden, Germany
| | - Julia Franzen
- grid.1957.a0000 0001 0728 696XHelmholtz-Institute for Biomedical Engineering, Stem Cell Biology and Cellular Engineering, RWTH Aachen University Medical School, Aachen, Germany
| | - Wolfgang Wagner
- grid.1957.a0000 0001 0728 696XHelmholtz-Institute for Biomedical Engineering, Stem Cell Biology and Cellular Engineering, RWTH Aachen University Medical School, Aachen, Germany
| | - Veit Roessner
- grid.4488.00000 0001 2111 7257Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Faculty of Medicine, 01307 Dresden, Germany
| | - Yulia Golub
- grid.4488.00000 0001 2111 7257Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Faculty of Medicine, 01307 Dresden, Germany
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Basedow LA, Wiedmann M, Roessner V, Golub Y, Kuitunen-Paul S. Selbstmedikation und Coping bei Jugendlichen mit PTBS und
Substanzabhängigkeit. Suchttherapie 2022. [DOI: 10.1055/s-0042-1756084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
| | | | | | - Y Golub
- Technische Universität Dresden, Dresden
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Wiedmann M, Kuitunen-Paul S, Kutz O, Basedow LA, Roessner V, Golub Y. Assoziationen zwischen CRHR1 und DDC DNA Methylierung und depressiven
Symptomen bei jugendlichen Patient*innen mit
Cannabiskonsumstörung. Suchttherapie 2022. [DOI: 10.1055/s-0042-1756082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- M Wiedmann
- Uniklinikum Carl Gustav Carus, Kinder und Jugendpsychiatrie und
Psychotherapie, Dresden
| | - S Kuitunen-Paul
- Technische Universität Chemnitz, Professur für
Klinische Psychologie und Psychotherapie, Chemnitz
| | - O Kutz
- Uniklinikum Carl Gustav Carus, Kinder und Jugendpsychiatrie und
Psychotherapie, Dresden
| | - LA Basedow
- Uniklinikum Carl Gustav Carus, Kinder und Jugendpsychiatrie und
Psychotherapie, Dresden
| | - V Roessner
- Uniklinikum Carl Gustav Carus, Kinder und Jugendpsychiatrie und
Psychotherapie, Dresden
| | - Y Golub
- Uniklinikum Carl Gustav Carus, Kinder und Jugendpsychiatrie und
Psychotherapie, Dresden
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Wiedmann M, Atzendorf J, Basedow LA, Roessner V, Golub Y, Kuitunen-Paul S. [Substance Use, Resulting Disorders, and Collateral Mental Disorders Among Adolescents in a Special Outpatient Institutions for Addictions]. Z Kinder Jugendpsychiatr Psychother 2022; 50:105-119. [PMID: 35005989 DOI: 10.1024/1422-4917/a000846] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Substance Use, Resulting Disorders, and Collateral Mental Disorders Among Adolescents in a Special Outpatient Institutions for Addictions Abstract. Objective: Only few clinics offer the outpatient treatment of substance use disorders (SUDs) among adolescents. Therefore, only limited data describe substance use patterns, SUDs, and co-occurring psychiatric disorders characteristic of adolescents who present in such outpatient clinics specialized in the treatment of SUDs. Method: Via interview we collected data from n = 201 patients between 12 and 19 years concerning their substance use, SUDs, and current co-occurring psychiatric disorders. We created descriptive presentation of data regarding use patterns, SUDs, and co-occurring disorders divided by sex and current age. Results: Tobacco (88 %) and cannabis (86 %) were the most frequently used substances. 67 % of all patients presented with more than one SUD, cannabis use disorder being the most prevalent one (84 %). 72 % presented with at least one co-occurring disorder, with conduct disorders (40 %), attention deficit (hyperactivity) disorders (21 %), and depressive disorders (18 %) being the most frequent ones. Conclusions: Adolescent SUD patients often present with co-occurring psychiatric disorders. Institutions for adolescent SUD treatment should also focus on treating co-occurring conduct disorders, depression, and attention deficit disorders.
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Affiliation(s)
- Melina Wiedmann
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden
| | - Josefine Atzendorf
- Munich Center for the Economics of Aging (MEA), Max-Plank-Institut für Sozialrecht und Sozialpolitik, München
| | - Lukas Andreas Basedow
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden
| | - Veit Roessner
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden
| | - Yulia Golub
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden
| | - Sören Kuitunen-Paul
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden
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Basedow LA, Kuitunen-Paul S, Wiedmann MF, Ehrlich S, Roessner V, Golub Y. Verbal learning impairment in adolescents with methamphetamine use disorder: a cross-sectional study. BMC Psychiatry 2021; 21:166. [PMID: 33765981 PMCID: PMC7993453 DOI: 10.1186/s12888-021-03169-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/15/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Methamphetamine (MA) use has been shown to be associated with deficits in impulsivity, verbal learning, and working memory. Additionally, methamphetamine use disorder (MUD) is related to various brain changes, especially in adolescent users who might be more vulnerable to detrimental effects on brain development. However, little is known about the relationship between adolescent MA use and cognitive impairment. This cross-sectional study aims to explore how the presence of a MUD in adolescents is related to impairments of verbal memory, inhibition, and alertness. METHODS N = 18 psychiatric outpatients with MUD were matched in terms of depressivity, age, and gender to n = 18 adolescents with other substance use disorders (SUDs), as well as n = 18 controls without SUDs. We compared these three groups on the Verbal Learning and Memory Task (VLMT), and the alertness and go/noGo subtests of the Test of Attentional Performance (TAP). Additionally, Spearman's rank order correlation coefficients were calculated to investigate whether cognitive functioning was directly associated with frequency of past year MA use. RESULTS The three groups differed significantly in their verbal learning performance (H (2) = 11.7, p = .003, ηp2 = .19), but not in short-term memory, inhibition, cued recall, or alertness. Post hoc tests revealed significant differences in verbal learning between the MA using group and the control group without a SUD (U = 56.5, p = .001, ηp2 = .31). Frequency of past year MA use correlated negatively with short-term memory (ρ = -.25, p < .01) and verbal learning (ρ = -.41, p < .01). No other cognitive variables correlated significantly with MA use frequency. Significant p-values were considered significant after Bonferroni correction. CONCLUSIONS Adolescent MUD outpatients with regular MA use show specific impairment in verbal learning performance, but not in other basal cognitive functions when compared to adolescents without a MUD. Verbal learning and short-term memory performance is negatively associated with the frequency of MA use. Future research should apply longitudinal designs to investigate long-term effects of methamphetamine and reversibility of these effects on cognitive functioning.
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Affiliation(s)
- Lukas Andreas Basedow
- TU Dresden, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Dresden, Germany.
| | - Sören Kuitunen-Paul
- grid.4488.00000 0001 2111 7257TU Dresden, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Dresden, Germany
| | - Melina Felicitas Wiedmann
- grid.4488.00000 0001 2111 7257TU Dresden, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Dresden, Germany
| | - Stefan Ehrlich
- grid.4488.00000 0001 2111 7257TU Dresden, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Dresden, Germany ,grid.4488.00000 0001 2111 7257TU Dresden, Faculty of Medicine, Division of Psychological and Social Medicine and Developmental Neurosciences, Dresden, Germany
| | - Veit Roessner
- grid.4488.00000 0001 2111 7257TU Dresden, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Dresden, Germany
| | - Yulia Golub
- grid.4488.00000 0001 2111 7257TU Dresden, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Dresden, Germany
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Plank AC, Frey S, Basedow LA, Solati J, Canneva F, von Hörsten S, Kratz O, Moll GH, Golub Y. Prenatally traumatized mice reveal hippocampal methylation and expression changes of the stress-related genes Crhr1 and Fkbp5. Transl Psychiatry 2021; 11:183. [PMID: 33758173 PMCID: PMC7988147 DOI: 10.1038/s41398-021-01293-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 01/11/2021] [Accepted: 02/01/2021] [Indexed: 11/17/2022] Open
Abstract
In our previous study, we found that prenatal trauma exposure leads to an anxiety phenotype in mouse pups, characterized by increased corticosterone levels and increased anxiety-like behavior. In order to understand the mechanisms by which aversive in utero experience leads to these long-lasting behavioral and neuroendocrine changes, we investigated stress reactivity of prenatally traumatized (PT) mice, as well as the expression and methylation levels of several key regulatory genes of the stress axis in the dorsal hippocampus (dHPC) of the PT embryo and adult mice. We detected increased corticotropin-releasing hormone receptor 1 (Crhr1) and decreased FK506 binding protein 5 (Fkbp5) mRNA levels in the left dHPC of adult PT mice. These alterations were accompanied by a decreased methylation status of the Crhr1 promoter and an increased methylation status of the Fkbp5 promoter, respectively. Interestingly, the changes in Fkbp5 and Crhr1 mRNA levels were not detected in the embryonic dHPC of PT mice. Together, our findings provide evidence that prenatal trauma has a long-term impact on stress axis function and anxiety phenotype associated with altered Crhr1 and Fkbp5 transcripts and promoter methylation.
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Affiliation(s)
- Anne-Christine Plank
- grid.411668.c0000 0000 9935 6525Department of Child and Adolescent Mental Health, University Hospital Erlangen, Schwabachanlage 6 and 10, 91054 Erlangen, Germany
| | - Stefan Frey
- grid.411668.c0000 0000 9935 6525Department of Child and Adolescent Mental Health, University Hospital Erlangen, Schwabachanlage 6 and 10, 91054 Erlangen, Germany
| | - Lukas Andreas Basedow
- grid.4488.00000 0001 2111 7257Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| | - Jalal Solati
- grid.411668.c0000 0000 9935 6525Department of Child and Adolescent Mental Health, University Hospital Erlangen, Schwabachanlage 6 and 10, 91054 Erlangen, Germany
| | - Fabio Canneva
- grid.5330.50000 0001 2107 3311Department Experimental Therapy, University Hospital Erlangen and Preclinical Experimental Animal Center, Friedrich-Alexander-University Erlangen-Nürnberg, Palmsanlage 5, 91054 Erlangen, Germany
| | - Stephan von Hörsten
- grid.5330.50000 0001 2107 3311Department Experimental Therapy, University Hospital Erlangen and Preclinical Experimental Animal Center, Friedrich-Alexander-University Erlangen-Nürnberg, Palmsanlage 5, 91054 Erlangen, Germany
| | - Oliver Kratz
- grid.411668.c0000 0000 9935 6525Department of Child and Adolescent Mental Health, University Hospital Erlangen, Schwabachanlage 6 and 10, 91054 Erlangen, Germany
| | - Gunther H. Moll
- grid.411668.c0000 0000 9935 6525Department of Child and Adolescent Mental Health, University Hospital Erlangen, Schwabachanlage 6 and 10, 91054 Erlangen, Germany
| | - Yulia Golub
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Schwabachanlage 6 and 10, 91054, Erlangen, Germany. .,Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany.
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Basedow LA, Kuitunen-Paul S, Wiedmann MF, Roessner V, Golub Y. Self-reported PTSD is associated with increased use of MDMA in adolescents with substance use disorders. Eur J Psychotraumatol 2021; 12:1968140. [PMID: 34603636 PMCID: PMC8480619 DOI: 10.1080/20008198.2021.1968140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Adolescent patients with a substance use disorder (SUD) often fulfil the criteria for a co-occurring post-traumatic stress disorder (PTSD). However, it is not clear if these dual-diagnosed adolescents present with unique levels of substance use and how their substance use relates to PTSD symptom clusters. OBJECTIVE To investigate substance use in adolescents with co-occurring PTSD and SUD. Additionally, we explored how the use of specific substances is related to specific PTSD symptom clusters. METHOD We recruited n = 121 German adolescent SUD patients, in three groups: no history of traumatic events (TEs) (n = 35), TEs but not PTSD (n = 48), probable PTSD (n = 38). All groups were administered a trauma questionnaire and were asked to report their past-month substance use. RESULTS Adolescents with probable PTSD and SUD report a higher frequency of MDMA use than adolescents with no PTSD and no TE (PTSD vs. noTE: U = 510.5, p = .016; PTSD vs. TE: U = 710.0, p = .010). The use of MDMA was more frequent in adolescents with avoidance symptoms (X2 (1) = 6.0, p = .014). Participants report using substances at a younger age (PTSD vs. noTE: U = 372.0, p = .001; PTSD vs. TE: U = 653.5, p = .022) and PTSD symptom onset was on average 2.2 years earlier than first MDMA use (t (26) = -2.89, p = .008). CONCLUSIONS Adolescent SUD patients with probable PTSD are more likely to use MDMA than SUD patients without PTSD. The use of MDMA was associated with reported avoidance symptoms. The first age of MDMA use is initiated after PTSD onset. It is unclear whether the association of MDMA use with avoidance symptoms is due to efforts to reduce these symptoms or a result of regular MDMA use.
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Affiliation(s)
- Lukas Andreas Basedow
- Department Of Child And Adolescent Psychiatry, Faculty Of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Sören Kuitunen-Paul
- Department Of Child And Adolescent Psychiatry, Faculty Of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Melina Felicitas Wiedmann
- Department Of Child And Adolescent Psychiatry, Faculty Of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Department Of Child And Adolescent Psychiatry, Faculty Of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Yulia Golub
- Department Of Child And Adolescent Psychiatry, Faculty Of Medicine, Technische Universität Dresden, Dresden, Germany
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