The influence of genetic factors and life stress on depression among adolescent girls

Microbial bionic nano-aromatic drugs for prevention of depression induced by chronic stress

Depression is a mood disorder mainly clinically characterized by significant and persistent low spirits. Chronic stress is the leading cause of depression. However, traditional medicine has severe side effects in treating depression, ineffective treatment, and easy recurrence. Therefore, it is of great significance to prevent depression in the environment of chronic stress. In this study, aromatherapy was used for the prevention of depression. To solve the defects of intense volatility and inconvenience in using essential oils, we designed bionic nano-aromatic drugs and adhered them to the wallpaper. Inspired by the moldy wallpaper, we successively prepared the morphology-bionic nano-aromatic drugs, the function-bionic nano-aromatic drugs, and the bionic plus nano-aromatic drugs by referring to the morphology of microorganisms and substances in bacterial biofilms. Bionic nano-aromatic drugs remarkably promoted their adhesion on wallpaper. Molecular dynamics simulation explored its molecular mechanism. The essential oils, which were slowly released from the bionic nano-aromatic drugs, showed excellent biosecurity and depression prevention. These sustainedly released essential oils could significantly increase monoamine neurotransmitters in the brain under a chronic stress environment and had excellent neuroprotection. Besides, the bionic nano-aromatic drugs with simple preparation process and low cost had excellent application potential.

Investigation on the Attitude of Middle School Students with Depression in the City Toward Professional Psychological Help-Seeking

Background

Many middle school students are depressed due to pressure from family, study, life, and communication. With the increasing depression of middle school students, professional psychological counseling institutions have also become more numerous. Therefore, students need to be guided to correctly recognize difficulties and seek professional psychological assistance.

Aim

We aimed to investigate the depression status of middle school students in the city and analyze their attitude towards professional psychological help-seeking.

Methods

A total of 2485 students from two classes of each grade from six middle schools in the city were randomly selected as the research objects. They were subjected to answer the general questionnaire and professional psychological help-seeking attitude questionnaire to analyze their depression status, psychological help-seeking status, and attitude towards professional psychological help-seeking.

Results

2485 questionnaires were distributed, and 2205 valid questionnaires were returned. A total of 791 (35.9%) of students had depressive symptoms. The detection rate and depression scores in girls were significantly higher than in boys, and the detection rate in junior high school students in the city was notably higher than in high school students and students from rural areas (P<0.05). Only 31 (3.9%) middle school students with depressive symptoms have sought professional psychological help. The scores of self-cognition, stigma tolerance, interpersonal openness, and trust scores of middle school students with depressive symptoms in help-seeking attitude were significantly lower than those of normal students, while self-stigma scores were significantly higher in those with depressive symptoms (P<0.001).

Conclusion

Middle school students in the city with depression have a poor attitude towards professional psychological help-seeking. Educators should positively and correctly guide depressed middle school students to seek professional psychological assistance when they need help.

Prevalence of depression in junior and senior adolescents

Background

Depression affects the development of adolescents and makes it difficult for them to adapt to future life. The purpose of this study was to elucidate the population characteristics of adolescent depression.

Methods

This study measured depression based on the Patient Health Questionnaire-9 items and sociodemographic questionnaire. A total of 8,235 valid questionnaires were collected from six schools in Haikou and Qionghai, Hainan Province, covering the ages of 13 to 18. The questionnaires included high schools with multiple levels, including general high schools, key high schools, and vocational high schools. Latent category analysis (LCA) was used to identify potential categories of depressive symptoms among adolescents. Latent Class Analysis (LCA) was used for determining depressive symptom latent categories and their proportional distribution among adolescents.

Results

LCA analysis divided the data into 3 categories, namely no depression, low depression, and high depression groups. The percentage of the high depression group was 10.1%, and that of the low depression group was 48.4%. The Jorden index was greatest for a PHQ-9 score of 14.5. The 1st grade of junior middle school students entered the high and low depression groups 1.72 and 1.33 times more often than seniors. The number of the 1st grade of high school students included in the high and low depression groups was 1.55 and 1.42 times of the 3rd grade of high school students group. The detection rate of the high depression group of vocational school adolescents was 13.5%, which was significantly higher than that of key high schools (9.6%) and general high schools (9.0%).

Conclusion

This study found that 1st grade of junior middle school students and the 1st grade of high school students were more likely to fall into depressive conditions. Moreover, Adolescent girls require more attention than boys. Vocational school students need more psychological guidance.

Mendelian randomization studies of depression: evidence, opportunities, and challenges

BACKGROUND

Major depressive disorder (MDD) poses a significant social and economic burden worldwide. Identifying exposures, risk factors, and biological mechanisms that are causally connected to MDD can help build a scientific basis for disease prevention and development of novel therapeutic approaches.

METHODS

In this systematic review, we assessed the evidence for causal relationships between putative causal risk factors and MDD from Mendelian randomization (MR) studies, following PRISMA. We assessed methodological quality based on key elements of the MR design: use of a full instrumental variable analysis and validation of the three key MR assumptions.

RESULTS

We included methodological details and results from 52 articles. A causal link between lifestyle, metabolic, inflammatory biomarkers, particular pathological states and MDD is supported by MR investigations, although results for each category varied substantially.

CONCLUSIONS

While this review shows how MR can offer useful information for examining prospective treatment targets and better understanding the pathophysiology of MDD, some methodological flaws in the existing literature limit reliability of results and probably underlie their heterogeneity. We highlight perspectives and recommendations for future works on MR in psychiatry.

Association of maternal mental health and drinking/smoking with adolescents' mental health based on the Korea National Health and Nutrition Examination Survey

Introduction

Depression is one of the major concerns in adolescence, with a global prevalence of approximately 5%. Diverse environmental factors can affect the development of depression depending on the individual developmental stage.

Methods

Using data from the Korea National Health and Nutrition Examination Survey (KNHANES), we aimed to investigate the association between socioeconomic factors and mental health in a population of non-clinically ill adolescents in Korea totaling 6,261 adolescents aged 12-18 years.

Results

Drinking, smoking, stress, depressed mood, suicidal ideation in adolescents, and stress, depressed mood, and suicidal ideation in mothers were identified as factors associated with adolescent depression. In addition to depressed mood and suicidal ideation, the higher perception of stress in mothers was related to higher stress perception, depressed mood, and suicidal ideation in adolescents. The association of adolescents' mental health with fathers' mental health was weaker than that with mothers' mental health. Additionally, increased smoking and drinking were commonly reported in adolescents with higher stress perception, depressed mood, and suicidal ideation.

Discussion

We conclude that close monitoring of mental health is required for adolescents with drinking and smoking habits and mothers with mental health problems.

Depressive symptoms among a sample of Lebanese adolescents: Scale validation and correlates with disordered eating

BACKGROUND

Adolescence is a transitional phase that brings many psychological and physiological challenges that increase emotional vulnerability and threaten the adolescent's mental well-being. Indeed, mental illnesses, such as depression and eating disorders, show an alarming increase in prevalence after puberty. Adolescent depression is particularly concerning owing to the fact that it is a principal cause of disability among adolescents, an important risk factor for suicidality, and is associated with higher risks of present and subsequent morbidity. Our study aimed at (1) examining the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9) and (2) evaluating the correlation between depression, eating disorders, stress, and other variables in a sample of Lebanese adolescents.

METHODS

This cross-sectional research enlisted 555 Lebanese teenagers (15-18 years) from all Lebanese governorates (May-June 2020). The confirmatory factor analysis of the PHQ-9 scale items was carried out using the SPSS AMOS program v.24. The relative chi-square, the root mean square error of approximation (RMSEA), Tucker Lewis Index (TLI) and the comparative fit index (CFI) were all utilized as goodness-of-fit indexes.

RESULTS

The median age of the participants was 16.66 ± 1.00 years, with 75.7% females. Among these 555 adolescents, 62.9% had mild-to-moderate depression and 14% reported moderately severe-to-severe depression, while only 23.1% were classified as not suffering from depression. Confirmatory factor analysis of the PHQ-9 scale was conducted using the one-factor structure that is described in the literature; the fit indices obtained were acceptable as follows: χ²/df= 136.26/27 =5.05, CFI=0.92, TLI=0.90 and RMSEA=0.085 [0.072-0.100]. However, the modification indices between items 6 and 9 were high; after correlating these two items, the fit indices improved more as follows: χ²/df= 105.59/26=4.06, CFI=0.94, TLI=0.92 and RMSEA=0.074 [0.060-0.089]. The multivariable analysis results showed that more stress (β=0.59), female sex (β=1.54), and more binge eating (β=0.16) were significantly associated with more depression.

CONCLUSION

This study supports the validity of the PHQ-9, which presents as a reliable tool for the evaluation of depression in future epidemiological studies of Lebanese adolescents. It also elucidates the high level of depression among this age group and its correlation with modifiable and unmodifiable factors.

The role of puberty on physical and brain development: A longitudinal study in male Rhesus Macaques

This study examined the role of male pubertal maturation on physical growth and development of neurocircuits that regulate stress, emotional and cognitive control using a translational nonhuman primate model. We collected longitudinal data from male macaques between pre- and peri-puberty, including measures of physical growth, pubertal maturation (testicular volume, blood testosterone -T- concentrations) and brain structural and resting-state functional MRI scans to examine developmental changes in amygdala (AMY), hippocampus (HIPPO), prefrontal cortex (PFC), as well as functional connectivity (FC) between those regions. Physical growth and pubertal measures increased from pre- to peri-puberty. The indexes of pubertal maturation -testicular size and T- were correlated at peri-puberty, but not at pre-puberty (23 months). Our findings also showed ICV, AMY, HIPPO and total PFC volumetric growth, but with region-specific changes in PFC. Surprisingly, FC in these neural circuits only showed developmental changes from pre- to peri-puberty for HIPPO-orbitofrontal FC. Finally, testicular size was a better predictor of brain structural maturation than T levels -suggesting gonadal hormones-independent mechanisms-, whereas T was a strong predictor of functional connectivity development. We expect that these neural circuits will show more drastic pubertal-dependent maturation, including stronger associations with pubertal measures later, during and after male puberty.

Effects of social rank and pubertal delay on brain structure in female rhesus macaques

Adverse social experience during childhood and adolescence leads to developmental alterations in emotional and stress regulation and underlying neurocircuits. We examined the consequences of social subordination (low social rank) in juvenile female rhesus monkeys, as an ethologically valid model of chronic social stressor exposure, on brain structural and behavioral development through the pubertal transition. Adolescence is a developmental period of extensive brain remodeling and increased emotional and stress reactivity. Puberty-induced increases in gonadal hormones, particularly estradiol (E2), are likely involved due to its organizational effects on the brain and behavior. Thus, we also examined how experimentally delaying pubertal onset with Lupron (gonadotropin releasing hormone -GnRH- agonist used clinically to delay early puberty) interacted with social rank (dominant vs. subordinate) to affect brain and behavioral outcomes. Using a longitudinal experimental design, structural MRI (sMRI) scans were collected on socially housed juvenile female rhesus monkeys living in indoor-outdoor enclosures prior to the onset of puberty (18-25 months), defined as menarche or the initial occurrence of perineal swelling and coloration, and again at 29-36 months, when all control animals had reached puberty but none of the Lupron-treated had. We examined the effects of both social rank and pubertal delay on overall structural brain volume (i.e. intracranial, grey matter (GM) and white matter (WM) volumes), as well as on cortico-limbic regions involved in emotion and stress regulation: amygdala (AMYG), hippocampus (HC), and prefrontal cortex (PFC). Measures of stress physiology, social behavior, and emotional reactivity were collected to examine functional correlates of the brain structural effects. Apart from expected developmental effects, subordinates had bigger AMYG volumes than dominant animals, most notably in the right hemisphere, but pubertal delay with Lupron-treatment abolished those differences, suggesting a role of gonadal hormones potentiating the brain structural impact of social stress. Subordinates also had elevated baseline cortisol, indicating activation of stress systems. In general, Lupron-treated subjects had smaller AMYG and HC volume than controls, but larger total PFC (driven by bigger GM volumes), and different, region-specific, developmental patterns dependent on age and social rank. These findings highlight a region-specific effect of E2 on structural development during female adolescence, independent of those due to chronological age. Pubertal delay and AMYG volume, in turn, predicted differences in emotional reactivity and social behavior. These findings suggest that exposure to developmental increases in E2 modifies the consequences of adverse social experience on the volume of cortico-limbic regions involved in emotional and stress regulation during maturation. But, even more importantly, they indicate different brain structural effects of chronological age and pubertal developmental stage in females, which are very difficult to disentangle in human studies. These findings have additional relevance for young girls who experience prolonged pubertal delays or for those whose puberty is clinically arrested by pharmacological administration of Lupron.

Estrogen receptors mediate the antidepressant effects of aerobic exercise: A possible new mechanism

Purpose

This study aimed to examine whether aerobic exercise exerts mood-modulating effects through an estrogen signaling mechanism.

Method

The experiment was divided into two parts. The first part is to compare the three modeling methods to obtain the most obvious method of depression-like phenotype for further study in the second part. The first part of ovariectomized rats (age, 13 weeks) was tested when rats were 14 or 22 weeks old or in the sixth week after 3 weeks of chronic restraint stress. The second part was to treat the animals with the most obvious depression-like phenotype in different ways, placebo treatment or estradiol (E2) replacement therapy was administered, aerobic training, or estrogen receptor antagonist treatment. The cognitive (Barnes maze and 3-chamber social tests), anxiety-like (open-field and elevated plus maze tests) and depression-like (sucrose preference and forced swim tests) behaviors of rats in both parts were analyzed to study the effects of estrogen depletion and aerobic exercise.

Results

Rats did not develop depressive symptoms immediately after ovariectomy, however, the symptoms became more pronounced with a gradual decrease in ovarian hormone levels. Compared with the placebo or control groups, the exercise and E2 groups showed improved performance in all behavioral test tasks, and the antidepressant effects of aerobic exercise were comparable to those of estrogen. Moreover, the estrogen receptor antagonist has markedly inhibited the antidepressant effects of aerobic exercise.

Conclusion

Estrogen receptors may mediate the antidepressant effects of aerobic exercise. In addition, an increasingly fragile ovarian hormonal environment may underlies chronic restraint stress-induced depression.

Prenatal stress induces a depressive-like phenotype in adolescent rats: The key role of TGF-β1 pathway

Stressful experiences early in life, especially in the prenatal period, can increase the risk to develop depression during adolescence. However, there may be important qualitative and quantitative differences in outcome of prenatal stress (PNS), where some individuals exposed to PNS are vulnerable and develop a depressive-like phenotype, while others appear to be resilient. PNS exposure, a well-established rat model of early life stress, is known to increase vulnerability to depression and a recent study demonstrated a strong interaction between transforming growth factor-β1 (TGF-β1) gene and PNS in the pathogenesis of depression. Moreover, it is well-known that the exposure to early life stress experiences induces brain oxidative damage by increasing nitric oxide levels and decreasing antioxidant factors. In the present work, we examined the role of TGF-β1 pathway in an animal model of adolescent depression induced by PNS obtained by exposing pregnant females to a stressful condition during the last week of gestation. We performed behavioral tests to identify vulnerable or resilient subjects in the obtained litters (postnatal day, PND &gt; 35) and we carried out molecular analyses on hippocampus, a brain area with a key role in the pathogenesis of depression. We found that female, but not male, PNS adolescent rats exhibited a depressive-like behavior in forced swim test (FST), whereas both male and female PNS rats showed a deficit of recognition memory as assessed by novel object recognition test (NOR). Interestingly, we found an increased expression of type 2 TGF-β1 receptor (TGFβ-R2) in the hippocampus of both male and female resilient PNS rats, with higher plasma TGF-β1 levels in male, but not in female, PNS rats. Furthermore, PNS induced the activation of oxidative stress pathways by increasing inducible nitric oxide synthase (iNOS), NADPH oxidase 1 (NOX1) and NOX2 levels in the hippocampus of both male and female PNS adolescent rats. Our data suggest that high levels of TGF-β1 and its receptor TGFβ-R2 can significantly increase the resiliency of adolescent rats to PNS, suggesting that TGF-β1 pathway might represent a novel pharmacological target to prevent adolescent depression in rats.

Depressive symptoms and HIV risk behaviours among adolescents enrolled in the HPTN071 (PopART) trial in Zambia and South Africa

BACKGROUND

Mental health is a critical and neglected public health problem for adolescents in sub-Saharan Africa. In this paper we aim to determine the prevalence of depressive symptoms and the association with HIV risk behaviours in adolescents aged 15-19 years in Zambia and SA.

METHODS

We conducted a cross-sectional survey from August-November 2017 in seven control communities of HPTN 071 (PopART) trial (a community-randomised trial of universal HIV testing and treatment), enrolling approximately 1400 eligible adolescents. HIV-status was self-reported. Depressive symptoms were measured with the Short Mood and Feelings Questionnaire (SMFQ), with a positive screen if adolescents scored ≥12. We fitted a logistic regression model to identify correlates of depressive symptoms with subgroup analyses among those who self-reported ever having had sex, by gender and country.

RESULTS

Out of 6997 households approached, 6057 (86.6%) were enumerated. 2546 adolescents were enumerated of whom 2120 (83.3%) consented to participate and were administered the SMFQ. The prevalence of depressive symptoms was 584/2120 (27.6%) [95%CI: 25.7%-29.5%]. Adolescents in SA were less likely to experience depressive symptoms (Adjusted Odds Ratio [AOR] = 0.63 (95% CI: 0.50, 0.79), p-value<0.0001). Female adolescents (AOR = 1.46 (95% CI: 1.19, 1.81), p-value<0.0001); those who reported ever having sex and being forced into sex (AOR = 1.80 (95% CI: 1.45, 2.23), p-value<0.001) and AOR = 1.67 (95% CI: 0.99, 2.84); p-value = 0.057 respectively) were more likely to experience depressive symptoms. Among 850 (40.1%) adolescents who self-reported to ever having had sex; those who used alcohol/drugs during their last sexual encounter were more likely to experience depressive symptoms (AOR = 2.18 (95% CI: 1.37, 3.47); p-value = 0.001), whereas those who reported using a condom were less likely to experience depressive symptoms (AOR = 0.74 (95% CI: 0.55, 1.00); p-value = 0.053).

CONCLUSION

The prevalence of depressive symptoms among adolescents ranged from 25-30% and was associated with increased HIV-risk behaviour.

Causal Effect of Age at Menarche on the Risk for Depression: Results From a Two-Sample Multivariable Mendelian Randomization Study

A fair number of epidemiological studies suggest that age at menarche (AAM) is associated with depression, but the reported effect sizes are small, and there is evidence of residual confounding. Moreover, previous Mendelian randomization (MR) studies to avoid inferential problems inherent to epidemiological studies have provided mixed findings. To clarify the causal relationship between age at menarche and broadly defined depression risk, we used 360 genome-wide significantly AAM-related single-nucleotide polymorphisms (SNPs) as instrumental variable and data from the latest GWAS for the broadly defined depression risk on 807,553 individuals (246,363 cases and 561,190 controls). Multiple methods to account for heterogeneity of the instrumental variable (penalized weighted median, MR Lasso, and contamination mixture method), systematic and idiosyncratic pleiotropy (MR RAPS), and horizontal pleiotropy (MR PRESSO and multivariable MR using three methods) were used. Body mass index, education attainment, and total white blood count were considered pleiotropic phenotypes in the multivariable MR analysis. In the univariable [inverse-variance weighted (IVW): OR = 0.96, 95% confidence interval = 0.94–0.98, p = 0.0003] and multivariable MR analysis (IVW: OR = 0.96, 95% confidence interval = 0.94–0.99, p = 0.007), there was a significant causal effect of AAM on depression risk. Thus, the present study supports conclusions from previous epidemiological studies implicating AAM in depression without the pitfalls of residual confounding and reverse causation. Considering the adverse consequences of an earlier AAM on mental health, this finding should foster efforts to address risk factors that promote an earlier AAM.

Prevalence, Risk Factors, and Negative Outcomes of Anxiety and Depressive Disorders among HIV-Infected Children and Adolescents in Uganda: CHAKA Study 2014-2017

Background. Children and adolescents infected with HIV/AIDS (CA-HIV) experience a considerable burden of depressive and anxiety disorders that have a tendency to persist into adulthood. The aim of this study was to determine the prevalence of anxiety, depression, and their clinical correlates among children and adolescents with HIV/AIDS (CA-HIV) in Uganda. Methods. A random sample of 1339 CA-HIV (ages 5-18 years) and their caregivers completed a standardized DSM-5-referenced psychiatric rating scale, the Child and Adolescent Symptom Inventory-5 (CASI-5). The prevalence of “anxiety and depression” was estimated at 95% confidence intervals. Logistic and ordinal regression models were fitted for the clinical correlates and clinical outcomes. Results. The overall prevalence of “any anxiety and depressive disorders” was 13.7% at 95% CI (based upon the symptom count criteria); 4.0% (95% CI) met the clinical psychiatric disorder criteria (both symptom count and functional impairment criteria). Anxiety disorder was more prevalent (9%, 95% CI) than depression (6.4%, 95% CI). Correlates of “anxiety and depressive disorders” included age of the child, caregiver’ psychological distress, caregivers’ age, child-caregiver relationship, and child’s current CD4 count (aOR1.00, 95% CI 1.02–1.05; $p=0.021$ ). Anxiety disorders (aOR 2.58, 95% CI 1.16-5.42; $p=0.02$ ) and depressive disorders (aOR 2.47, 95% CI 1.93–6.52; $p=0.041$ ) were also associated with hospital admissions. Limitations. Analyses were cross-sectional; we cannot comment on the causal directions. The results are entirely based upon caregiver’ reports. Conclusions. There is an urgent need to integrate mental health services into routine HIV care for CA-HIV in sub-Saharan Africa.

Harmonized Phenotypes for Anxiety, Depression, and Attention-Deficit Hyperactivity Disorder (ADHD)

In multi-cohort consortia, the problem often arises that a phenotype is measured using different questionnaires. This study aimed to harmonize scores based on the Child Behaviour Check List (CBCL) and the Strength and Difficulties Questionnaire (SDQ) for anxiety/depression and ADHD. To link the scales, we used parent reports on 1330 children aged 10–11.5 years from the Raine study on both SDQ and CBCL. Harmonization was done based on Item Response Theory. We started from existing CBCL and SDQ scales related to anxiety/depression and ADHD (theoretical approach). Next, we conducted a data-driven approach using factor analysis to validate the theoretical approach. Both approaches yielded similar scales, validating the combination of existing scales. In addition, we studied the impact of harmonized (IRT-based) scores on the statistical power of the results in meta-analytic gene-finding studies. The results showed that the IRT-based harmonized scores increased the statistical power of the results compared to sum scores, even with an equal sample size. These findings can help future researchers to harmonize data from different samples and/or different questionnaires that measure anxiety, depression, and ADHD, in order to obtain the larger sample sizes, to compare research results across subpopulations or to increase generalizability, the validity or statistical power of research results. We recommend using our item parameters to estimate harmonized scores that represent commensurate phenotypes across cohorts, and we explained in detail how other researchers can use our results to harmonize data in their studies.

The Meaning of "Cause" in Genetics

Causation has multiple distinct meanings in genetics. One reason for this is meaning slippage between two concepts of the gene: Mendelian and molecular. Another reason is that a variety of genetic methods address different kinds of causal relationships. Some genetic studies address causes of traits in individuals, which can only be assessed when single genes follow predictable inheritance patterns that reliably cause a trait. A second sense concerns the causes of trait differences within a population. Whereas some single genes can be said to cause population-level differences, most often these claims concern the effects of many genes. Polygenic traits can be understood using heritability estimates, which estimate the relative influences of genetic and environmental differences to trait differences within a population. Attempts to understand the molecular mechanisms underlying polygenic traits have been developed, although causal inference based on these results remains controversial. Genetic variation has also recently been leveraged as a randomizing factor to identify environmental causes of trait differences. This technique-Mendelian randomization-offers some solutions to traditional epidemiological challenges, although it is limited to the study of environments with known genetic influences.

Prevalence of depressive symptoms among older children and young adolescents: a longitudinal population-based study

Introduction

This paper investigates levels of depressive symptoms among older children and young adolescents, 11-14 years of age. The population-based sample was assessed twice during a 12-month period. Point-prevalence, 12-month prevalence, and 12-month incidence were measured by a validated self-reported scale (SFMQ) and are presented in this paper.

Methods

A total of 2148 pupils were invited to participate in this study, and 1748 pupils and at least one parent/guardian provided informed consent. The population was assessed twice within one 12-month period resulting in 1439 participants at both data collection points. Depressive symptoms were measured by a validated self-reported scale, The Short Mood and Feelings Questionnaire (SMFQ).

Results

The results indicate that the point-prevalence was just under 10% in 6^th to 10^th grade with a 12-month prevalence at almost 3%. The results also indicate an incidence rate of 4.5% over 12-months. This study confirms that girls report a higher range of point prevalence, 12- month-prevalence, and 12-month incidence compared to boys.

Conclusions

The results indicate that depressive symptoms among children and young adolescents is a serious health challenge. The results demonstrate substantial gender differences even at an early age (11-14 years), where girls report significantly higher point prevalence, 12-month-prevalence, and 12-month incidence compared to boys. Results from this study suggest that depressive symptoms are an important problem that young adolescents face, and the study underlines the need for more intervention tailored to gender at the middle-school level, especially with respect to those children and adolescents who experience persistent depressive symptoms.

Using the tools of genetic epidemiology to understand sex differences in neuropsychiatric disorders

Many neuropsychiatric disorders exhibit differences in prevalence, age of onset, symptoms or course of illness between males and females. For the most part, the origins of these differences are not well understood. In this article, we provide an overview of sex differences in psychiatric disorders including autism spectrum disorder (ASD), attention deficit/hyperactivity disorder (ADHD), anxiety, depression, alcohol and substance abuse, schizophrenia, eating disorders and risk of suicide. We discuss both genetic and nongenetic mechanisms that have been hypothesized to underlie these differences, including ascertainment bias, environmental stressors, X‐ or Y‐linked risk loci, and differential liability thresholds in males and females. We then review the use of twin, family and genome‐wide association approaches to study potential genetic mechanisms of sex differences and the extent to which these designs have been employed in studies of psychiatric disorders. We describe the utility of genetic epidemiologic study designs, including classical twin and family studies, large‐scale studies of population registries, derived recurrence risks, and molecular genetic analyses of genome‐wide variation that may enhance our understanding sex differences in neuropsychiatric disorders.

Risk of Depression in the Adolescent and Adult Offspring of Mothers With Perinatal Depression: A Systematic Review and Meta-analysis

IMPORTANCE

Maternal depression during pregnancy is associated with emotional and behavioral difficulties of offspring during childhood that can increase the risk of depression in adolescence and adulthood.

OBJECTIVE

To investigate the association between perinatal maternal depression and an increased long-term risk of depression in their adolescent and adult offspring.

DATA SOURCES

A systematic search of the electronic databases of PubMed and PsycINFO was conducted from May 2019 to June 2019.

STUDY SELECTION

A total of 6309 articles were identified, of which 88 articles were extracted for full-text review by 2 reviewers. Only articles reporting data from prospective longitudinal studies that assessed maternal depression during antenatal and/or postnatal periods and resulting offspring 12 years or older with measures of established psychometric properties were included. Exclusion criteria consisted of all other study designs, mothers with other medical and psychiatric comorbidities, and offspring younger than 12 years.

DATA EXTRACTION AND SYNTHESIS

Data were extracted by 2 independent reviewers, and discrepancies were mediated by an expert third reviewer. Meta-analysis was performed using Bayesian statistical inference and reported using Meta-analysis of Observational Studies in Epidemiology (MOOSE) guideline. The association of depression timing with the sex of offspring was explored using metaregression.

MAIN OUTCOMES AND MEASURES

Offspring depression was evaluated using standardized depression scales or clinical interviews.

RESULTS

Six studies with a total of 15 584 mother-child dyads were included in the meta-analysis, which found the offspring of mothers who experienced perinatal depression to have increased odds of depression (odds ratio [OR], 1.70; 95% credible interval [CrI], 1.60-2.65; posterior probability [PP] [OR >1], 98.6%). Although metaregression found no evidence for an overall association between perinatal depression timing and offspring depression (antenatal vs postnatal, PP [OR >1] = 53.8%), subgroup analyses showed slightly higher pooled odds for the antenatal studies (OR, 1.78; 95% CrI, 0.93-3.33; PP [OR >1] = 96.2%) than for the postnatal studies (OR, 1.66; 95% CrI, 0.65-3.84; PP [OR >1] = 88.0%). Female adolescent offspring recorded higher rates of depression in metaregression analyses, such that a 1% increase in the percentage of female (relative to male) offspring was associated with a 6% increase in the odds of offspring depression (OR, 1.06; 95% CrI, 0.99-1.14; τ2 = 0.31).

CONCLUSIONS AND RELEVANCE

In this study, maternal perinatal depression, especially antenatal depression, was associated with the risk of depression in adolescence and adulthood. More research into the mechanisms of depression risk transmission and assessments of postinterventional risk reduction could aid in the development of future strategies to tackle depressive disorders in pregnancy.

Longitudinal changes of inflammatory biomarkers moderate the relationship between recent stressful life events and prospective symptoms of depression in a diverse sample of urban adolescents

This study investigated whether longitudinal changes in inflammatory physiology moderated the relationship between recent stressful life events and subsequent depressive symptoms in adolescence. A diverse sample of adolescents representative of an urban community (N = 129; Age at baseline = 12.5 years; 48.8% female; 55.0% African American) completed measures of stressful life events, depressive symptoms, and two annual blood draws (BD1 and BD2). Controlling for inflammatory activity at BD1, depression at BD1, demographics and the time between assessments, increases in interleukin-6 (IL-6; b = 0.878, p = .007) and C-reactive protein (CRP; b = 0.252, p = .024) from BD1 to BD2 interacted with recent stressful life events before BD1 to predict severity of depressive symptoms at BD2. Similar associations were evident for IL-6 (b = 2.074, p = .040) and CRP (b = 0.919, p = .050) when considering acute stressful life events that had occurred within the two weeks before the first blood collection. More frequent stressful life events before BD1 predicted significantly more severe depressive symptoms at BD2, but only for adolescents with moderate (50th percentile) and high (84th percentile) levels of IL-6 and CRP at BD2. In conclusion, adolescents who experienced both recent stressful life events and larger increases in inflammatory activity following these stressors were at increased risk for more severe depressive symptoms after approximately one year. The findings indicate that the interaction of stress and larger changes in inflammatory activity following these stressors are prognostic risk factors for depression severity in adolescents.

Polygenic Influences on Pubertal Timing and Tempo and Depressive Symptoms in Boys and Girls

This study used polygenic scoring (PGS) to test whether puberty-related genes were correlated with depressive symptoms, and whether there were indirect effects through pubertal maturation. The sample included 8,795 adolescents from the Avon Longitudinal Study of Parents and Children (measures of puberty drawn ages 8-17 years; of depressive symptoms at age 16.5 years). The PGS (derived from a genome-wide meta-analysis of later age at menarche) predicted boys' and girls' later pubertal timing, boys' slower gonadal development, and girls' faster breast development. Earlier perceived breast development timing predicted more depressive symptoms in girls. Findings support shared genetic underpinnings for boys' and girls' puberty, contributing to multiple pubertal phenotypes with differences in how these genetic variants affect boys' and girls' development.

Self-esteem and other risk factors for depressive symptoms among adolescents in United Arab Emirates

BACKGROUND

Little is known about depressive symptoms among adolescents in the United Arab Emirates (UAE). This study aimed to identify the prevalence of depression and its association with self-esteem, individual, parental and family factors among adolescents aged 12 to 18 in UAE.

METHODS

Six hundred adolescents, aged 12 to 18 years were recruited from 4 of 111 schools in a cross-sectional study. We administered Beck Depression Inventory Scale and Rosenberg Self-esteem Scale to measure self-report symptoms of depression and self-esteem. We used multiple linear regression to identify significant predictors of depression.

RESULTS

Over 86% of the identified sample participated to the survey. The mean age of the sample was 14.3 (±1.3) with an excess of girls (61%). Depressive symptoms were detected in 17.2% (95% CI 14.2-20.7). There was an inverse relationship between self-esteem scores and depressive symptoms. Positive predictors of depressive symptoms, having controlled for age, gender, and ethnicity included experiencing neglect, being verbally abused in school, having no monthly allowance to spend in school, a history of physical morbidities requiring treatment, being a current or past smoker and a low family income.

CONCLUSION

The high prevalence of depressive symptoms measured in this survey suggests a significant public health problem among adolescents in the UAE. Public health interventions aimed at facilitating education and early detection and potential treatment of depressive symptoms are a priority in the region.

Variation in early life maternal care predicts later long range frontal cortex synapse development in mice

Empirical and theoretical work suggests that early postnatal experience may inform later developing synaptic connectivity to adapt the brain to its environment. We hypothesized that early maternal experience may program the development of synaptic density on long range frontal cortex projections. To test this idea, we used maternal separation (MS) to generate environmental variability and examined how MS affected 1) maternal care and 2) synapse density on virally-labeled long range axons of offspring reared in MS or control conditions. We found that MS and variation in maternal care predicted bouton density on dorsal frontal cortex axons that terminated in the basolateral amygdala (BLA) and dorsomedial striatum (DMS) with more, fragmented care associated with higher density. The effects of maternal care on these distinct axonal projections of the frontal cortex were manifest at different ages. Maternal care measures were correlated with frontal cortex → BLA bouton density at mid-adolescence postnatal (P) day 35 and frontal cortex → DMS bouton density in adulthood (P85). Meanwhile, we found no evidence that MS or maternal care affected bouton density on ascending orbitofrontal cortex (OFC) or BLA axons that terminated in the dorsal frontal cortices. Our data show that variation in early experience can alter development in a circuit-specific and age-dependent manner that may be relevant to understanding the effects of early life adversity.

Serotonergic multilocus genetic variation moderates the association between major interpersonal stress and adolescent depressive symptoms: Replication and candidate environment specification

Serotonin-linked genetic risk and stressful life event (SLE) interaction research has been criticized for using single genetic variants with inconsistent replicability. A recent study showed that a multilocus genetic profile score (MGPS) capturing additive risk from five serotonin-linked polymorphisms moderated the association between major interpersonal SLEs and depression, but no subsequent replication attempts have been reported. Moreover, major interpersonal SLEs have been suggested as "candidate environments" for this MGPS, but it has never been demonstrated that gene-environment interactions (G × Es) for major interpersonal SLEs are significantly stronger than for other contexts. Adolescents (N = 241) completed contextual-threat life stress interviews and clinical interviews assessing depressive symptoms, and provided DNA. MGPS intensified the major interpersonal stress-depression association; the interaction accounted for 4% of depressive symptom variance. Genetic moderation was statistically unique to major interpersonal stress versus other environments. Extending previous findings, results support an MGPS approach and underscore the cruciality of the G × E candidate environment.

College affirmative action bans and smoking and alcohol use among underrepresented minority adolescents in the United States: A difference-in-differences study

BACKGROUND

College affirmative action programs seek to expand socioeconomic opportunities for underrepresented minorities. Between 1996 and 2013, 9 US states-including California, Texas, and Michigan-banned race-based affirmative action in college admissions. Because economic opportunity is known to motivate health behavior, banning affirmative action policies may have important adverse spillover effects on health risk behaviors. We used a quasi-experimental research design to evaluate the association between college affirmative action bans and health risk behaviors among underrepresented minority (Black, Hispanic, and Native American) adolescents.

METHODS AND FINDINGS

We conducted a difference-in-differences analysis using data from the 1991-2015 US national Youth Risk Behavior Survey (YRBS). We compared changes in self-reported cigarette smoking and alcohol use in the 30 days prior to survey among underrepresented minority 11th and 12th graders in states implementing college affirmative action bans (Arizona, California, Florida, Michigan, Nebraska, New Hampshire, Oklahoma, Texas, and Washington) versus outcomes among those residing in states not implementing bans (n = 35 control states). We also assessed whether underrepresented minority adults surveyed in the 1992-2015 Tobacco Use Supplement to the Current Population Survey (TUS-CPS) who were exposed to affirmative action bans during their late high school years continued to smoke cigarettes between the ages of 19 and 30 years. Models adjusted for individual demographic characteristics, state and year fixed effects, and state-specific secular trends. In the YRBS (n = 34,988 to 36,268, depending on the outcome), cigarette smoking in the past 30 days among underrepresented minority 11th-12th graders increased by 3.8 percentage points after exposure to an affirmative action ban (95% CI: 2.0, 5.7; p < 0.001). In addition, there were also apparent increases in past-30-day alcohol use, by 5.9 percentage points (95% CI: 0.3, 12.2; p = 0.041), and past-30-day binge drinking, by 3.5 percentage points (95% CI: -0.1, 7.2, p = 0.058), among underrepresented minority 11th-12th graders, though in both cases adjustment for multiple comparisons resulted in failure to reject the null hypothesis (adjusted p = 0.083 for both outcomes). Underrepresented minority adults in the TUS-CPS (n = 71,575) exposed to bans during their late high school years were also 1.8 percentage points more likely to report current smoking (95% CI: 0.1, 3.6; p = 0.037). Event study analyses revealed a discrete break for all health behaviors timed with policy discussion and implementation. No substantive or statistically significant effects were found for non-Hispanic White adolescents, and the findings were robust to a number of additional specification checks. The limitations of the study include the continued potential for residual confounding from unmeasured time-varying factors and the potential for recall bias due to the self-reported nature of the health risk behavior outcomes.

CONCLUSIONS

In this study, we found evidence that some health risk behaviors increased among underrepresented minority adolescents after exposure to state-level college affirmative action bans. These findings suggest that social policies that shift socioeconomic opportunities could have meaningful population health consequences.

Neurocognitive Development of Motivated Behavior: Dynamic Changes across Childhood and Adolescence

The ability to anticipate and respond appropriately to the challenges and opportunities present in our environments is critical for adaptive behavior. Recent methodological innovations have led to substantial advances in our understanding of the neurocircuitry supporting such motivated behavior in adulthood. However, the neural circuits and cognitive processes that enable threat- and reward-motivated behavior undergo substantive changes over the course of development, and these changes are less well understood. In this article, we highlight recent research in human and animal models demonstrating how developmental changes in prefrontal-subcortical neural circuits give rise to corresponding changes in the processing of threats and rewards from infancy to adulthood. We discuss how these developmental trajectories are altered by experiential factors, such as early-life stress, and highlight the relevance of this research for understanding the developmental onset and treatment of psychiatric disorders characterized by dysregulation of motivated behavior.

Society and 'good woman': A critical review of gender difference in depression

BACKGROUND

Worldwide, women are found to suffer from depression significantly more than men. This has puzzled the scientists since no biological explanation can completely resolve the matter.

METHOD

Extant empirical work has been conducted to solve the mystery of the issue. However, most of the research has pivoted their attention to biology. Therefore, based on the previous literature from the disciplines of medicine, psychology and sociology, the author aimed at looking and reviewing the matter critically. Specifically, the present critical review aims at conceptualising the psychological, social and cultural factors in the context of gender difference in depression.

DISCUSSION

The work reveals that psychological variables such as women's unique attachment patterns, relational self-construal, as well as a macro-level issue like power dynamics based on gender, and the skewed division of labour play an important role in gender difference in depression. The work also suggests that focusing solely on biological underpinnings may result in losing the entire scenario; therefore, social and cultural issues that place women in a socially disadvantaged position are equally important.

Association between HIV status and depressive symptoms among children and adolescents in the Southern Highlands Zone, Tanzania: A case-control study

BACKGROUND

Children and adolescents continue to have HIV/AIDS in southern Saharan Africa. Scaling up of HIV services has significantly improved access to ARV and consequently improved on morbidity and mortality related to HIV/AIDS including opportunistic infection. Despite the above efforts, non-communicable conditions including mental disorders such as depression have been observed to contribute to the burden of disabilities about which little is documented. This study, therefore, aimed to determine the magnitude of depressive symptoms and the associated factors among HIV-infected children and adolescents.

METHODS

The study was a matched case-control design involving 300 cases of HIV-infected children matched by age and sex against 600 uninfected controls. Systematic sampling technique was used to select the cases while multistage sampling technique was employed to identify villages/ streets purposive and sampling technique was employed to obtain participants from households.

RESULTS

The overall prevalence of depressive symptoms among the cohort of 900 participants was found to be 12.9%, with 27% of HIV-infected and 5.8% of HIV-uninfected children and adolescents screened positive for depressive symptoms. Multiple logistic regression revealed that being HIV-infected (AOR 1.96(1.11-3.45)), residing in a rural setting (AOR 0.61(0.39-0.96)) and history of childhood deprivation (AOR 4.76 (2.79-8.13)) were significantly associated with depressive symptoms.

CONCLUSION

HIV infected adolescents are more affected by depression compared to non-infected counterparts. Childhood deprivation was significantly associated with presence of depressive symptoms. Integration of mental health evaluation and treatment into the HIV care provided for adolescents can be beneficial. More studies to delineate factors associated with depressed adolescents with HIV may add value to the body of knowledge and overall improvement of care.

Financial circumstances, mastery, and mental health: Taking unobserved time-stable influences into account

This paper examines whether low income and subjective financial strain are associated with mental health, as well as whether mastery weakens this association. We analyze three waves of a large sample of Canadians and utilize random and fixed effects regression strategies to assess bias introduced by unobserved time-stable confounders. In random effects models, both low income and subjective financial strain are associated with distress and anger. In fixed effects models that control for all time-stable confounders, the effect of low income is reduced to non-significance for both outcomes. The effect of subjective strain is also reduced in fixed effects models, but remained statistically significant. Sobel tests indicated that the effect of subjective strain on mental health is transmitted through mastery, but this indirect path is modest in magnitude. When interactions are tested, mastery weakens the association between subjective strain and distress, and this effect is robust to the influence of time-stable controls, but mastery does not buffer the subjective strain-anger relationship in either random or fixed-effects models. Finally, moving below the low income threshold increases anger for low mastery individuals, but seems to reduce anger when moving below the low income threshold is coupled with increases in mastery. Collectively, our findings demonstrate the importance of assessing the influence of unobserved time-stable confounders in stress research. Further, discrepancies in the moderating role of mastery reinforce calls for the assessment of multiple outcomes in mental health research.

Age, sex, and gonadal hormones differently influence anxiety- and depression-related behavior during puberty in mice

Anxiety and depression symptoms increase dramatically during adolescence, with girls showing a steeper increase than boys after puberty onset. The timing of the onset of this sex bias led us to hypothesize that ovarian hormones contribute to depression and anxiety during puberty. In humans, it is difficult to disentangle direct effects of gonadal hormones from social and environmental factors that interact with pubertal development to influence mental health. To test the role of gonadal hormones in anxiety- and depression-related behavior during puberty, we manipulated gonadal hormones in mice while controlling social and environmental factors. Similar to humans, we find that mice show an increase in depression-related behavior from pre-pubertal to late-pubertal ages, but this increase is not dependent on gonadal hormones and does not differ between sexes. Anxiety-related behavior, however, is more complex during puberty, with differences that depend on sex, age, behavioral test, and hormonal status. Briefly, males castrated before puberty show greater anxiety-related behavior during late puberty compared to intact males, while pubertal females are unaffected by ovariectomy or hormone injections in all assays except the marble burying test. Despite this sex-specific effect of pubertal hormones on anxiety-related behavior, we find no sex differences in intact young adults, suggesting that males and females use separate mechanisms to converge on a similar behavioral phenotype. Our results are consistent with anxiolytic effects of testicular hormones during puberty in males but are not consistent with a causal role for ovarian hormones in increasing anxiety- and depression-related behavior during puberty in females.

Genetics of depressive symptoms in adolescence

BACKGROUND

Despite many attempts to understand the genetic architecture of depression, little progress has been made. The majority of these studies, however, have been carried out in adults and do not account for the potential influence of development.

METHODS

The Avon Longitudinal Study of Parents and Children (ALSPAC) is a longitudinal pregnancy cohort which recruited participants between April 1991 and December 1992. Analyses were replicated in two independent European cohorts. Genome-wide complex trait analysis (GCTA) software was used to investigate SNP-heritability (h2SNP) of depression across adolescence, the role of puberty was investigated by stratifying these estimates according to pubertal onset. Genome-wide association studies were performed to identify genetic variants associated with depression at different stages of development.

RESULTS

Heritability was estimated between the ages of 11 and 18 with sample sizes ranging from 3289 to 5480. Heritability was low with an apparent peak was found at age 13 (h2 = 0.17, p = 0.006). Confidence intervals around these estimates suggest an upper-bound to h2SNP of around 30%. A variant located on chromosome 7 was found to be associated with depressive symptoms at age 13 in ALSPAC (rs138191010: β = 0.142, p = 2.51 × 10-8), although this was not replicated.

CONCLUSIONS

Although power is a potential limitation, the observed patterns provide interesting hypotheses surrounding the heritability of depression at different developmental stages. We found substantially lower estimates for depressive symptoms at age 11 (0.07) compared to those previously estimated in adults (0.21). We also found a peak in heritability at age 13. These findings suggest environmental factors are likely to be more important in the aetiology of depressive symptoms in early adolescence than in adulthood.

Developmental change in the association between adolescent depressive symptoms and the home environment: results from a longitudinal, genetically informative investigation

BACKGROUND

Depression is already highly prevalent by late adolescence, indicating that research into its developmental emergence should consider earlier risk factors and environmental contexts. The home environment is a key context for children and adolescents throughout development. However, the nature of relationships that exist between aspects of the home environment and the development of depressive symptoms cannot be assumed. Genetically informative studies have been used to provide insights about the aetiology of such relationships, often finding them to be partly confounded by the influence of children's genes. Here, we investigate developmental change in the aetiology of the association between aspects of the home environment and depressive symptoms at the onset of adolescence.

METHODS

We used longitudinal child- and parent-report data from >5,000 twin pairs enrolled in the UK-representative Twins Early Development Study. Multivariate, genetically sensitive structural equation models were used to decompose latent variance and covariance in depressive symptoms (measured at 12 and 16 years) and aspects of the home environment (at 9 and 14 years) into genetic and environmental influences.

RESULTS

Going from childhood to adolescence, genetic influences accounted for an increasing proportion of the association [30% (16-42) of r = .44 in childhood; 40% (25-61) of r = .43 in adolescence], at the expense of shared environmental influences, which decreased from 70% (58-83) to 48% (29-62). Unique environmental influences accounted for a significant proportion of the association in adolescence only [12% (06-18)]. Developmental changes could largely be attributed to subtle shifts in the relative importance of stable aetiological factors, rather than the emergence of influences unique to adolescence.

CONCLUSIONS

These findings emphasise the importance of developmental and aetiological context in interpreting associations between aspects of the home environment and child emotional outcomes.

Ovarian Hormones Organize the Maturation of Inhibitory Neurotransmission in the Frontal Cortex at Puberty Onset in Female Mice

The frontal cortex matures late in development, showing dramatic changes after puberty onset, yet few experiments have directly tested the role of pubertal hormones in cortical maturation. One mechanism thought to play a primary role in regulating the maturation of the neocortex is an increase in inhibitory neurotransmission, which alters the balance of excitation and inhibition. We hypothesized that pubertal hormones could regulate maturation of the frontal cortex by this mechanism. Here, we report that manipulations of gonadal hormones do significantly alter the maturation of inhibitory neurotransmission in the cingulate region of the mouse medial frontal cortex, an associative region that matures during the pubertal transition and is implicated in decision making, learning, and psychopathology. We find that inhibitory neurotransmission, but not excitatory neurotransmission, increases onto cingulate pyramidal neurons during peri-pubertal development and that this increase can be blocked by pre-pubertal, but not post-pubertal, gonadectomy. We next used pre-pubertal hormone treatment to model early puberty onset, a phenomenon increasingly observed in girls living in developed nations. We find that pre-pubertal hormone treatment drives an early increase in inhibitory neurotransmission in the frontal cortex, but not the somatosensory cortex, suggesting that earlier puberty can advance cortical maturation in a regionally specific manner. Pre-pubertal hormone treatment also accelerates maturation of tonic inhibition and performance in a frontal-cortex-dependent reversal-learning task. These data provide rare evidence of enduring, organizational effects of ovarian hormones at puberty and provide a potential mechanism by which gonadal hormones could regulate the maturation of the associative neocortex.

Does puberty mark a transition in sensitive periods for plasticity in the associative neocortex?

Postnatal brain development is studded with sensitive periods during which experience dependent plasticity is enhanced. This enables rapid learning from environmental inputs and reorganization of cortical circuits that matches behavior with environmental contingencies. Significant headway has been achieved in characterizing and understanding sensitive period biology in primary sensory cortices, but relatively little is known about sensitive period biology in associative neocortex. One possible mediator is the onset of puberty, which marks the transition to adolescence, when animals shift their behavior toward gaining independence and exploring their social world. Puberty onset correlates with reduced behavioral plasticity in some domains and enhanced plasticity in others, and therefore may drive the transition from juvenile to adolescent brain function. Pubertal onset is also occurring earlier in developed nations, particularly in unserved populations, and earlier puberty is associated with vulnerability for substance use, depression and anxiety. In the present article we review the evidence that supports a causal role for puberty in developmental changes in the function and neurobiology of the associative neocortex. We also propose a model for how pubertal hormones may regulate sensitive period plasticity in associative neocortex. We conclude that the evidence suggests puberty onset may play a causal role in some aspects of associative neocortical development, but that further research that manipulates puberty and measures gonadal hormones is required. We argue that further work of this kind is urgently needed to determine how earlier puberty may negatively impact human health and learning potential. This article is part of a Special Issue entitled SI: Adolescent plasticity.

Correlates of Childhood vs. Adolescence Internalizing Symptomatology from Infancy to Young Adulthood

In light of its associations with child and adolescent health and well-being, there remains a need to better understand the etiological underpinnings and developmental course of internalizing symptomatology in children and adolescents. This study leveraged intensive longitudinal data (N = 959; 49.6 % females) to test the hypothesis that internalizing symptoms in childhood may be driven more strongly by family experiences whereas internalizing symptoms in adolescence may derive more uniquely from familial loading for affective disorders (i.e., maternal depression). We evaluated the relative contributions of (a) family experiences (b) maternal depression, and (c) peer influences in testing this hypothesis. The results indicated that family predictors were more strongly correlated with childhood (relative to adolescent) internalizing symptoms. In contrast to previous findings, maternal depression also exhibited stronger associations with childhood internalizing symptoms. Although often overlooked in theories concerning potential differential origins of childhood vs. adolescent internalizing symptomatology, peer experiences explained unique variation in both childhood and adolescent internalizing problems.

Do better executive functions buffer the effect of current parental depression on adolescent depressive symptoms?

BACKGROUND

Offspring of parents with a history of major depressive disorder (MDD) and especially those exposed to a current episode of parental depression have been found to be at increased risk for developing depression themselves. Exposure to a current parental depressive episode also reduces the efficacy of interventions in high risk or depressed adolescents. This highlights the need to identify protective factors for adolescents exposed to a current parental depressive episode. Executive functions serve as an important cognitive resource, involved in the ability to regulate mood and thoughts and cope with stressful events. This study examined the buffering role of two components of executive functioning, inhibitory control and mental flexibility, in the association between a current parental episode of MDD and adolescent depressive symptoms.

METHODS

A high-risk sample of 288 adolescent offspring of parents with recurrent major depressive disorder completed an Affective Go/No Go and a Verbal Fluency task. Parents and adolescents underwent psychiatric interviews.

RESULTS

In the presence of a current parental depressive episode in the parent, adolescents with better inhibitory control and mental flexibility had fewer depressive symptoms after controlling for age, gender and IQ.

LIMITATIONS

Participants were the offspring of depressed parents and it is not clear whether the protective effects of executive functioning observed here would generalise to other populations.

CONCLUSIONS

Executive functions may protect against adolescent depression in the presence of a parental depressive episode. It may be beneficial to target executive functions in preventive programs for individuals at high-risk for depression.

Adolescent Neurodevelopment and Psychopathology

Adolescence is a high-risk period for the onset of psychopathology. The occurrence of depression increases markedly in the years following the onset of puberty, and most individuals who are eventually diagnosed with a psychotic disorder show a marked rise in adjustment problems during adolescence. It is well established that puberty involves increases in the secretion of gonadal hormones. More recently, research has shown that stress hormones show a similar normative rise following puberty. Accumulating findings indicate that the postpubescent period is also characterized by significant neurodevelopment; there are changes in brain structure and function that are partially a consequence of hormonal factors. Researchers are now challenged to elucidate the neural mechanisms relating postpubertal neurodevelopment with the elevations in risk for psychopathology that characterize adolescence. One plausible mechanism is the effect of hormones on gene expression. The normal neuromaturational processes observed in adolescence partially reflect the effect of gonadal hormones on the expression of genes that control brain development. Hormone surges following puberty may also trigger the expression of genes that code for brain abnormalities that give rise to mental disorders.

Aetiological influences on stability and change in emotional and behavioural problems across development: a systematic review

Emotional and behavioural problems in childhood and adolescence can be chronic and are predictive of future psychiatric problems. Understanding what factors drive the development and maintenance of these problems is therefore crucial. Longitudinal behavioural genetic studies using twin, sibling or adoption data can be used to explore the developmental aetiology of stability and change in childhood and adolescent psychopathology. We present a systematic review of longitudinal, behavioural genetic analyses of emotional and behavioural problems between ages 0 to 18 years. We identified 58 studies, of which 19 examined emotional problems, 30 examined behavioural problems, and 9 examined both. In the majority of studies, stability in emotional and behavioural problems was primarily genetically influenced. Stable environmental factors were also widely found, although these typically played a smaller role. Both genetic and environmental factors were involved in change across development. We discuss the findings in the context of the wider developmental literature and make recommendations for future research.

Polygenic interactions with environmental adversity in the aetiology of major depressive disorder

BACKGROUND

Major depressive disorder (MDD) is a common and disabling condition with well-established heritability and environmental risk factors. Gene-environment interaction studies in MDD have typically investigated candidate genes, though the disorder is known to be highly polygenic. This study aims to test for interaction between polygenic risk and stressful life events (SLEs) or childhood trauma (CT) in the aetiology of MDD.

METHOD

The RADIANT UK sample consists of 1605 MDD cases and 1064 controls with SLE data, and a subset of 240 cases and 272 controls with CT data. Polygenic risk scores (PRS) were constructed using results from a mega-analysis on MDD by the Psychiatric Genomics Consortium. PRS and environmental factors were tested for association with case/control status and for interaction between them.

RESULTS

PRS significantly predicted depression, explaining 1.1% of variance in phenotype (p = 1.9 × 10(-6)). SLEs and CT were also associated with MDD status (p = 2.19 × 10(-4) and p = 5.12 × 10(-20), respectively). No interactions were found between PRS and SLEs. Significant PRSxCT interactions were found (p = 0.002), but showed an inverse association with MDD status, as cases who experienced more severe CT tended to have a lower PRS than other cases or controls. This relationship between PRS and CT was not observed in independent replication samples.

CONCLUSIONS

CT is a strong risk factor for MDD but may have greater effect in individuals with lower genetic liability for the disorder. Including environmental risk along with genetics is important in studying the aetiology of MDD and PRS provide a useful approach to investigating gene-environment interactions in complex traits.

Genes, environments and depressions in young people

Among the common mental illnesses in childhood and adolescence, the unipolar depressions are the most concerning. These mental illnesses are aetiologically and clinically heterogeneous and little is known about their pathophysiology. This selected review considers the contribution of genetic and environmental factors in the emergence of these illnesses in the second decade of life.

Sex differences in anxiety disorders: Interactions between fear, stress, and gonadal hormones

This article is part of a Special Issue "SBN 2014". Women are more vulnerable to stress- and fear-based disorders, such as anxiety and post-traumatic stress disorder. Despite the growing literature on this topic, the neural basis of these sex differences remains unclear, and the findings appear inconsistent. The neurobiological mechanisms of fear and stress in learning and memory processes have been extensively studied, and the crosstalk between these systems is beginning to explain the disproportionate incidence and differences in symptomatology and remission within these psychopathologies. In this review, we discuss the intersect between stress and fear mechanisms and their modulation by gonadal hormones and discuss the relevance of this information to sex differences in anxiety and fear-based disorders. Understanding these converging influences is imperative to the development of more effective, individualized treatments that take sex and hormones into account.

Depression from childhood into late adolescence: Influence of gender, development, genetic susceptibility, and peer stress

Depression is a debilitating mental illness with clear developmental patterns from childhood through late adolescence. Here, we present data from the Gene Environment Mood (GEM) study, which used an accelerated longitudinal cohort design with youth (N = 665) starting in 3rd, 6th, and 9th grades, and a caretaker, who were recruited from the general community, and were then assessed repeatedly through semistructured diagnostic interviews every 6 months over 3 years (7 waves of data) to establish and then predict trajectories of depression from age 8 to 18. First, we demonstrated that overall prevalence rates of depression over time, by age, gender, and pubertal status, in the GEM study closely match those trajectories previously obtained in past developmental epidemiological research. Second, we tested whether a genetic vulnerability-stress model involving 5-HTTLPR and chronic peer stress was moderated by developmental factors. Results showed that older aged adolescents with SS/SL genotype, who experienced higher peer chronic stress over 3 years, were the most likely to be diagnosed with a depressive episode over time. Girls experiencing greater peer chronic stress were the most likely to develop depression. This study used repeated assessments of diagnostic interviewing in a moderately large sample of youth over 3 years to show that depression rates increase in middle to late adolescence, or postpubertally, and that the gender difference in depression emerges earlier in adolescence (age 12.5), or postpubertally. Additionally, genetically susceptible older adolescents who experience chronic peer stress were the most likely to become depressed over time.

Association among number, order and type of siblings and adolescent mental health at age 12

BACKGROUND

Although the sibling relationship is a unique one, the effects of the number and type of siblings on mental health among adolescents have not been reported.

METHODS

Japanese children (total, 9276; boys, 4654; girls, 4622), all 12 years old, and from the Japanese Toyama Birth Cohort Study, were followed up until 2002. Subject self-reported mental health was obtained from the Japanese version of the Dartmouth Primary Care Co-operative Project (COOP) charts. The associations between number and type of siblings and self-reported mental health were examined.

RESULTS

There was a significant difference in mental health between different sibling pairs, with brother pairs and brother/sister pairs having a positive effect on adolescent mental health, compared with those in sister pairs. Girls with brothers had better self-reported mental health than those without. The adjusted OR of good mental health was 1.44 (95%CI:1.00-2.08) for those with an older brother and 1.67 (95%CI: 1.17-2.38) for those with a younger brother compared with those without. Boys with a younger sister had a higher OR of good self-reported health than those without (OR, 1.62; 95%CI: 1.08-2.43).

CONCLUSIONS

Children with siblings had better mental health status than those without, which has practical implications for Asian countries and worldwide considering the declining fertility.

Multifinality of peer victimization: maladjustment patterns and transitions from early to mid-adolescence

Peer victimization is a common and pervasive experience in childhood and adolescence and is associated with various maladjustment symptoms, including internalizing, externalizing, and somatic problems. This variety suggests that peer victimization is multifinal where exposure to the same risk leads to different outcomes. However, very little is known about the relative likelihood of each form of maladjustment. We used a latent profile approach to capture multiple possible outcomes and examined prediction by peer victimization. We also examined the role of peer victimization with regard to stability and change in maladjustment. Maladjustment symptoms and peer victimization were assessed from the participants of the large cohort study TRacking Adolescents' Individual Lives Survey in early and mid-adolescence. Latent profile and latent transition analyses were conducted to examine associations between victimization and maladjustment profile and to test the role of victimization in maladjustment profile transitions. Four maladjustment profiles were identified for early adolescence (Low, Internalizing, Externalizing, Comorbid) and three profiles (Low, Internalizing, Externalizing) were identified for mid-adolescence. Internalizing problems were more likely in victimized adolescents than low symptom levels or externalizing problems. Victimized adolescents were at greater risk to develop internalizing problems between early and mid-adolescence than non-victimized adolescents. Peer victimization is multifinal mostly when outcomes are examined separately. If multiple outcomes are tested simultaneously, internalizing problems seem to be the most likely outcome.

Ten-year trends in adolescents' self-reported emotional and behavioral problems in the Netherlands

Changes in social, cultural, economic, and governmental systems over time may affect adolescents' development. The present study examined 10-year trends in self-reported emotional and behavioral problems among 11- to 16-year-old adolescents in the Netherlands. In addition, gender (girls versus boys), ethnic (Dutch versus non western) and educational (vocational versus academic) differences in these trends were examined. By means of the Strengths and Difficulties Questionnaire, trends in emotional and behavioral problems were studied in adolescents belonging to one of five independent population representative samples (2003: n = 6,904; 2005: n = 5,183; 2007: n = 6,228; 2009: n = 5,559; 2013: n = 5,478). Structural equation models indicated rather stable levels of emotional and behavioral problems over time. Whereas some small changes were found between different time points, these changes did not represent consistent changes in problem levels. Similarly, gender, ethnic and educational differences in self-reported problems on each time point were highly comparable, indicating stable mental health inequalities between groups of adolescents over time. Future internationally comparative studies using multiple measurement moments are needed to monitor whether these persistent mental health inequalities hold over extended periods of time and in different countries.

A critical assessment of the equal-environment assumption of the twin method for schizophrenia

The classical twin method (CTM) is central to the view that schizophrenia is ~80% heritable. The CTM rests on the equal-environment assumption (EEA) that identical and fraternal twin pairs experience equivalent trait-relevant environmental exposures. The EEA has not been directly tested for schizophrenia with measures of child social adversity, which is particularly etiologically relevant to the disorder. However, if child social adversity is more similar in identical than fraternal pairs in the general twin population, the EEA is unlikely to be valid for schizophrenia, a question which we tested in this study. Using results from prior twin studies, we tested if intraclass correlations for the following five categories of child social adversity are larger in identical than fraternal twins: bullying, sexual abuse, physical maltreatment, emotional neglect and abuse, and general trauma. Eleven relevant studies that encompassed 9119 twin pairs provided 24 comparisons of intraclass correlations, which we grouped into the five social exposure categories. Fisher's z-test revealed significantly higher correlations in identical than fraternal pairs for each exposure category (z ≥ 3.53, p < 0.001). The difference remained consistent across gender, study site (country), sample size, whether psychometric instruments were used, whether interviewing was proximate or distant to the exposures, and whether informants were twins or third persons. Combined with other evidence that the differential intraclass correlation for child social adversity cannot be explained by evocative gene-environment covariation, our results indicate that the CTM does not provide any valid indication of genomic effects in schizophrenia.

Testing Models for the Contributions of Genes and Environment to Developmental Change in Adolescent Depression

We tested two models to identify the genetic and environmental processes underlying longitudinal changes in depression among adolescents. The first assumes that observed changes in covariance structure result from the unfolding of inherent, random individual differences in the overall levels and rates of change in depression over time (random growth curves). The second assumes that observed changes are due to time-specific random effects (innovations) accumulating over time (autoregressive effects). We found little evidence of age-specific genetic effects or persistent genetic innovations. Instead, genetic effects are consistent with a gradual unfolding in the liability to depression and rates of change with increasing age. Likewise, the environment also creates significant individual differences in overall levels of depression and rates of change. However, there are also time-specific environmental experiences that persist with fidelity. The implications of these differing genetic and environmental mechanisms in the etiology of depression are considered.

Clarifying the associations between age at menarche and adolescent emotional and behavioral problems

Better understanding risk factors for the development of adolescent emotional and behavioral problems can help with intervention and prevention efforts. Previous studies have found that an early menarcheal age predicts several adolescent problems, including depressive symptoms, delinquency, and early age at first intercourse. Few studies, nevertheless, have explicitly tested (a) whether the associations with menarcheal age vary across racial/ethnic groups or (b) whether the sources of the associations are within-families (i.e., consistent with a direct, causal link) or only between-families (i.e., due to selection or confounding factors). The current study analyzed data from a nationally representative US Sample of females (N = 5,637). We examined whether race/ethnicity moderated the associations between early menarche and several adolescent problems by using multiple-group analyses and we examined the degree to which genetic and environmental factors shared by family members account for the associations by comparing sisters and cousins with differing menarcheal ages. Menarcheal age predicted subsequent depressive symptoms, delinquency, and early age at first intercourse in the population. The magnitudes of the associations were similar across all racial/ethnic groups for all outcomes. The within-family associations (i.e., when comparing siblings and cousins with different menarcheal age) were large and statistically significant when predicting early intercourse, but not the other outcomes. The findings suggest that selection or confounding factors account for the associations between menarcheal age and subsequent depressive symptoms and delinquency, whereas the independent association between menarcheal age and early age at first intercourse is consistent with a direct, causal effect.

Brain 5-HT deficiency increases stress vulnerability and impairs antidepressant responses following psychosocial stress

Brain serotonin (5-HT) deficiency and exposure to psychosocial stress have both been implicated in the etiology of depression and anxiety disorders, but whether 5-HT deficiency influences susceptibility to depression- and anxiety-like phenotypes induced by psychosocial stress has not been formally established. Most clinically effective antidepressants increase the extracellular levels of 5-HT, and thus it has been hypothesized that antidepressant responses result from the reversal of endogenous 5-HT deficiency, but this hypothesis remains highly controversial. Here we evaluated the impact of brain 5-HT deficiency on stress susceptibility and antidepressant-like responses using tryptophan hydroxylase 2 knockin (Tph2KI) mice, which display 60-80% reductions in brain 5-HT. Our results demonstrate that 5-HT deficiency leads to increased susceptibility to social defeat stress (SDS), a model of psychosocial stress, and prevents the fluoxetine (FLX)-induced reversal of SDS-induced social avoidance, suggesting that 5-HT deficiency may impair antidepressant responses. In light of recent clinical and preclinical studies highlighting the potential of inhibiting the lateral habenula (LHb) to achieve antidepressant and antidepressant-like responses, we also examined whether LHb inhibition could achieve antidepressant-like responses in FLX-insensitive Tph2KI mice subjected to SDS. Our data reveal that using designer receptors exclusively activated by designer drugs (DREADDs) to inhibit LHb activity leads to reduced SDS-induced social avoidance behavior in both WT and Tph2KI mice. This observation provides additional preclinical evidence that inhibiting the LHb might represent a promising alternative therapeutic approach under conditions in which selective 5-HT reuptake inhibitors are ineffective.