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Schury K, Koenig AM, Isele D, Hulbert AL, Krause S, Umlauft M, Kolassa S, Ziegenhain U, Karabatsiakis A, Reister F, Guendel H, Fegert JM, Kolassa IT. Alterations of hair cortisol and dehydroepiandrosterone in mother-infant-dyads with maternal childhood maltreatment. BMC Psychiatry 2017; 17:213. [PMID: 28587668 PMCID: PMC5461775 DOI: 10.1186/s12888-017-1367-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [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: 11/12/2016] [Accepted: 05/19/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Child maltreatment (CM) has severe effects on psychological and physical health. The hypothalamic-pituitary-adrenal (HPA) axis, the major stress system of the body, is dysregulated after CM. The analysis of cortisol and dehydroepiandrosterone (DHEA) in scalp hair presents a new and promising methodological approach to assess chronic HPA axis activity. This study investigated the effects of CM on HPA axis activity in the last trimester of pregnancy by measuring the two important signaling molecules, cortisol and DHEA in hair, shortly after parturition. In addition, we explored potential effects of maternal CM on her offspring's endocrine milieu during pregnancy by measuring cortisol and DHEA in newborns' hair. METHODS CM was assessed with the Childhood Trauma Questionnaire (CTQ). Cortisol and DHEA were measured in hair samples of 94 mothers and 30 newborns, collected within six days after delivery. Associations of maternal CM on her own and her newborn's cortisol as well as DHEA concentrations in hair were analyzed with heteroscedastic regression models. RESULTS Higher CM was associated with significantly higher DHEA levels, but not cortisol concentrations in maternal hair. Moreover, maternal CM was positively, but only as a non-significant trend, associated with higher DHEA levels in the newborns' hair. CONCLUSIONS Results suggest that the steroid milieu of the mother, at least on the level of DHEA, is altered after CM, possibly leading to non-genomic transgenerational effects on the developing fetus in utero. Indeed, we observed on an explorative level first hints that the endocrine milieu for the developing child might be altered in CM mothers. These results need extension and replication in future studies. The measurement of hair steroids in mothers and their newborns is promising, but more research is needed to better understand the effects of a maternal history of CM on the developing fetus.
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Affiliation(s)
- K. Schury
- 0000 0004 1936 9748grid.6582.9Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89081 Ulm, Germany ,grid.410712.1Department of Child and Adolscent Psychiatry and Psychotherapy, University Hospital Ulm, 89075 Ulm, Germany
| | - A. M. Koenig
- 0000 0004 1936 9748grid.6582.9Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89081 Ulm, Germany
| | - D. Isele
- 0000 0001 0658 7699grid.9811.1Department of Psychology, University of Konstanz and vivo international, 78457 Konstanz, Germany
| | - A. L. Hulbert
- 0000 0004 1936 9748grid.6582.9Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89081 Ulm, Germany ,grid.410712.1Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, 89081 Ulm, Germany
| | - S. Krause
- grid.410712.1Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, 89081 Ulm, Germany
| | - M. Umlauft
- 0000 0004 1936 9748grid.6582.9Institute of Statistics, Ulm University, 89081 Ulm, Germany
| | - S. Kolassa
- SAP Switzerland, 8274 Tägerwilen, Switzerland
| | - U. Ziegenhain
- grid.410712.1Department of Child and Adolscent Psychiatry and Psychotherapy, University Hospital Ulm, 89075 Ulm, Germany
| | - A. Karabatsiakis
- 0000 0004 1936 9748grid.6582.9Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89081 Ulm, Germany
| | - F. Reister
- grid.410712.1Department of Obstetrics and Gynecology, University Hospital Ulm, 89075 Ulm, Germany
| | - H. Guendel
- grid.410712.1Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, 89081 Ulm, Germany
| | - J. M. Fegert
- grid.410712.1Department of Child and Adolscent Psychiatry and Psychotherapy, University Hospital Ulm, 89075 Ulm, Germany
| | - I.-T. Kolassa
- 0000 0004 1936 9748grid.6582.9Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89081 Ulm, Germany
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Schury K, Zimmermann J, Umlauft M, Hulbert AL, Guendel H, Ziegenhain U, Kolassa IT. Childhood maltreatment, postnatal distress and the protective role of social support. Child Abuse Negl 2017; 67:228-239. [PMID: 28282596 DOI: 10.1016/j.chiabu.2017.02.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 02/13/2017] [Accepted: 02/17/2017] [Indexed: 06/06/2023]
Abstract
The postpartum period is a vulnerable period for women with a history of childhood maltreatment. This study investigated the association between childhood maltreatment and postnatal distress three months postpartum and examined the role of social support provided by different sources (intimate partner, parents, parents-in-law, and friends). Analyses are based on N=66 women, who were screened for maltreatment experiences shortly after parturition with the Childhood Trauma Questionnaire. Their levels of postnatal distress (symptoms of depression, anxiety, and stress; assessed with the Hospital Anxiety and Depression Scale and the 4-Item version of the Perceived Stress Scale) and postpartum social support (measured with the Postpartum Social Support Questionnaire) were assessed three months postpartum. Adjusting for educational level and the experience of a recent stressful event, childhood maltreatment was directly associated with higher levels of postnatal distress. Social support provided by friends moderated this association in a heteroscedastic regression analysis. No moderating effect was observed for support provided by the own parents, the intimate partner, or parents-in-law. The association between childhood maltreatment and postnatal distress was not mediated by social support. Additional analyses revealed no main, moderating, or mediating effects of satisfaction with support. Results suggest that support provided by friends may promote resilience during the postpartum period in women with a history of childhood maltreatment. Efforts to better understand the role of postpartum support and mechanisms that may enhance a mother's ability to develop and maintain supportive friendships may be promising for guiding preventive interventions.
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Affiliation(s)
- K Schury
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Germany.
| | | | - M Umlauft
- Institute of Statistics, Ulm University, Germany
| | - A L Hulbert
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Germany
| | - H Guendel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Germany
| | - U Ziegenhain
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Germany
| | - I-T Kolassa
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Germany
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Pimpl W, Wayand W, Umlauft M. [Vagotomy for the surgical treatment of severe gastroduodenal hemorrhages]. Wien Klin Wochenschr 1985; 97:285-9. [PMID: 3873141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
24 patients (8 female, 16 male) with severe gastroduodenal haemorrhage were treated by vagotomy; in 17 cases highly selective vagotomy was performed, in 3 case truncal vagotomy + pyloroplasty and in 4 patients vagotomy was combined with excision or purse-string suture of the ulcer. Treatment was effective in 23 patients, without recurrence of haemorrhage. In 19 patients vagotomy not only curbed the bleeding but provided definitive therapy (Visick I-II); 4 patients died (mortality rate 16%).
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Wayand W, Rieger R, Umlauft M. [Single or double layer? A controlled prospective study on the comparison of 2 suture technics in gastrointestinal anastomoses]. Chirurg 1984; 55:650-2. [PMID: 6391862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In a controlled clinical trial in 165 patients single layer anastomoses (n = 103) were compared to two layer anastomoses (n = 62). All anastomoses were controlled radiologically. The rate of dehiscence was 7.7% (n = 8) for the single layer group, 6.5% (n = 4) for the two layer group. Six patients died, 3 of both groups (2.9%:4.8%). There was no significant difference. However, for gastrectomies and anastomoses of small and large bowel single layer anastomoses seem to be preferable, for partial gastric resection two layer anastomoses. Factors predisposing for anastomotic breakdown are: age beyond 50, colo-rectal anastomoses, protein levels beyond 6 mg%, carcinosis peritonei.
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Waclawiczek HW, Umlauft M, Weitgasser R. [Surgical treatment of malignant melanoma of the skin with special reference to the vertical tumor diameter]. Chirurg 1984; 55:508-11. [PMID: 6488996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The level of invasion of the primary tumor is a reliable criterion of prognosis for cutaneous melanoma. Hence it follows that a differential surgical treatment is possible especially in the clinical stage I. Primary treatment of malignant melanoma consists of three-dimensional excision. The width of excision is determinated by the microstage. The elective regional lymphadenectomy shows an apparant benefit for stage I melanoma with a level between 1.5 and 4.0 mm. The value of added treatments (radiotherapy, systemic, and local chemotherapy, immuntherapy) is still controversial, but should be considered in the future clinical and therapeutical research.
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Wayand W, Pattermann M, Umlauft M, Schur W. [Measurement of the pancreatic blood supply before and after duct occlusion]. Z Exp Chir 1982; 15:14-7. [PMID: 7080567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Blood flow measurements in the pancreas were performed in 12 pigs in situ, after the splenectomy, and then after the occlusion of the pancreatic duct by means of prolamin as well during a relaparotomy after 6 weeks. No change was pointed out immediately after the occlusion in face of the state following the splenectomy. The flow in the splenic artery was reduced significantly (p less than or equal to 0.0001) by 62% after 6 weeks.
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Pimpl W, Wayand W, Zimmermann G, Umlauft M. [Selective proximal vagotomy with intraoperative monitoring using Burge's test]. Z Exp Chir 1981; 14:345-8. [PMID: 7340261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Only the test by Burge shows an effective evidence among the intraoperative control methods for testing the completeness of section during selective proximal vagotomy. The postoperative results are discussed in this study. 78 patients of 91 could be controlled endoscopically 3 to 60 months postoperatively. The result of the group with the Burge test (n = 38) does not differ essentially from the group without the Burge test (n = 40). However, the Burge test has a didactic importance certainly for surgeons in the training.
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Schmoller H, Wayand W, Umlauft M, Klozenbücher H. [Diagnosis of subphrenic abscess by sonography (author's transl)]. Wien Med Wochenschr 1980; 130:81-3. [PMID: 7385896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The diagnosis of a subphrenic abscess by sonography is based mainly on the experience of the examiner. A short description of the normal subphrenium is given. The diagnostic criteria for a subphrenic abscess and the differentialdiagnosis are discussed. In 19 cases of subphrenic abscess in question the diagnosis was missed in two cases, giving a success rate of 89.5%.
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