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Salokangas RKR, Salokangas HRW, From T, Lehtoranta L, Juolevi A, Hietala J, Koskinen S. Gender differences in the association between adverse childhood experiences and premature mortality: A prospective population study. CHILD ABUSE & NEGLECT 2024; 153:106838. [PMID: 38744042 DOI: 10.1016/j.chiabu.2024.106838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 04/22/2024] [Accepted: 04/30/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Birth cohort studies have shown that adverse childhood experiences (ACEs) are associated with all-cause mortality. The effect of ACEs on premature mortality among working-age people is less clear and may differ between the genders. OBJECTIVE In this prospective population study, we investigated the association of ACEs with all-cause mortality in a working-age population. PARTICIPANTS AND METHODS In a representative Finnish population study, Health 2000, individuals aged 30 to 64 years were interviewed in 2000, and their deaths were registered until 2020. At baseline, the participants (n = 4981, 2624 females) completed a questionnaire that included 11 questions on ACEs and questions on tobacco smoking, alcohol abuse, self-reported health and sufficiency of income. All-cause mortality was analysed by Cox regression analysis. RESULTS Of the ACEs, financial difficulties, parental unemployment and individual's own chronic illness were associated with mortality. High number (4+) of ACEs was significantly associated with all-cause mortality in females (HR 2.11, p < 0.001), not in males. Poor health behaviour, self-reported health and low income were the major predictors of mortality in both genders. When the effects of these factors were controlled, childhood family conflicts associated with mortality in both genders. CONCLUSIONS Among working-age people, females seem to be sensitive to the effects of numerous adverse childhood experiences, exhibiting higher premature all-cause mortality. Of the individual ACEs, family conflicts may increase risk of premature mortality in both genders. The effect of ACEs on premature mortality may partly be mediated via poor adult health behaviour and low socioeconomic status. WHAT IS ALREADY KNOWN In birth cohort studies, adverse childhood experiences (ACEs) have been associated with all-cause mortality. In working-age people, the association of ACEs with premature mortality is less clear and may differ between the genders. WHAT THIS STUDY ADDS In working-age people, high number of ACEs associate with all-cause premature mortality in females, not in males. The effect of ACEs on premature mortality may partly be mediated via poor adult health behaviour, self-reported health and low socioeconomic status.
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Affiliation(s)
| | - Henri R W Salokangas
- Department of Economics, University of Turku, Turku, Finland; Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tiina From
- Department of Psychiatry, University of Turku, Turku, Finland
| | | | - Anne Juolevi
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital, The Wellbeing services county of Southwest Finland, Turku, Finland
| | - Seppo Koskinen
- Finnish Institute for Health and Welfare, Helsinki, Finland
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Wen S, Zhu J, Han X, Li Y, Liu H, Yang H, Hou C, Xu S, Wang J, Hu Y, Qu Y, Liu D, Aspelund T, Fang F, Valdimarsdóttir UA, Song H. Childhood maltreatment and risk of endocrine diseases: an exploration of mediating pathways using sequential mediation analysis. BMC Med 2024; 22:59. [PMID: 38331807 PMCID: PMC10854183 DOI: 10.1186/s12916-024-03271-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 01/22/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs), including childhood maltreatment, have been linked with increased risk of diabetes and obesity during adulthood. A comprehensive assessment on the associations between childhood maltreatment and all major endocrine diseases, as well as the relative importance of different proposed mechanistic pathways on these associations, is currently lacking. METHODS Based on the UK Biobank, we constructed a cohort including 151,659 participants with self-reported data on childhood maltreatment who were 30 years of age or older on/after January 1, 1985. All participants were followed from the index date (i.e., January 1, 1985, or their 30th birthday, whichever came later) until the first diagnosis of any or specific (12 individual diagnoses and 9 subtypes) endocrine diseases, death, or the end of follow-up (December 31, 2019), whichever occurred first. We used Cox models to examine the association of childhood maltreatment, treated as continuous (i.e., the cumulative number of experienced childhood maltreatment), ordinal (i.e., 0, 1 and ≥ 2), or binary (< 2 and ≥ 2) variable, with any and specific endocrine diseases, adjusted for multiple covariates. We further examined the risk of having multiple endocrine diseases using Linear or Logistic Regression models. Then, sequential mediation analyses were performed to assess the contribution of four possible mechanisms (i.e., suboptimal socioeconomic status (SES), psychological adversities, unfavorable lifestyle, and biological alterations) on the observed associations. RESULTS During an average follow-up of 30.8 years, 20,885 participants received a diagnosis of endocrine diseases. We observed an association between the cumulative number of experienced childhood maltreatment and increased risk of being diagnosed with any endocrine disease (adjusted hazard ratio (HR) = 1.10, 95% confidence interval 1.09-1.12). The HR was 1.26 (1.22-1.30) when comparing individuals ≥ 2 with those with < 2 experienced childhood maltreatment. We further noted the most pronounced associations for type 2 diabetes (1.40 (1.33-1.48)) and hypothalamic-pituitary-adrenal (HPA)-axis-related endocrine diseases (1.38 (1.17-1.62)), and the association was stronger for having multiple endocrine diseases, compared to having one (odds ratio (95% CI) = 1.24 (1.19-1.30), 1.35 (1.27-1.44), and 1.52 (1.52-1.53) for 1, 2, and ≥ 3, respectively). Sequential mediation analyses showed that the association between childhood maltreatment and endocrine diseases was consistently and most distinctly mediated by psychological adversities (15.38 ~ 44.97%), while unfavorable lifestyle (10.86 ~ 25.32%) was additionally noted for type 2 diabetes whereas suboptimal SES (14.42 ~ 39.33%) for HPA-axis-related endocrine diseases. CONCLUSIONS Our study demonstrates that adverse psychological sequel of childhood maltreatment constitutes the main pathway to multiple endocrine diseases, particularly type 2 diabetes and HPA-axis-related endocrine diseases. Therefore, increased access to evidence-based mental health services may also be pivotal in reducing the risk of endocrine diseases among childhood maltreatment-exposed individuals.
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Affiliation(s)
- Shu Wen
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jianwei Zhu
- Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Han
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yuchen Li
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Haowen Liu
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Huazhen Yang
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Can Hou
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Shishi Xu
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Division of Endocrinology & Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Junren Wang
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yao Hu
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yuanyuan Qu
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Di Liu
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
- Sichuan University - Pittsburgh Institute, Sichuan University, Chengdu, China
| | - Thor Aspelund
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Unnur A Valdimarsdóttir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Huan Song
- Mental Health Center and West China Biomedical Big Data Center West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China.
- Med-X Center for Informatics, Sichuan University, Chengdu, China.
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
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Qu G, Liu H, Ma S, Han T, Zhang H, Sun L, Qin Q, Chen M, Sun Y. Inflammatory burden of adolescents with childhood maltreatment: results from baseline data of a school cohort. Eur Child Adolesc Psychiatry 2024; 33:539-548. [PMID: 36877251 DOI: 10.1007/s00787-023-02181-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 02/27/2023] [Indexed: 03/07/2023]
Abstract
Increasing studies have investigated inflammatory burden of adults with childhood adversity, but less is known about how childhood maltreatment affects the inflammation level of adolescents. Baseline data of a school cohort of physical and mental health status and life experience survey on primary and secondary school students in Anhui Province, China was used. Childhood maltreatment of children and adolescents was assessed by Chinese version of Childhood Trauma Questionnaire-Short Form (CTQ-SF). Urine samples were collected to assess levels of soluble urokinase Plasminogen Activator Receptor (suPAR), C-reactive protein (CRP) and cytokines interleukin-6 (IL-6) by enzyme-linked immunosorbent assay (ELISA). Logistic regression was conducted to examine the association between childhood maltreatment exposure and risk of high inflammation burden. A total of 844 students were included with mean age 11.41 ± 1.57 years old. Adolescents with emotional abuse were significantly more likely to have high level of IL-6 (OR = 3.59, 95% CI 1.16-11.14). In addition, adolescents with emotional abuse were more likely to show high IL-6 and high suPAR combination (OR = 33.41, 95% CI 1.69-659.22), and high IL-6 and low CRP combination (OR = 4.34, 95% CI 1.29-14.55). Subgroup analyses showed that emotional abuse was associated with high IL-6 burden among boys or adolescents with depression. Childhood emotional abuse was positively associated with higher burden of IL-6. Early detection and prevention of emotional abuse for children and adolescents, especially for boys or adolescents with depression status, may be helpful for preventing elevated inflammatory burden and related health problems.
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Affiliation(s)
- Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shaodi Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Tiantian Han
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Huimei Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Liang Sun
- Fuyang Center for Disease Control and Prevention, No.19, Zhongnan Avenue, Fuyang, 236000, Anhui, China
| | - Qirong Qin
- Ma'anshan Center for Disease Control and Prevention, No.849, Jiangdong Avenue, Ma'anshan, 243000, Anhui, China
| | - Mingchun Chen
- Changfeng Center for Disease Control and Prevention, Changfeng, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
- Chaohu Hospital, Anhui Medical University, Hefei, 238000, Anhui, China.
- Center for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
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Baca KJ, Salsbury SA. Adverse childhood experiences and trauma informed care for chiropractors: a call to awareness and action. Chiropr Man Therap 2023; 31:30. [PMID: 37580756 PMCID: PMC10426155 DOI: 10.1186/s12998-023-00503-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/20/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Trauma is an emotional response to distressing events where coping and subsequent recovery are absent. Adverse Childhood Experiences (ACEs) are traumas, occurring before the age of 18 years, such as child abuse or neglect, caregiver instability, and household dysfunction. Sixty-four percent of the U.S. population report experiencing at least one ACE, with over 1 billion children experiencing abuse and neglect annually worldwide. Chronic exposure to stressful circumstances or multiple traumatic events has negative physiologic impacts. Persons who experience 3 or more ACEs in childhood are at greater risk of poor mental health outcomes and may be more likely to engage in high-risk behaviors, predisposing them to long-term health impacts, such as metabolic diseases, anxiety, depression, substance use, and chronic pain. Trauma informed care (TIC) is a recommended approach to healthcare delivery across professions, especially when a trauma history is suspected. This commentary aims to increase awareness of the impact of ACEs on health outcomes and introduce TIC concepts as they may apply to chiropractic care for adults with a history of ACEs. DISCUSSION This commentary reviews an introductory model (4R's: realize, recognize, respond, resist re-traumatization) as one TIC framework used by healthcare practitioners. Prior trauma can lessen trust, alter perceptions of physical touch, and hands-on examinations and chiropractic treatments may trigger stress responses. Using TIC after appropriate training, includes referrals to multidisciplinary providers to address trauma-related concerns outside the scope of chiropractic, and screening for ACEs if deemed appropriate. Creating safe spaces, communicating clearly, avoiding victimizing language, explaining procedures, asking for consent before physical contact, and giving patients choice and control in their own care may avoid triggering prior traumas. CONCLUSION Given the high worldwide prevalence of persons experiencing 3 or more ACEs, TIC principles are practical adaptations to chiropractic care for use with many patient populations. As TIC and ACEs are emerging concepts within chiropractic, students and practitioners are encouraged to undertake additional training to better understand these complex and sensitive topics. Exploratory research on the incidence, presentation, and impacts of various trauma types, including ACEs, to support adoption of TIC in chiropractic settings is essential.
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Affiliation(s)
- Kira J Baca
- Palmer College of Chiropractic, 1000 Brady St, Davenport, IA, 52803, USA.
| | - Stacie A Salsbury
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, 741 Brady St, Davenport, IA, 52803, USA
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Muroi K, Ishitsuka M, Hori D, Doki S, Takahashi T, Ikeda T, Saito T, Shinichiro S, Matsuzaki I. Relationships Between Childhood Bullying/Domestic Violence Experience and Insomnia among Employees in Japan. F1000Res 2023; 12:103. [PMID: 37384304 PMCID: PMC10293797 DOI: 10.12688/f1000research.129340.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVE Traumatic childhood experiences such as domestic violence and bullying have been reported to be associated with insomnia in adulthood. However, little evidence is available for the long-term effects of childhood adversity on workers' insomnia worldwide. Our objective was to examine whether childhood experiences of bullying and domestic violence are associated with insomnia in workers in adulthood. METHODS We used survey data from a cross-sectional study of the Tsukuba Science City Network in Tsukuba City, Japan. Workers aged 20 to 65 years (4509 men and 2666 women) were targeted. Binomial logistic regression analysis was performed with the Athens Insomnia Scale as the objective variable. RESULTS Binomial logistic regression analysis showed that childhood bullying and domestic violence experience of childhood bullying and domestic violence were associated with insomnia. As for the experience of domestic violence, the higher the time of experience, the higher the odds ratio of insomnia. CONCLUSIONS It may be useful to focus on childhood traumatic experiences regarding insomnia in workers. In the future, objective sleep time and sleep efficiency should be evaluated using an activity meter and other methods to verify the effects of bullying and domestic violence experiences.
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Affiliation(s)
- Kei Muroi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Mami Ishitsuka
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Daisuke Hori
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Shotaro Doki
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tsukasa Takahashi
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tomohiko Ikeda
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tamaki Saito
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Sasahara Shinichiro
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Ichiyo Matsuzaki
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
- International Institute for Integrative Sleep Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
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6
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Muroi K, Ishitsuka M, Hori D, Doki S, Takahashi T, Ikeda T, Saito T, Shinichiro S, Matsuzaki I. Relationships Between Childhood Bullying/Domestic Violence Experience and Insomnia among Employees in Japan. F1000Res 2023; 12:103. [PMID: 37384304 PMCID: PMC10293797 DOI: 10.12688/f1000research.129340.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVE Traumatic childhood experiences such as domestic violence and bullying have been reported to be associated with insomnia in adulthood. However, little evidence is available for the long-term effects of childhood adversity on workers' insomnia worldwide. Our objective was to examine whether childhood experiences of bullying and domestic violence are associated with insomnia in workers in adulthood. METHODS We used survey data from a cross-sectional study of the Tsukuba Science City Network in Tsukuba City, Japan. Workers aged 20 to 65 years (4509 men and 2666 women) were targeted. Binomial logistic regression analysis was performed with the Athens Insomnia Scale as the objective variable. RESULTS Binomial logistic regression analysis showed that childhood bullying and domestic violence experience of childhood bullying and domestic violence were associated with insomnia. As for the experience of domestic violence, the higher the time of experience, the higher the odds ratio of insomnia. CONCLUSIONS It may be useful to focus on childhood traumatic experiences regarding insomnia in workers. In the future, objective sleep time and sleep efficiency should be evaluated using an activity meter and other methods to verify the effects of bullying and domestic violence experiences.
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Affiliation(s)
- Kei Muroi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Mami Ishitsuka
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Daisuke Hori
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Shotaro Doki
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tsukasa Takahashi
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tomohiko Ikeda
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tamaki Saito
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Sasahara Shinichiro
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Ichiyo Matsuzaki
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
- International Institute for Integrative Sleep Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
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Basile KC, Chen J, Smith SG, Clayton HB, Simon TR, Mercy JA. Violent Victimization During Childhood in the United States: Associations With Revictimization and Health. VIOLENCE AND VICTIMS 2023; 38:375-395. [PMID: 37308183 PMCID: PMC10578136 DOI: 10.1891/vv-2022-0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Childhood violence victimization is a serious adverse childhood experience with lasting health impacts. This study examined the prevalence and characteristics of five forms of childhood violence victimization and their association with revictimization and negative health conditions among adults. Data are from the 2010-2012 National Intimate Partner and Sexual Violence Survey. Age at first victimization and perpetrator sex were assessed; adjusted odds ratios assessed associations with revictimization and health. Ages 14-17 were the most common age at first victimization for most violence types; almost half of male (46.7%) and a quarter of female (27.0%) rape victims reported first victimization before age 10. Most victimization was associated with revictimization and negative health, controlling for adult victimization. Primary prevention of childhood violence may reduce later health risks.
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Affiliation(s)
- Kathleen C Basile
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jieru Chen
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sharon G Smith
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Heather B Clayton
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Thomas R Simon
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James A Mercy
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Peckham H. Introducing the Neuroplastic Narrative: a non-pathologizing biological foundation for trauma-informed and adverse childhood experience aware approaches. Front Psychiatry 2023; 14:1103718. [PMID: 37283710 PMCID: PMC10239852 DOI: 10.3389/fpsyt.2023.1103718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 04/20/2023] [Indexed: 06/08/2023] Open
Abstract
Most people accessing mental health services have adverse childhood experiences (ACEs) and/or histories of complex trauma. In recognition of this, there are calls to move away from medical model approaches and move toward trauma-informed approaches which privilege the impact of life experience over underlying pathology in the etiology of emotional and psychological suffering. Trauma-informed approaches lack a biological narrative linking trauma and adversity to later suffering. In its absence, this suffering is diagnosed and treated as a mental illness. This study articulates the Neuroplastic Narrative, a neuroecological theory that fills this gap, conceptualizing emotional and psychological suffering as the cost of surviving and adapting to the impinging environments of trauma and adversity. The Neuroplastic Narrative privileges lived experience and recognizes that our experiences become embedded in our biology through evolved mechanisms that ultimately act to preserve survival in the service of reproduction. Neuroplasticity refers to the capacity of neural systems to adapt and change. Our many evolved neuroplastic mechanisms including epigenetics, neurogenesis, synaptic plasticity, and white matter plasticity allow us to learn from, and adapt to, past experiences. This learning and adaption in turn allows us to better anticipate and physiologically prepare for future experiences that (nature assumes) are likely to occur, based on past experiences. However, neuroplastic mechanisms cannot discriminate between experiences; they function to embed experience regardless of the quality of that experience, generating vicious or virtuous cycles of psychobiological anticipation, to help us survive or thrive in futures that resemble our privileged or traumatic pasts. The etiology of suffering that arises from this process is not a pathology (a healthy brain is a brain that can adapt to experience) but is the evolutionary cost of surviving traumatizing environments. Misidentifying this suffering as a pathology and responding with diagnosis and medication is not trauma-informed and may cause iatrogenic harm, in part through perpetuating stigma and exacerbating the shame which attends complex trauma and ACEs. As an alternative, this study introduces the Neuroplastic Narrative, which is situated within an evolutionary framework. The Neuroplastic Narrative complements both Life History and Attachment Theory and provides a non-pathologizing, biological foundation for trauma-informed and Adverse Childhood Experience aware approaches.
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Affiliation(s)
- Haley Peckham
- Centre for Mental Health Nursing, School of Health Sciences, University of Melbourne, Carlton, VIC, Australia
- Department of Psychology, University of Exeter, Exeter, United Kingdom
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Dai J, Xu Y, Wang T, Zeng P. Exploring the relationship between socioeconomic deprivation index and Alzheimer's disease using summary-level data: From genetic correlation to causality. Prog Neuropsychopharmacol Biol Psychiatry 2023; 123:110700. [PMID: 36566903 DOI: 10.1016/j.pnpbp.2022.110700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 11/04/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
Patients with Alzheimer's disease (AD) are markedly increasing as population aging and no disease-modifying therapies are currently available for AD. Previous studies suggested a broad link between socioeconomic status and a variety of disorders, including mental illness and cognitive abilities. However, the association between socioeconomic deprivation and AD has been unknown. We here employed Townsend deprivation index (TDI) to explore such relation and found a positive genetic correlation (r̂g=0.211, P = 8.00 × 10-4) between the two traits with summary statistics data (N = 455,258 for TDI and N = 455,815 for AD). Then, we performed pleiotropy analysis at both variant and gene levels using a powerful method called PLACO and detected 87 distinct pleiotropic genes. Functional analysis demonstrated these genes were significantly enriched in pancreas, liver, heart, blood, brain, and muscle tissues. Using Mendelian randomization methods, we further found that one genetically predicted standard deviation elevation in TDI could lead to approximately 18.5% (95% confidence intervals 1.6- 38.2%, P = 0.031) increase of AD risk, and that the identified causal association was robust against used MR approaches, horizontal pleiotropy, and instrumental selection. Overall, this study provides deep insight into common genetic components underlying TDI and AD, and further reveals causal connection between them. It is also helpful to develop a more suitable plan for ameliorating inequities, hardship, and disadvantage, with the hope of improving health outcomes among economically disadvantaged people.
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Affiliation(s)
- Jing Dai
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Yue Xu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Ting Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Ping Zeng
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China; Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China; Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China; Key Laboratory of Environment and Health, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China; Engineering Research Innovation Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China.
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10
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Mazurek B, Rose M, Schulze H, Dobel C. Systems Medicine Approach for Tinnitus with Comorbid Disorders. Nutrients 2022; 14:nu14204320. [PMID: 36297004 PMCID: PMC9611054 DOI: 10.3390/nu14204320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/26/2022] [Accepted: 10/06/2022] [Indexed: 11/07/2022] Open
Abstract
Despite the fact that chronic diseases usually occur together with a spectrum of possible comorbidities that may differ strongly between patients, they are classically still viewed as distinct disease entities and, consequently, are often treated with uniform therapies. Unfortunately, such an approach does not take into account that different combinations of symptoms and comorbidities may result from different pathological (e.g., environmental, genetic, dietary, etc.) factors, which require specific and individualised therapeutic strategies. In this opinion paper, we aim to put forward a more differentiated, systems medicine approach to disease and patient treatment. To elaborate on this concept, we focus on the interplay of tinnitus, depression, and chronic pain. In our view, these conditions can be characterised by a variety of phenotypes composed of variable sets of symptoms and biomarkers, rather than distinct disease entities. The knowledge of the interplay of such symptoms and biomarkers will provide the key to a deeper, mechanistic understanding of disease pathologies. This paves the way for prediction and prevention of disease pathways, including more personalised and effective treatment strategies.
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Affiliation(s)
- Birgit Mazurek
- Tinnitus Center, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
- Correspondence:
| | - Matthias Rose
- Medical Department, Division of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Holger Schulze
- Department of Otorhinolaryngology–Head and Neck Surgery, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Christian Dobel
- Department of Otorhinolaryngology, Jena University Hospital, 07743 Jena, Germany
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11
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Barcelona V, Huang Y, Caceres BA, Newhall KP, Hui Q, Cerdeña JP, Crusto CA, Sun YV, Taylor JY. Experiences of Trauma and DNA Methylation Profiles among African American Mothers and Children. Int J Mol Sci 2022; 23:ijms23168951. [PMID: 36012217 PMCID: PMC9408935 DOI: 10.3390/ijms23168951] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 11/18/2022] Open
Abstract
Potentially traumatic experiences have been associated with chronic diseases. Epigenetic mechanisms, including DNA methylation (DNAm), have been proposed as an explanation for this association. We examined the association of experiences of trauma with epigenome-wide DNAm among African American mothers (n = 236) and their children aged 3–5 years (n = 232; N = 500), using the Life Events Checklist-5 (LEC) and Traumatic Events Screening Inventory—Parent Report Revised (TESI-PRR). We identified no DNAm sites significantly associated with potentially traumatic experience scores in mothers. One CpG site on the ENOX1 gene was methylome-wide-significant in children (FDR-corrected q-value = 0.05) from the TESI-PRR. This protein-coding gene is associated with mental illness, including unipolar depression, bipolar, and schizophrenia. Future research should further examine the associations between childhood trauma, DNAm, and health outcomes among this understudied and high-risk group. Findings from such longitudinal research may inform clinical and translational approaches to prevent adverse health outcomes associated with epigenetic changes.
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Affiliation(s)
- Veronica Barcelona
- Center for Research on People of Color, Columbia University School of Nursing, 560 West 168th St., New York, NY 10032, USA
| | | | - Billy A. Caceres
- Center for Research on People of Color, Columbia University School of Nursing, 560 West 168th St., New York, NY 10032, USA
| | - Kevin P. Newhall
- School of Medicine, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, USA
| | - Qin Hui
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Jessica P. Cerdeña
- MD-PhD Program, Yale School of Medicine, 367 Cedar St., New Haven, CT 06520, USA
- Department of Anthropology and Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, 354 Mansfield Rd., Storrs, CT 06269, USA
| | - Cindy A. Crusto
- Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT 06511, USA
- Department of Psychology, University of Pretoria, Private Bag x 20, Hatfield, Pretoria 0028, South Africa
| | - Yan V. Sun
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Jacquelyn Y. Taylor
- Center for Research on People of Color, Columbia University School of Nursing, 560 West 168th St., New York, NY 10032, USA
- Correspondence: ; Tel.: +1-(212)-342-3986
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12
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Xin N, Wang DT, Zhang L, Zhou Y, Cheng Y. Early developmental stage glucocorticoid exposure causes DNA methylation and behavioral defects in adult zebrafish. Comp Biochem Physiol C Toxicol Pharmacol 2022; 256:109301. [PMID: 35182718 DOI: 10.1016/j.cbpc.2022.109301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 01/21/2022] [Accepted: 02/12/2022] [Indexed: 11/20/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a psychiatric disorder caused by genetic and environmental factors. It is closely related to a dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, in which the epigenetic modification of the nr3c1 plays an important role. It is well known that nr3c1 methylation in offspring is reportedly related to early adverse life experiences, prenatal stress response, and early nursing conditions; however, the methylation location and extent of the nr3c1 are not sufficiently elucidated. In order to study the internal mechanism of PTSD caused by early adverse life experience, we used zebrafish to construct a psychopathological model. We found that early developmental stage prednisolone exposure caused HPA axis negative feedback dysfunction and hormone secretion disorder in adult male zebrafish. By analyzing nr3c1 promoter, we found that cytosine-guanine island (CpGI) 2 was highly methylated in adult male zebrafish, which affected the expression of glucocorticoid receptor, resulting in abnormal behavior and anxiety like phenotype of adult male zebrafish. Therefore, we believed that an early exposure of zebrafish larvae to prednisolone may be recorded through a change of CpGI 2 methylation in the nr3c1 promoter region, causing abnormal adult male zebrafish behavior. Moreover, the establishment of the zebrafish psychopathological model may facilitate the study of the clinical management of patients with PTSD.
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Affiliation(s)
- Ning Xin
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, China
| | - Da-Tong Wang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, China
| | - Li Zhang
- Department of Geriatrics, Jinan Laigang Hospital, No.68 Xinxing Road, Jinan, Shandong 271100, China
| | - Yanlong Zhou
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, China
| | - Yanbo Cheng
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, China.
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13
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Adverse childhood experiences and late-life diurnal HPA axis activity: Associations of different childhood adversity types and interaction with timing in a sample of older East Prussian World War II refugees. Psychoneuroendocrinology 2022; 139:105717. [PMID: 35313255 DOI: 10.1016/j.psyneuen.2022.105717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 02/21/2022] [Accepted: 03/07/2022] [Indexed: 11/21/2022]
Abstract
Adverse childhood experiences (ACEs) have been associated with unfavorable health outcomes throughout the life up to old age. Mechanisms through which ACEs impact later life health are still not entirely clear. There is growing evidence for the idea that alterations in the hypothalamic pituitary adrenal (HPA) axis might cause the effects of ACEs on later health consequences. Only few studies have investigated associations between ACEs and diurnal HPA axis functioning in older adults. Therefore, we investigated the impact of type and timing of ACEs linked to flight of war on diurnal HPA axis activity in a sample of East Prussian World War II refugees aged 74-91 years. We calculated a dichotomous variable according to the (minimum) age at trauma: early ACE (eACE; 0-5 years) and late ACE (lACE; 6-17 years). Multiple linear regression analysis using different ACEs linked to flight of war (war-related trauma, individual experience of violence, neglect) as well as age at trauma and the interactions of ACEs and age at trauma as predictors and three cortisol outcomes (AUCG (area under the curve with respect to the ground), decline (morning to night) and CAR (cortisol awakening response)) was performed. For AUCG, we found a negative association of individual experience of violence only in lACE participants. For decline, a positive association with neglect was observed for the whole study sample. The overall model for CAR was not statistically significant. Our findings support the hypothesis that type as well as timing of ACEs might influence diurnal HPA axis functioning into old age. These findings may contribute to a better understanding of the lifelong influence of ACEs.
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14
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Amone-P'Olak K. Prevalence, distribution and attributable risks of adverse childhood experiences in different family types: A survey of young adults in Botswana. CHILD ABUSE & NEGLECT 2022; 126:105513. [PMID: 35144077 DOI: 10.1016/j.chiabu.2022.105513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 11/15/2021] [Accepted: 01/14/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Although adverse childhood experiences (ACEs) are often associated with poor outcomes in adulthood, little is known about its distribution in various family types, especially in low- and middle-income countries. OBJECTIVE We assessed the prevalence, distribution, and attributable risks of ACEs in different family types in early adults. METHODS Using data from 483 young adults (18-25 years of age), we assessed the prevalence and distribution of ACEs and employed binary logistic regressions to quantify the attributable risk of ACEs in different family types: nuclear (reference), single-mother, separated/divorced, and extended family types. We compared respondents without reports of ACEs (reference) to those reporting different numbers of ACEs (1 or more, 2 or more, 3 or more, 4 or more and 5 or more) to assess attributable risks of ACEs in different family types. RESULTS Out of the 483 participants, (female = 262 [53.3%]), 26.7% reported no ACEs, 21.1% reported 1 ACE, 13.3% reported 2 ACEs, and 38.9% reported 3 or more ACEs. Two hundred thirty-two (48%) and 153 (31.7%) students reported that they were from a nuclear and single-mother family types, respectively. Overall, there were higher densities of ACEs in single-mother and separated/divorced compared to nuclear family type. Compared to nuclear family type, the attributable risks of ACEs for single-mother family type ranged from 2.85 (95% Confidence Intervals (CI) 1.65) to 4.13 (95% CI: 1.92-8.91) and for separate/divorced family type ranging from 3.69 (95% CI: 1.72) to 6.32 (95% CI: 2.40-16.64). CONCLUSIONS The odds of ACEs differ with family types and were markedly pronounced in single-mother and separated/divorced compared to nuclear family types. Interventions to mitigate the effects of ACEs should be targeted at family types with a high density of ACEs. Professionals should design programmes targeting single-mother, separated/divorced and extended family types to alleviate the negative effects of childhood adversity.
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Affiliation(s)
- Kennedy Amone-P'Olak
- Department of Psychology, Faculty of Social Sciences, Kyambogo University, Uganda.
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15
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Banihashemi L, Peng CW, Rangarajan A, Karim HT, Wallace ML, Sibbach BM, Singh J, Stinley MM, Germain A, Aizenstein HJ. Childhood Threat Is Associated With Lower Resting-State Connectivity Within a Central Visceral Network. Front Psychol 2022; 13:805049. [PMID: 35310241 PMCID: PMC8927539 DOI: 10.3389/fpsyg.2022.805049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/09/2022] [Indexed: 11/25/2022] Open
Abstract
Childhood adversity is associated with altered or dysregulated stress reactivity; these altered patterns of physiological functioning persist into adulthood. Evidence from both preclinical animal models and human neuroimaging studies indicates that early life experience differentially influences stressor-evoked activity within central visceral neural circuits proximally involved in the control of stress responses, including the subgenual anterior cingulate cortex (sgACC), paraventricular nucleus of the hypothalamus (PVN), bed nucleus of the stria terminalis (BNST) and amygdala. However, the relationship between childhood adversity and the resting-state connectivity of this central visceral network remains unclear. To this end, we examined relationships between childhood threat and childhood socioeconomic deprivation, the resting-state connectivity between our regions of interest (ROIs), and affective symptom severity and diagnoses. We recruited a transdiagnostic sample of young adult males and females (n = 100; mean age = 27.28, SD = 3.99; 59 females) with a full distribution of maltreatment history and symptom severity across multiple affective disorders. Resting-state data were acquired using a 7.2-min functional magnetic resonance imaging (fMRI) sequence; noted ROIs were applied as masks to determine ROI-to-ROI connectivity. Threat was determined by measures of childhood traumatic events and abuse. Socioeconomic deprivation (SED) was determined by a measure of childhood socioeconomic status (parental education level). Covarying for age, race and sex, greater childhood threat was significantly associated with lower BNST-PVN, amygdala-sgACC and PVN-sgACC connectivity. No significant relationships were found between SED and resting-state connectivity. BNST-PVN connectivity was associated with the number of lifetime affective diagnoses. Exposure to threat during early development may entrain altered patterns of resting-state connectivity between these stress-related ROIs in ways that contribute to dysregulated neural and physiological responses to stress and subsequent affective psychopathology.
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Affiliation(s)
- Layla Banihashemi
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
- *Correspondence: Layla Banihashemi,
| | - Christine W. Peng
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Anusha Rangarajan
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Helmet T. Karim
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Meredith L. Wallace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA, United States
| | - Brandon M. Sibbach
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jaspreet Singh
- Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States
| | - Mark M. Stinley
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Anne Germain
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Howard J. Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
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16
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Horton MK, McCurdy S, Shao X, Bellesis K, Chinn T, Schaefer C, Barcellos LF. Case-control study of adverse childhood experiences and multiple sclerosis risk and clinical outcomes. PLoS One 2022; 17:e0262093. [PMID: 35025951 PMCID: PMC8757911 DOI: 10.1371/journal.pone.0262093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 12/16/2021] [Indexed: 12/19/2022] Open
Abstract
Background Adverse childhood experiences (ACEs) are linked to numerous health conditions but understudied in multiple sclerosis (MS). This study’s objective was to test for the association between ACEs and MS risk and several clinical outcomes. Methods We used a sample of adult, non-Hispanic MS cases (n = 1422) and controls (n = 1185) from Northern California. Eighteen ACEs were assessed including parent divorce, parent death, and abuse. Outcomes included MS risk, age of MS onset, Multiple Sclerosis Severity Scale score, and use of a walking aid. Logistic and linear regression estimated odds ratios (ORs) (and beta coefficients) and 95% confidence intervals (CIs) for ACEs operationalized as any/none, counts, individual events, and latent factors/patterns. Results Overall, more MS cases experienced ≥1 ACE compared to controls (54.5% and 53.8%, respectively). After adjusting for sex, birthyear, and race, this small difference was attenuated (OR = 1.01, 95% CI: 0.87, 1.18). There were no trends of increasing or decreasing odds of MS across ACE count categories. Consistent associations between individual ACEs between ages 0–10 and 11–20 years and MS risk were not detected. Factor analysis identified five latent ACE factors, but their associations with MS risk were approximately null. Age of MS onset and other clinical outcomes were not associated with ACEs after multiple testing correction. Conclusion Despite rich data and multiple approaches to operationalizing ACEs, no consistent and statistically significant effects were observed between ACEs with MS. This highlights the challenges of studying sensitive, retrospective events among adults that occurred decades before data collection.
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Affiliation(s)
- Mary K. Horton
- Division of Epidemiology and Biostatistics, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, United States of America
- Computational Biology Graduate Group, University of California, Berkeley, California, United States of America
- * E-mail:
| | - Shannon McCurdy
- California Institute for Quantitative Biosciences, University of California Berkeley, Berkeley, CA, United States of America
| | - Xiaorong Shao
- Division of Epidemiology and Biostatistics, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, United States of America
| | - Kalliope Bellesis
- Kaiser Permanente Division of Research, Oakland, CA, United States of America
| | - Terrence Chinn
- Kaiser Permanente Division of Research, Oakland, CA, United States of America
| | - Catherine Schaefer
- Kaiser Permanente Division of Research, Oakland, CA, United States of America
| | - Lisa F. Barcellos
- Division of Epidemiology and Biostatistics, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, United States of America
- Computational Biology Graduate Group, University of California, Berkeley, California, United States of America
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17
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Impacts of a perinatal exposure to manganese coupled with maternal stress in rats: Maternal somatic measures and the postnatal growth and development of rat offspring. Neurotoxicol Teratol 2021; 90:107061. [PMID: 34971732 DOI: 10.1016/j.ntt.2021.107061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/13/2021] [Accepted: 12/23/2021] [Indexed: 12/18/2022]
Abstract
Psychological stress experienced by the mother during pregnancy has been associated with emotional and cognitive disorders in children such as depression and anxiety. Socioeconomically disadvantaged populations are vulnerable to adverse life experiences and can also be disproportionally exposed to environmental contaminants. To better understand the neurodevelopmental impacts of an environmental toxicant coupled with elevated psychological stress, we exposed pregnant rats to a series of perinatal stressors. Manganese (Mn), a neurotoxicant at excessive concentrations was delivered through drinking water (0, 2, or 4 mg/mL) from gestational day (GD) 7 to postnatal day (PND) 22. A variable stress paradigm was applied to half of the animals from GD13 to PND9. Measurements of somatic development and behavior were examined in the offspring at different developmental stages. No evidence of overt maternal toxicity was observed although the 4 mg/mL Mn-exposed dams gained less body weight during gestation compared to the other dams. Stress also reduced gestational maternal weight gain. Daily fluid consumption normalized for body weight was decreased in the Mn-exposed dams in a dose-dependent manner but was not altered by the stress paradigm. Maternal stress and/or Mn exposure did not affect litter size or viability, but pup weight was significantly reduced in the 4 mg/mL Mn-exposed groups on PNDs 9 through 34 when compared to the other offspring groups. The efficacy of the manipulations to increase maternal stress levels was determined using serum corticosterone as a biomarker. The baseline concentration was established prior to treatment (GD7) and levels were low and similar in all treatment groups. Corticosterone levels were elevated in the perinatal-stress groups compared to the no-stress groups, regardless of Mn exposure, on subsequent time points (GD16, PND9), but were only significantly different on GD16. An analysis of tissue concentrations revealed Mn was elevated similarly in the brain and blood of offspring at PND2 and at PND22 in a significant dose-dependent pattern. Dams also showed a dose-dependent increase in Mn concentrations in the brain and blood; the addition of stress increased the Mn concentrations in the maternal blood but not the brain. Perinatal stress did not alter the effects of Mn on the maternal or offspring somatic endpoints described here.
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18
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Hamilton CA, Matthews FE, Erskine D, Attems J, Thomas AJ. Neurodegenerative brain changes are associated with area deprivation in the United Kingdom: findings from the Brains for Dementia Research study. Acta Neuropathol Commun 2021; 9:198. [PMID: 34924033 PMCID: PMC8684681 DOI: 10.1186/s40478-021-01301-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 11/30/2021] [Indexed: 11/21/2022] Open
Abstract
Socioeconomic disadvantage is associated with greater risk of dementia. This has been theorised to reflect inequalities in cognitive reserve, healthcare access, lifestyle, and other health factors which may contribute to the clinical manifestation of dementia. We aimed to assess whether area deprivation in the United Kingdom was associated with greater risk or severity of the specific neurodegenerative diseases which lead to dementia in a multi-centre cohort with autopsy assessment. Participants underwent clinical assessment prior to brain tissue donation post-mortem. Each then underwent detailed, standardised neuropathological assessment. National area deprivation statistics were derived for each participant’s neighbourhood, for use as a predictor in binary and ordinal logistic models assessing the respective presence and severity of staging of key neuropathological changes, adjusting for theorised confounders. Individuals from among the 20% most deprived neighbourhoods in the United Kingdom had significantly higher neurofibrillary tangle and neuritic plaque staging, and increased risk of cerebral amyloid angiopathy. These findings were not explained by a greater risk of diabetes or hypertension, APOE genotype, alcohol misuse or tobacco smoking, sex, or age differences. A sensitivity analysis conditioning on baseline cognitive impairment did not meaningfully change the observed association. Socioeconomic disadvantage may contribute to dementia incidence through a greater severity of specific neuropathological changes (neurofibrillary tangles, neuritic plaques, and cerebral amyloid angiopathy), independent of other indirect influences. Mechanisms through which deprivation is associated with these require further exploration.
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Wakefield SM, McPherson P. How the Evolving State of Neuroscience Informs the Definition of Adulthood: a Psychiatrist’s Perspective. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2021. [DOI: 10.1007/s40817-021-00116-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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20
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Layfield SD, Duffy LA, Phillips KA, Lardenoije R, Klengel T, Ressler KJ. Multiomic biological approaches to the study of child abuse and neglect. Pharmacol Biochem Behav 2021; 210:173271. [PMID: 34508786 PMCID: PMC8501413 DOI: 10.1016/j.pbb.2021.173271] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/03/2021] [Accepted: 09/06/2021] [Indexed: 10/20/2022]
Abstract
Childhood maltreatment, occurring in up to 20-30% of the population, remains far too common, and incorporates a range of active and passive factors, from abuse, to neglect, to the impacts of broader structural and systemic adversity. Despite the effects of childhood maltreatment and adversity on a wide range of adult physical and psychological negative outcomes, not all individuals respond similarly. Understanding the differential biological mechanisms contributing to risk vs. resilience in the face of developmental adversity is critical to improving preventions, treatments, and policy recommendations. This review begins by providing an overview of childhood abuse, neglect, maltreatment, threat, and toxic stress, and the effects of these forms of adversity on the developing body, brain, and behavior. It then examines examples from the current literature of genomic, epigenomic, transcriptomic, and proteomic discoveries and biomarkers that may help to understand risk and resilience in the aftermath of trauma, predictors of traumatic exposure risk, and potential targets for intervention and prevention. While the majority of genetic, epigenetic, and gene expression analyses to date have focused on targeted genes and hypotheses, large-scale consortia are now well-positioned to better understand interactions of environment and biology with much more statistical power. Ongoing and future work aimed at understanding the biology of childhood adversity and its effects will help to provide targets for intervention and prevention, as well as identify paths for how science, health care, and policy can combine efforts to protect and promote the psychological and physiological wellbeing of future generations.
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Affiliation(s)
- Savannah Dee Layfield
- Depression & Anxiety Division, McLean Hospital, Mass General Brigham, Belmont, MA, United States of America
| | - Lucie Anne Duffy
- Depression & Anxiety Division, McLean Hospital, Mass General Brigham, Belmont, MA, United States of America
| | - Karlye Allison Phillips
- Depression & Anxiety Division, McLean Hospital, Mass General Brigham, Belmont, MA, United States of America
| | - Roy Lardenoije
- Depression & Anxiety Division, McLean Hospital, Mass General Brigham, Belmont, MA, United States of America; Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Torsten Klengel
- Depression & Anxiety Division, McLean Hospital, Mass General Brigham, Belmont, MA, United States of America; Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany; Department of Psychiatry, Harvard Medical School, United States of America
| | - Kerry J Ressler
- Depression & Anxiety Division, McLean Hospital, Mass General Brigham, Belmont, MA, United States of America; Department of Psychiatry, Harvard Medical School, United States of America.
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21
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Kemp AJ, Kazi SE, Megna JL, Leontieva LV. Synergistic Effects of Psychotropics Leading to Extraordinary Weight Gain. Cureus 2021; 13:e17978. [PMID: 34660157 PMCID: PMC8507601 DOI: 10.7759/cureus.17978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2021] [Indexed: 12/03/2022] Open
Abstract
A 22-year-old woman had significant weight gain after being on two atypical antipsychotics, an antiepileptic, and an antidepressant for 12 months, with her weight increasing from 70 kg to 160 kg, or by 90 kg, over 16 months. This case report examines the possible synergistic effects of psychotropics, particularly two atypical antipsychotics, leading to adverse side effects, particularly severe obesity, in the context of other examined pharmacological and non-pharmacologic risk factors. Psychotropic monotherapy is the advised prescribing treatment guideline. The extraordinary weight gain resulting in severe obesity in this case demonstrates just one of the many concerns for psychotropic polypharmacy from the same sub-class of psychiatric drugs leading to increased morbidity and mortality in the psychiatric population.
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Affiliation(s)
- Allyson J Kemp
- Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, Syracuse, USA
| | - Sana E Kazi
- Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, Syracuse, USA
| | - James L Megna
- Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, Syracuse, USA
| | - Lubov V Leontieva
- Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, Syracuse, USA
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Yang JZ, Kang CY, Yuan J, Zhang Y, Wei YJ, Xu L, Zhou F, Fan X. Effect of adverse childhood experiences on hypothalamic-pituitary-adrenal (HPA) axis function and antidepressant efficacy in untreated first episode patients with major depressive disorder. Psychoneuroendocrinology 2021; 134:105432. [PMID: 34607174 DOI: 10.1016/j.psyneuen.2021.105432] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/07/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
Adverse childhood experiences (ACEs) has been associated not only with an increased vulnerability for stress-related psychiatric disorders but also with distinct alterations of the hypothalamic-pituitary-adrenal (HPA) axis function and the immune system. The aim of this study is to examine differences in the HPA axis between major depressive disorder (MDD) patients with and without ACEs, and to explore differences in efficacy and HPA changes after long term antidepressant treatment between these two groups. A cohort of 803 patients with MDD were recruited. After the determination of cortisol (COR) and adrenocorticotropic hormone (ACTH), Hamilton Rating Scale for Depression (HAMD), Hamilton Rating Scale for Anxiety (HAMA), the Childhood Trauma Questionnaire (CTQ), 403 subjects were recruited for the following treatment study. Finally 330 MDD patients finished the monotherapy treatments of four antidepressants (Fluoxetine, Sertraline, Venlafaxine-extended release (XR), Duloxetine hydrochloride) for 12 weeks. Of 403 patients, 226 (56%) patients reported ACEs. Total score of HAMD in MDD with ACEs were higher than those in MDD without ACEs. There were significant differences for both ACTH and COR between MDD patients with and without ACEs that MDD patients with any types of maltreatment had higher level. Both COR and ACTH was positively and significantly correlated with the total scores of CTQ, HAMD, HAMA. After 12 weeks treatment of antidepressants monotherapy, the mean (SD) changes in HAMD and HAMA total scores was greater in MDD without ACEs than those in MDD with ACEs. At the 12-week end point, response was achieved by 37.2% in the MDD with ACEs group, 59.0% in the MDD without ACEs group respectively, with significant difference. Remission was achieved by 15.2% in the MDD with ACEs group and 32.2% in the MDD without ACEs group, with significant difference. The change in ACTH level in MDD without ACEs was also greater than that in MDD with ACEs, which was positively and significantly correlated with the HAMD total score only in MDD patient without ACEs. Logistic regression analysis showed that the total scores of CTQ, level of COR and ACTH at baseline were significantly associated with the response and remission. These findings indicated that exposure to ACEs for MDD could influence the HPA function and severity of symptoms. ACEs, ACTH and COR could be used as predictors of long term antidepressant treatment, suggested that are poor prognostic signs for antidepressants monotherapy in MDD with ACEs.
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Affiliation(s)
- Jian Zhong Yang
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, China.
| | - Chuan Yuan Kang
- Department of Clinical Psychology, East Hospital Affiliated to Tongji University (Shanghai East Hospital), 150 Jimo Road, Pudong New District, Shanghai 200120, China.
| | - Jing Yuan
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, China
| | - Yan Zhang
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, China
| | - Yu Jun Wei
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, China
| | - Li Xu
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, China
| | - Fang Zhou
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, China
| | - Xinxin Fan
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, China
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The role of maternal nutrition during pregnancy in the intergenerational transmission of childhood adversity. Psychoneuroendocrinology 2021; 130:105283. [PMID: 34082275 DOI: 10.1016/j.psyneuen.2021.105283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 01/30/2023]
Abstract
Adverse childhood experiences (ACEs) of a woman can lead to dysregulated hypothalamus-pituitary-adrenal (HPA) axis during pregnancy, which can in turn adversely affect her offspring HPA axis function. Choline and docosahexaenoic acid (DHA) are dietary factors with the potential to favorably modify the stress response system. The current study aimed to investigate whether maternal choline intake and DHA status moderate the effects of maternal ACEs exposure on maternal and infant HPA axes function. Participants were a sub-sample of the prospective longitudinal Alberta Pregnancy Outcomes and Nutrition (APrON) study consisting of 340 mothers and 238 infants. We collected data on maternal ACEs, maternal choline intake (24-hour dietary recall) and serum phospholipid DHA concentrations (at each trimester). Women self-collected saliva samples on two consecutive days (at waking, +30 min, 1100 h, and 2100 h) in each trimester to calculate the cortisol awakening response (CAR) and total daytime cortisol. Infants' salivary cortisol was measured before and after (20, and 40 min) exposure to a blood draw stressor 3 months postpartum. During pregnancy, choline intake moderated (reduced) the association between maternal ACEs and CAR (β = -0.003; 95% CI -0.006, -0.003), but not total daytime cortisol. DHA status did not moderate the association between ACEs and CAR or total daytime cortisol. Choline intake also moderated (reduced) the association between maternal CAR and infant cortisol during a stress task (β = -0.0001; 95% CI -0.0002, -0.00003). Maternal DHA status revealed no modifying effects on these associations. Our findings suggest that maternal choline intake, but not DHA status, can buffer the associations between ACEs and maternal HPA axis, as well as maternal and infant HPA axes function.
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Wang W, Xie X, Yuan T, Wang Y, Zhao F, Zhou Z, Zhang H. Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population-based study. BMC Pregnancy Childbirth 2021; 21:364. [PMID: 33964896 PMCID: PMC8106862 DOI: 10.1186/s12884-021-03809-2] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Relevant studies focusing on epidemiological of profiles hypertensive disorders of pregnancy from global data that report the cause-specific prevalence and trends of hypertensive disorders of pregnancy at global, regional and national levels from 1990 to 2019 by age and sociodemographic index are still limited. METHODS For hypertensive disorders of pregnancy, point prevalence, annual incidence, and years lived with disability numbers and age standardized rates per 100,000 population were compared at regional and national levels by age and sociodemographic index using data from the global Burden of Disease 2019 Study, covering populations from 204 countries and territories. Estimates are reported with uncertainty intervals to exhibit the changing trends during a specific period. RESULTS The incidence of hypertensive disorders of pregnancy increased from 16.30 million to 18.08 million globally, with a total increase of 10.92 % from 1990 to 2019. The age-standardized incidence rate decreased, with an estimated annual percent change of -0.68 (95 % confidence interval [CI] -0.49 to -0.86). The number of deaths due to hypertensive disorders of pregnancy was approximately 27.83 thousand in 2019, representing a 30.05 % decrease from 1990. Based on the incidence and prevalence, the number of deaths and years lived with disability were highest in the group aged 25-29 years, followed by the groups aged 30-34 and 20-24 years, while the lowest estimated incidence rate was observed in the group aged 25-29 years and higher incidence rates were observed in the youngest and oldest groups. Positive associations between incidence rates and the sociodemographic index and human development index were found for all countries and regions in 2019. Age-standardized incidence rates were higher in countries/regions with lower sociodemographic indices and human development indices. CONCLUSIONS Our study provides a comprehensive overview of the global burden of hypertensive disorders of pregnancy. The death and incidence rates are decreasing in most countries and all regions except for those with low sociodemographic and human development indexes. This difference is mainly due to the increasing attention to prenatal examinations and health education. Further investigations should focus on forecasting the global disease burden of specific hypertensive disorders of pregnancy and modifiable risk factors.
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Affiliation(s)
- Wei Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi, China
| | - Xin Xie
- Department of Nuclear Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi, China
| | - Ting Yuan
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi, China
| | - Yanyan Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi, China
| | - Fei Zhao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi, China
| | - Zhangjian Zhou
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, 710004, Xi'an, Shaanxi, China
| | - Hao Zhang
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi, China. .,Department of Public Health, Baoji High-tech People's Hospital, Shaanxi, 721000, Baoji, China.
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25
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Khan RJ, Needham BL, Advani S, Brown K, Dagnall C, Xu R, Gibbons GH, Davis SK. Association of Childhood Socioeconomic Status with Leukocyte Telomere Length Among African Americans and the Mediating Role of Behavioral and Psychosocial Factors: Results from the GENE-FORECAST Study. J Racial Ethn Health Disparities 2021; 9:1012-1023. [PMID: 33948907 PMCID: PMC9061663 DOI: 10.1007/s40615-021-01040-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/04/2021] [Accepted: 04/05/2021] [Indexed: 11/26/2022]
Abstract
Purpose We examined if childhood socioeconomic status (SES) was related to adult leucocyte telomere length (TL) using the data of 361 African American (AA) participants from the GENE-FORECAST Study. We also assessed the mediating role of behavioral and psychosocial factors in the association between childhood SES and adult TL. Methods Childhood SES was assessed individually by using participant’s mother’s education and occupation, father’s education and occupation, parental home ownership, and family structure. TL was assessed using the quantitative polymerase chain reaction method. Information on potential confounders and mediators were collected. The associations of childhood SES with TL were assessed using multivariable linear regression models. We used path analysis to quantify and test the share of these associations that was statistically explained by each of the mediators (participant’s educational attainment, smoking status, physical activity, dietary habit, perceived stress, and depressive symptoms). Results Mother’s education was associated with longer average TL (β: 0.021; 95% CI: 0.001, 0.04, p=0.038) in confounder adjusted models. Once mediators were introduced in the model, the estimates were reduced and remained marginally significant (β: 0.017; 95% CI: −0.003, 0.038, p=0.061). According to path model, approximately 19% of the effect of mother’s education on TL (β: 0.004; 95% CI: −0.001, 0.01, p < 0.10) was mediated through participant’s own education level. No significant mediation effect was observed for any other mediators. Conclusions These data provide evidence that participant’s mother’s education was positively linked to adult TL in AA population. Participant’s own educational level partially explained this association. Supplementary Information The online version contains supplementary material available at 10.1007/s40615-021-01040-5.
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Affiliation(s)
- Rumana J Khan
- Cardiovascular Section, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Room 7N316 MSC 1644, Bethesda, MD, USA.
| | - Belinda L Needham
- Department of Epidemiology, School of Public Health, University of Michigan, 1415, Ann Arbor, Washington Heights, MI, USA
| | - Shailesh Advani
- Cardiovascular Section, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Room 7N316 MSC 1644, Bethesda, MD, USA
| | - Kristen Brown
- Cardiovascular Section, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Room 7N316 MSC 1644, Bethesda, MD, USA
| | - Casey Dagnall
- Cancer Genomics Research Laboratory, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Ruihua Xu
- Cardiovascular Section, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Room 7N316 MSC 1644, Bethesda, MD, USA
| | - Gary H Gibbons
- Cardiovascular Disease Section, Metabolic, Cardiovascular and Inflammatory Disease, Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sharon K Davis
- Cardiovascular Section, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Room 7N316 MSC 1644, Bethesda, MD, USA
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26
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Barnes AJ, Gower AL, Sajady M, Lingras KA. Health and adverse childhood experiences among homeless youth. BMC Pediatr 2021; 21:164. [PMID: 33827511 PMCID: PMC8025366 DOI: 10.1186/s12887-021-02620-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/21/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Homelessness is associated with health problems and with adverse childhood experiences (ACEs). The risk of chronic health conditions for homeless compared to housed youth, and how this risk interacts with ACEs remains unclear. This study investigated the relationship between ACEs, housing, and child health, and whether: 1) ACEs and health vary by housing context; 2) ACEs and homelessness confer independent health risks; and 3) ACEs interact with housing with regard to adolescent health. METHODS Using data from 119,254 8th-11th graders, we tested independent and joint effects of ACEs and past-year housing status (housed, family homelessness, unaccompanied homelessness) on overall health and chronic health conditions, controlling for sociodemographic covariates. RESULTS The prevalence of ACEs varied by housing status, with 34.1% of housed youth experiencing ≥1 ACE vs. 56.3% of family-homeless and 85.5% of unaccompanied-homeless youth. Health status varied similarly. Homelessness and ACEs were independently associated with low overall health and chronic health conditions, after adjusting for covariates. Compared to housed youth, both family-homeless youth and unaccompanied-homeless youth had increased odds of low overall health and chronic physical and/or mental health conditions. All ACE x housing-status interactions were significant (all p < 0.001), such that ACE-related health risks were moderated by housing status. CONCLUSIONS ACEs and housing status independently predict health status during adolescence beyond other sociodemographic risks. Experiencing homelessness, whether unaccomapnied or with family, is associated with increased health risk, and every additional ACE increases this risk. Clinicians and health systems should advocate for policies that include stable housing as a protective factor.
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Affiliation(s)
- Andrew J Barnes
- Developmental-Behavioral Pediatrics, Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
| | - Amy L Gower
- Department of Pediatrics, University of Minnesota Medical School, 717 Delaware Street SE, Minneapolis, MN, 55414, USA
| | - Mollika Sajady
- Children's Minnesota Developmental Pediatrics, 2530 Chicago Ave S STE G055, Minneapolis, MN, 55404, USA
| | - Katherine A Lingras
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
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27
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Banihashemi L, Peng CW, Verstynen T, Wallace ML, Lamont DN, Alkhars HM, Yeh FC, Beeney JE, Aizenstein HJ, Germain A. Opposing relationships of childhood threat and deprivation with stria terminalis white matter. Hum Brain Mapp 2021; 42:2445-2460. [PMID: 33739544 PMCID: PMC8090789 DOI: 10.1002/hbm.25378] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 01/27/2021] [Accepted: 02/04/2021] [Indexed: 12/12/2022] Open
Abstract
While stress may be a potential mechanism by which childhood threat and deprivation influence mental health, few studies have considered specific stress‐related white matter pathways, such as the stria terminalis (ST) and medial forebrain bundle (MFB). Our goal was to examine the relationships between childhood adversity and ST and MFB structural integrity and whether these pathways may provide a link between childhood adversity and affective symptoms and disorders. Participants were young adults (n = 100) with a full distribution of maltreatment history and affective symptom severity. Threat was determined by measures of childhood abuse and repeated traumatic events. Socioeconomic deprivation (SED) was determined by a measure of childhood socioeconomic status (parental education). Participants underwent diffusion spectrum imaging. Human Connectome Project data was used to perform ST and MFB tractography; these tracts were used as ROIs to extract generalized fractional anisotropy (gFA) from each participant. Childhood threat was associated with ST gFA, such that greater threat was associated with less ST gFA. SED was also associated with ST gFA, however, conversely to threat, greater SED was associated with greater ST gFA. Additionally, threat was negatively associated with MFB gFA, and MFB gFA was negatively associated with post‐traumatic stress symptoms. Our results suggest that childhood threat and deprivation have opposing influences on ST structural integrity, providing new evidence that the context of childhood adversity may have an important influence on its neurobiological effects, even on the same structure. Further, the MFB may provide a novel link between childhood threat and affective symptoms.
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Affiliation(s)
- Layla Banihashemi
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Christine W Peng
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Timothy Verstynen
- Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Daniel N Lamont
- Petersen Institute of NanoScience and Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Hussain M Alkhars
- Department of Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Fang-Cheng Yeh
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Joseph E Beeney
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Howard J Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Anne Germain
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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28
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Plasma Arginase-1 Level Is Associated with the Mental Status of Outpatients with Chronic Liver Disease. Diagnostics (Basel) 2021; 11:diagnostics11020317. [PMID: 33669265 PMCID: PMC7920070 DOI: 10.3390/diagnostics11020317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/09/2021] [Accepted: 02/14/2021] [Indexed: 11/21/2022] Open
Abstract
While plasma arginase-1 has been suggested as a biomarker of mental status in healthy individuals, it has not been evaluated in patients with chronic liver disease. This cross-sectional study investigated the utility of plasma arginase-1 for screening mental status in patients with chronic liver disease. This study included outpatients with chronic liver disease who underwent regular check-ups at Okayama University Hospital between September 2018 and January 2019. In addition to the standard blood tests, the plasma arginase-1 level was analyzed. The patients’ mental status was assessed using the Japanese version of the General Health Questionnaire-28 (GHQ-28). The associations between mental status and various parameters, including plasma arginase-1, were investigated using logistic regression analysis. Among 114 participating patients, 8 were excluded, comprising 6 with insufficient blood samples for plasma arginase-1 measurement and 2 with incomplete questionnaires. Multivariate binomial logistic regression analysis revealed that plasma arginase-1 was significantly and negatively associated with the GHQ-total score, especially somatic symptoms. Therefore, plasma arginase-1 may be a useful biomarker for assessing the mental status of outpatients with chronic liver disease.
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29
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Yao Y, Lawrence DA. Susceptibility to COVID-19 in populations with health disparities: Posited involvement of mitochondrial disorder, socioeconomic stress, and pollutants. J Biochem Mol Toxicol 2021; 35:e22626. [PMID: 32905655 PMCID: PMC9340490 DOI: 10.1002/jbt.22626] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/30/2020] [Accepted: 08/25/2020] [Indexed: 12/18/2022]
Abstract
SARS-CoV-2 is a novel betacoronavirus that has caused the global health crisis known as COVID-19. The implications of mitochondrial dysfunction with COVID-19 are discussed as well as deregulated mitochondria and inter-organelle functions as a posited comorbidity enhancing detrimental outcomes. Many environmental chemicals (ECs) and endocrine-disrupting chemicals can do damage to mitochondria and cause mitochondrial dysfunction. During infection, SARS-CoV-2 via its binding target ACE2 and TMPRSS2 can disrupt mitochondrial function. Viral genomic RNA and structural proteins may also affect the normal function of the mitochondria-endoplasmic reticulum-Golgi apparatus. Drugs considered for treatment of COVID-19 should consider effects on organelles including mitochondria functions. Mitochondrial self-balance and clearance via mitophagy are important in SARS-CoV-2 infection, which indicate monitoring and protection of mitochondria against SARS-CoV-2 are important. Mitochondrial metabolomic analysis may provide new indicators of COVID-19 prognosis. A better understanding of the role of mitochondria during SARS-CoV-2 infection may help to improve intervention therapies and better protect mitochondrial disease patients from pathogens as well as people living with poor nutrition and elevated levels of socioeconomic stress and ECs.
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Affiliation(s)
- Yunyi Yao
- Wadsworth Center, New York State Department of Health, Center for Medical Science, Albany, New York
| | - David A Lawrence
- Wadsworth Center, New York State Department of Health, Center for Medical Science, Albany, New York
- Department of Environmental Health Sciences, University at Albany School of Public Health, Rensselaer, New York
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30
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Morris G, Bortolasci CC, Puri BK, Olive L, Marx W, O'Neil A, Athan E, Carvalho A, Maes M, Walder K, Berk M. Preventing the development of severe COVID-19 by modifying immunothrombosis. Life Sci 2021; 264:118617. [PMID: 33096114 PMCID: PMC7574725 DOI: 10.1016/j.lfs.2020.118617] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/01/2020] [Accepted: 10/13/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND COVID-19-associated acute respiratory distress syndrome (ARDS) is associated with significant morbidity and high levels of mortality. This paper describes the processes involved in the pathophysiology of COVID-19 from the initial infection and subsequent destruction of type II alveolar epithelial cells by SARS-CoV-2 and culminating in the development of ARDS. MAIN BODY The activation of alveolar cells and alveolar macrophages leads to the release of large quantities of proinflammatory cytokines and chemokines and their translocation into the pulmonary vasculature. The presence of these inflammatory mediators in the vascular compartment leads to the activation of vascular endothelial cells platelets and neutrophils and the subsequent formation of platelet neutrophil complexes. These complexes in concert with activated endothelial cells interact to create a state of immunothrombosis. The consequence of immunothrombosis include hypercoagulation, accelerating inflammation, fibrin deposition, migration of neutrophil extracellular traps (NETs) producing neutrophils into the alveolar apace, activation of the NLRP3 inflammazome, increased alveolar macrophage destruction and massive tissue damage by pyroptosis and necroptosis Therapeutic combinations aimed at ameliorating immunothrombosis and preventing the development of severe COVID-19 are discussed in detail.
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Affiliation(s)
- Gerwyn Morris
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Chiara C Bortolasci
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Deakin University, Centre for Molecular and Medical Research, School of Medicine, Geelong, Australia
| | | | - Lisa Olive
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; School of Psychology, Deakin University, Geelong, Australia
| | - Wolfgang Marx
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Adrienne O'Neil
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Melbourne School of Population and Global Health, Melbourne, Australia
| | - Eugene Athan
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Barwon Health, Geelong, Australia
| | - Andre Carvalho
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Department of Psychiatry, University of Toronto, Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Michael Maes
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Department of Psychiatry, King Chulalongkorn University Hospital, Bangkok, Thailand; Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Ken Walder
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Deakin University, Centre for Molecular and Medical Research, School of Medicine, Geelong, Australia
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia.
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31
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Lopez M, Ruiz MO, Rovnaghi CR, Tam GKY, Hiscox J, Gotlib IH, Barr DA, Carrion VG, Anand KJS. The social ecology of childhood and early life adversity. Pediatr Res 2021; 89:353-367. [PMID: 33462396 PMCID: PMC7897233 DOI: 10.1038/s41390-020-01264-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/14/2020] [Accepted: 10/12/2020] [Indexed: 01/30/2023]
Abstract
An increasing prevalence of early childhood adversity has reached epidemic proportions, creating a public health crisis. Rather than focusing only on adverse childhood experiences (ACEs) as the main lens for understanding early childhood experiences, detailed assessments of a child's social ecology are required to assess "early life adversity." These should also include the role of positive experiences, social relationships, and resilience-promoting factors. Comprehensive assessments of a child's physical and social ecology not only require parent/caregiver surveys and clinical observations, but also include measurements of the child's physiology using biomarkers. We identify cortisol as a stress biomarker and posit that hair cortisol concentrations represent a summative and chronological record of children's exposure to adverse experiences and other contextual stressors. Future research should use a social-ecological approach to investigate the robust interactions among adverse conditions, protective factors, genetic and epigenetic influences, environmental exposures, and social policy, within the context of a child's developmental stages. These contribute to their physical health, psychiatric conditions, cognitive/executive, social, and psychological functions, lifestyle choices, and socioeconomic outcomes. Such studies must inform preventive measures, therapeutic interventions, advocacy efforts, social policy changes, and public awareness campaigns to address early life adversities and their enduring effects on human potential. IMPACT: Current research does not support the practice of using ACEs as the main lens for understanding early childhood experiences. The social ecology of early childhood provides a contextual framework for evaluating the long-term health consequences of early life adversity. Comprehensive assessments reinforced with physiological measures and/or selected biomarkers, such as hair cortisol concentrations to assess early life stress, may provide critical insights into the relationships between early adversity, stress axis regulation, and subsequent health outcomes.
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Affiliation(s)
- Marcela Lopez
- Pain/Stress Neurobiology Lab, Maternal & Child Health Research Institute, Stanford University School of Medicine
| | - Monica O. Ruiz
- Pain/Stress Neurobiology Lab, Maternal & Child Health Research Institute, Stanford University School of Medicine,Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Cynthia R. Rovnaghi
- Pain/Stress Neurobiology Lab, Maternal & Child Health Research Institute, Stanford University School of Medicine
| | - Grace K-Y. Tam
- Pain/Stress Neurobiology Lab, Maternal & Child Health Research Institute, Stanford University School of Medicine
| | - Jitka Hiscox
- Pain/Stress Neurobiology Lab, Maternal & Child Health Research Institute, Stanford University School of Medicine,Department of Civil Engineering, Stanford School of Engineering, Stanford, CA
| | - Ian H. Gotlib
- Department of Psychology, Stanford University School of Humanities & Sciences, Stanford, CA
| | - Donald A. Barr
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA,Stanford University Graduate School of Education, Stanford, CA
| | - Victor G. Carrion
- Department of Psychiatry (Child and Adolescent Psychiatry), Clinical & Translational Neurosciences Incubator, Stanford University School of Medicine, Stanford, CA
| | - Kanwaljeet J. S. Anand
- Pain/Stress Neurobiology Lab, Maternal & Child Health Research Institute, Stanford University School of Medicine,Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
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West AN, Diaz-Thomas AM, Shafi NI. Evidence Limitations in Determining Sexually Dimorphic Outcomes in Pediatric Post-Traumatic Hypopituitarism and the Path Forward. Front Neurol 2020; 11:551923. [PMID: 33324312 PMCID: PMC7726201 DOI: 10.3389/fneur.2020.551923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 09/16/2020] [Indexed: 11/21/2022] Open
Abstract
Neuroendocrine dysfunction can occur as a consequence of traumatic brain injury (TBI), and disruptions to the hypothalamic-pituitary axis can be especially consequential to children. The purpose of our review is to summarize current literature relevant to studying sex differences in pediatric post-traumatic hypopituitarism (PTHP). Our understanding of incidence, time course, and impact is constrained by studies which are primarily small, are disadvantaged by significant methodological challenges, and have investigated limited temporal windows. Because hormonal changes underpin the basis of growth and development, the timing of injury and PTHP testing with respect to pubertal stage gains particular importance. Reciprocal relationships among neuroendocrine function, TBI, adverse childhood events, and physiological, psychological and cognitive sequelae are underconsidered influencers of sexually dimorphic outcomes. In light of the tremendous heterogeneity in this body of literature, we conclude with the common path upon which we must collectively arrive in order to make progress in understanding PTHP.
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Affiliation(s)
- Alina Nico West
- Division of Critical Care Medicine, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Alicia M Diaz-Thomas
- Division of Endocrinology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Nadeem I Shafi
- Division of Critical Care Medicine, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States
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33
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Luo S, Hou Y, Zhang Y, Feng L, Hunter RG, Yuan P, Jia Y, Li H, Wang G, K Manji H, S McEwen B, Xiao C, Bao H, Du J. Bag-1 mediates glucocorticoid receptor trafficking to mitochondria after corticosterone stimulation: Potential role in regulating affective resilience. J Neurochem 2020; 158:358-372. [PMID: 33025573 DOI: 10.1111/jnc.15211] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 08/31/2020] [Accepted: 09/29/2020] [Indexed: 01/03/2023]
Abstract
Molecular abnormalities within the Glucocorticoid Receptor (GR) stress signaling pathway involved in dysfunction of mitochondria and confer vulnerability to stress-related psychiatric disorders. Bcl-2 associated athanogene (Bag-1) is a target for the actions of mood stabilizers. Bag-1 interacts with GR, thereby regulating glucocorticoid function. In this study, we investigate the potential role of Bag-1 in regulating GR translocation into mitochondria. Corticosterone (CORT) treatment significantly enhanced Bag-1/GR complex formation and GR mitochondrial translocation in cultured rat cortical neurons after treatment for 30 min and 24 hr. By contrast, after stimulation with CORT for 3 days, localization of the Bag-1/GR complex and mitochondrial GR were reduced. Similar results were obtained in mice, in which administrated CORT in drinking water for 21 days significantly impaired the GR levels in the mitochondria, while Bag-1 over-expression rescued this reduction. Furthermore, chronic CORT exposure led to anhedonia-like and depression-like behaviors in the sucrose-consumption test and forced swimming test, and these behaviors were rescued by Bag-1 over-expression. These results suggest that Bag-1 mediates GR trafficking to mitochondria and regulates affective resilience in response to a CORT increase and provide potential insight into the mechanisms by which Bag-1 and GR could contribute to the physiology and pathogenesis of psychiatric disorders in response to the change of stress hormone.
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Affiliation(s)
- Shaolei Luo
- School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Yangyang Hou
- School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Yaping Zhang
- School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Lei Feng
- The National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, & Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Richard G Hunter
- Department of Psychology, Developmental and Brain Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Peixiong Yuan
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Yue Jia
- School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Haoran Li
- School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, & Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | | | - Bruce S McEwen
- Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, The Rockefeller University, New York, NY, USA
| | - Chunjie Xiao
- School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Hongkun Bao
- School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China
| | - Jing Du
- School of Medicine, Yunnan University, Kunming, Yunnan, P. R. China.,The National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, & Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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Perrin JM, Duncan G, Diaz A, Kelleher K. Principles And Policies To Strengthen Child And Adolescent Health And Well-Being. Health Aff (Millwood) 2020; 39:1677-1683. [PMID: 33017241 DOI: 10.1377/hlthaff.2020.00709] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Four recent reports from the National Academies of Sciences, Engineering, and Medicine framed around the issues of poverty; mental, emotional, and behavioral health; adolescence; and young family health and education build on extensive recent evidence of what can be done to improve the health and well-being of children, youth, and families. We describe the process of generating the reports, briefly summarize each report's content, and identify crosscutting themes and recommendations. We also note how the coronavirus disease 2019 (COVID-19) pandemic highlights major disparities and systemic problems addressed in the reports and heightens the relevance of their policy recommendations. The reports issue a unified, urgent call for measures with the potential to change the trajectory and outcomes for children and youth. Among these are basic income supports, other family supports, universal health care structured to meet family needs, and a broad national policy that prioritizes children and youth.
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Affiliation(s)
- James M Perrin
- James M. Perrin is a professor of pediatrics at Harvard Medical School and holds the John C. Robinson Distinguished Chair in Pediatrics at MassGeneral Hospital for Children, both in Boston, Massachusetts
| | - Greg Duncan
- Greg Duncan is a professor of education at the University of California Irvine, in Irvine, California
| | - Angela Diaz
- Angela Diaz is a professor of pediatrics, environmental medicine, and public health at the Icahn School of Medicine at Mt. Sinai, in New York, New York
| | - Kelly Kelleher
- Kelly Kelleher is a professor of pediatrics and psychiatry at Nationwide Children's Hospital and the Ohio State University School of Medicine, in Columbus, Ohio
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35
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Morris G, Puri BK, Olive L, Carvalho A, Berk M, Walder K, Gustad LT, Maes M. Endothelial dysfunction in neuroprogressive disorders-causes and suggested treatments. BMC Med 2020; 18:305. [PMID: 33070778 PMCID: PMC7570030 DOI: 10.1186/s12916-020-01749-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/16/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Potential routes whereby systemic inflammation, oxidative stress and mitochondrial dysfunction may drive the development of endothelial dysfunction and atherosclerosis, even in an environment of low cholesterol, are examined. MAIN TEXT Key molecular players involved in the regulation of endothelial cell function are described, including PECAM-1, VE-cadherin, VEGFRs, SFK, Rho GEF TRIO, RAC-1, ITAM, SHP-2, MAPK/ERK, STAT-3, NF-κB, PI3K/AKT, eNOS, nitric oxide, miRNAs, KLF-4 and KLF-2. The key roles of platelet activation, xanthene oxidase and myeloperoxidase in the genesis of endothelial cell dysfunction and activation are detailed. The following roles of circulating reactive oxygen species (ROS), reactive nitrogen species and pro-inflammatory cytokines in the development of endothelial cell dysfunction are then described: paracrine signalling by circulating hydrogen peroxide, inhibition of eNOS and increased levels of mitochondrial ROS, including compromised mitochondrial dynamics, loss of calcium ion homeostasis and inactivation of SIRT-1-mediated signalling pathways. Next, loss of cellular redox homeostasis is considered, including further aspects of the roles of hydrogen peroxide signalling, the pathological consequences of elevated NF-κB, compromised S-nitrosylation and the development of hypernitrosylation and increased transcription of atherogenic miRNAs. These molecular aspects are then applied to neuroprogressive disorders by considering the following potential generators of endothelial dysfunction and activation in major depressive disorder, bipolar disorder and schizophrenia: NF-κB; platelet activation; atherogenic miRs; myeloperoxidase; xanthene oxidase and uric acid; and inflammation, oxidative stress, nitrosative stress and mitochondrial dysfunction. CONCLUSIONS Finally, on the basis of the above molecular mechanisms, details are given of potential treatment options for mitigating endothelial cell dysfunction and activation in neuroprogressive disorders.
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Affiliation(s)
- Gerwyn Morris
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | | | - Lisa Olive
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
| | - Andre Carvalho
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Michael Berk
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia.
- Orygen, The National Centre of Excellence in Youth Mental Health, the Department of Psychiatry and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia.
| | - Ken Walder
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - Lise Tuset Gustad
- Department of Circulation and medical imaging, Norwegian University of Technology and Science (NTNU), Trondheim, Norway
- Nord-Trøndelag Hospital Trust, Levanger Hospital, Levanger, Norway
| | - Michael Maes
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
- Department of Psychiatry, King Chulalongkorn University Hospital, Bangkok, Thailand
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
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Thompson C, Szabo A. Psychedelics as a novel approach to treating autoimmune conditions. Immunol Lett 2020; 228:45-54. [PMID: 33035575 DOI: 10.1016/j.imlet.2020.10.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/12/2020] [Accepted: 10/01/2020] [Indexed: 12/12/2022]
Abstract
With a rise in the incidence of autoimmune diseases (AiD), health care providers continue to seek out more efficacious treatment approaches for the AiD patient population. Classic serotonergic psychedelics have recently been gaining public and professional interest as novel interventions to a number of mental health afflictions. Psychedelics have also been shown to be able to modulate immune functions, however, while there has been great interest to researching into their psychotherapeutic applications, there has so far been very little exploration into the potential to treat inflammatory and immune-related diseases with these compounds. A handful of studies from a variety of fields suggest that psychedelics do indeed have effects in the body that may attenuate the outcome of AiD. This literature review explores existing evidence that psychedelic compounds may offer a potential novel application in the treatment of pathologies related to autoimmunity. We propose that psychedelics hold the potential to attenuate or even resolve autoimmunity by targeting psychosomatic origins, maladaptive chronic stress responses, inflammatory pathways, immune modulation and enteric microbiome populations.
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Affiliation(s)
| | - Attila Szabo
- NORMENT Center of Excellence (CoE), Institute of Clinical Medicine, University of Oslo, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Medical Genetics, Oslo University Hospital, Oslo, Norway.
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Fowler C, Homandberg L, Steele C, Bolt MA, Tintle N, Van De Griend K, Ulrich R, Christians M. Adult correlates of adverse childhood experiences in Ukraine. CHILD ABUSE & NEGLECT 2020; 107:104617. [PMID: 32702584 DOI: 10.1016/j.chiabu.2020.104617] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 06/16/2020] [Accepted: 06/22/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The impact of adverse childhood experiences (ACEs) on adult life outcomes is well-documented by a considerable body of research. This study investigates the relationship between ACEs and both physical and mental health outcomes in a nationally representative sample of Ukrainian adults. OBJECTIVE The aim of this study was to analyze whether ACEs are associated with lifetime physical and mental health outcomes in a nationally representative sample of Ukrainian adults. Participants and Setting In 2002, the World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was administered to a national probability sample of Ukrainian adults (n = 4725). METHODS Associations between ACEs and later life physical and mental health outcomes are examined using logistic regression models. RESULTS ACEs were significantly correlated with poor later life mental and physical health. Participants with three or more ACEs were most likely to have chronic pain, cardiovascular disease, other disease, depressive disorders, anxiety disorders, substance abuse disorders, and all disability metrics analyzed. Adjusted odds ratios for these models ranged from 1.80 to 3.81. Additionally, we found a large association between the number of ACES and later negative health outcomes. CONCLUSIONS Our results indicate that in Ukraine, ACEs have a strong negative effect on later life mental and physical health. Further research is needed to explore specific ACEs and examine potential mediators such as social support in the relationship between ACEs and health outcomes.
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Affiliation(s)
| | - Lydia Homandberg
- Auburn University, 182 S College St, Auburn, Alabama 36849, USA.
| | - Christina Steele
- University of Pennsylvania, 1 College Hall, Room 1, Philadelphia, PA 19104-6376, USA.
| | - Matthew A Bolt
- Dordt University, 700 7th St NE, Sioux Center, IA 51250, USA.
| | - Nathan Tintle
- Dordt University, 700 7th St NE, Sioux Center, IA 51250, USA.
| | | | - Rachel Ulrich
- Montana State University, Culbertson Hall, 100, Bozeman, MT 59717, USA.
| | - Mark Christians
- Dordt University, 700 7th St NE, Sioux Center, IA 51250, USA.
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38
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Affiliation(s)
- George A. Mensah
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
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39
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The Association Between Adverse Childhood Experiences (ACEs) and Postoperative Bariatric Surgery Weight Loss Outcomes. Obes Surg 2020; 30:4258-4266. [PMID: 32562131 DOI: 10.1007/s11695-020-04779-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE Previous research demonstrates that exposure to adverse childhood experiences (ACEs) is associated with development of obesity. The same mechanisms mediating this relationship could theoretically affect attempts to lose weight in adulthood. However, it is unclear whether or not exposure to ACEs impacts the effectiveness of bariatric surgery. The present study aimed to examine the association of exposure to ACEs to postoperative weight loss outcomes. MATERIALS AND METHODS One hundred ninety-eight patients undergoing bariatric surgery were evaluated for their exposure to ACEs, determined by a presurgical questionnaire and recorded as an ACEs score. Percent total weight loss (%TWL) was calculated to evaluate postoperative weight loss at 1-, 3-, and 6-month intervals postoperatively. One hundred forty-two participants were available for follow-up at the 6-month postoperative interval. RESULTS The sample consisted of 167 women and 31 men with a mean age of 47.7. Twenty-five percent of participants experienced high exposure to ACEs, defined as experiencing ≥ 4 ACEs. The average %TWL at 6 months was 16.52%. Multilevel modeling found no significant relationship between ACEs score and %TWL at any of the postoperative time intervals, both before and after adjusting for age, sex, and race. CONCLUSION High exposure to ACEs was not associated with poorer weight loss outcomes, and participants with a large number of ACEs generally lost the anticipated amount of weight.
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Tracy DK, Holloway F, Hanson K, James A, Strathdee G, Holmes D, Kalidindi S, Shergill SS. Why care about integrated care? Part I. Demographics, finances and workforce: immovable objects facing mental health services. BJPSYCH ADVANCES 2020. [DOI: 10.1192/bja.2019.78] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Demands on health and social care are growing in quantity and complexity, with resources and staffing not projected to match this. The landmark NHS Long Term Plan calls for services in England to be delivered differently through integrated care systems (ICSs) that will better join commissioners and providers, and health and social care. The scale of these changes is immense, and the detail can feel confusing. However, they are important and will affect all clinicians in the public service. This three-part series provides a primer on integrated care, explaining why it is happening, how services are changing and why clinicians should get involved. In this first article we focus on the changing demographics, and the workforce and financial resources required to address these.
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Morris G, Puri BK, Carvalho A, Maes M, Berk M, Ruusunen A, Olive L. Induced Ketosis as a Treatment for Neuroprogressive Disorders: Food for Thought? Int J Neuropsychopharmacol 2020; 23:366-384. [PMID: 32034911 PMCID: PMC7311648 DOI: 10.1093/ijnp/pyaa008] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 01/05/2020] [Accepted: 02/06/2020] [Indexed: 12/12/2022] Open
Abstract
Induced ketosis (or ketone body ingestion) can ameliorate several changes associated with neuroprogressive disorders, including schizophrenia, bipolar disorder, and major depressive disorder. Thus, the effects of glucose hypometabolism can be bypassed through the entry of beta-hydroxybutyrate, providing an alternative source of energy to glucose. The weight of evidence suggests that induced ketosis reduces levels of oxidative stress, mitochondrial dysfunction, and inflammation-core features of the above disorders. There are also data to suggest that induced ketosis may be able to target other molecules and signaling pathways whose levels and/or activity are also known to be abnormal in at least some patients suffering from these illnesses such as peroxisome proliferator-activated receptors, increased activity of the Kelch-like ECH-associated protein/nuclear factor erythroid 2-related factor 2, Sirtuin-1 nuclear factor-κB p65, and nicotinamide adenine dinucleotide (NAD). This review explains the mechanisms by which induced ketosis might reduce mitochondrial dysfunction, inflammation, and oxidative stress in neuropsychiatric disorders and ameliorate abnormal levels of molecules and signaling pathways that also appear to contribute to the pathophysiology of these illnesses. This review also examines safety data relating to induced ketosis over the long term and discusses the design of future studies.
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Affiliation(s)
- Gerwyn Morris
- The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Australia
| | - Basant K Puri
- C.A.R., Cambridge, United Kingdom,Hammersmith Hospital, London, United Kingdom
| | - Andre Carvalho
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Michael Maes
- Department of Psychiatry and Medical Psychology, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria,Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Australia,Orygen, The National Centre of Excellence in Youth Mental Health, the Department of Psychiatry, and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Australia,Correspondence: Michael Berk, PO Box 281 Geelong, Victoria 3220 Australia ()
| | - Anu Ruusunen
- The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Australia
| | - Lisa Olive
- The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Australia
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Uchitel J, Alden E, Bhutta ZA, Goldhagen J, Narayan AP, Raman S, Spencer N, Wertlieb D, Wettach J, Woolfenden S, Mikati MA. The Rights of Children for Optimal Development and Nurturing Care. Pediatrics 2019; 144:peds.2019-0487. [PMID: 31771960 DOI: 10.1542/peds.2019-0487] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/19/2019] [Indexed: 11/24/2022] Open
Abstract
Millions of children are subjected to abuse, neglect, and displacement, and millions more are at risk for not achieving their developmental potential. Although there is a global movement to change this, driven by children's rights, progress is slow and impeded by political considerations. The United Nations Convention on the Rights of the Child, a global comprehensive commitment to children's rights ratified by all countries in the world except the United States (because of concerns about impingement on sovereignty and parental authority), has a special General Comment on "Implementing Child Rights in Early Childhood." More recently, the World Health Organization and United Nations Children's Fund have launched the Nurturing Care Framework for Early Childhood Development (ECD), which calls for public policies that promote nurturing care interventions and addresses 5 interrelated components that are necessary for optimal ECD. This move is also complemented by the Human Capital Project of the World Bank, providing a focus on the need for investments in child health and nutrition and their long-term benefits. In this article, we outline children's rights under international law, the underlying scientific evidence supporting attention to ECD, and the philosophy of nurturing care that ensures that children's rights are respected, protected, and fulfilled. We also provide pediatricians anywhere with the policy and rights-based frameworks that are essential for them to care for and advocate for children and families to ensure optimal developmental, health, and socioemotional outcomes. These recommendations do not necessarily reflect American Academy of Pediatrics policy.
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Affiliation(s)
| | - Errol Alden
- International Pediatric Association and Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Zulfiqar A Bhutta
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan.,Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | - Jeffrey Goldhagen
- Division of Community and Societal Pediatrics, Department of Pediatrics, College of Medicine, University of Florida, Jacksonville, Florida
| | | | - Shanti Raman
- International Pediatrics Association Standing Committee, International Society of Social Pediatrics and Child Health, Geneva, Switzerland.,Division of Community Pediatric, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Nick Spencer
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Donald Wertlieb
- Eliot-Pearson Department of Child Study and Human Development, School of Arts and Sciences, Tufts University, Medford, Massachusetts
| | - Jane Wettach
- Duke Children's Law Clinic, School of Law, Duke University, Durham, North Carolina; and
| | - Sue Woolfenden
- Discipline of Paediatrics, School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Mohamad A Mikati
- Division of Pediatric Neurology and .,Early Childhood Development Standing Advisory Group, International Pediatrics Association, St Louis, Missouri
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Abstract
Social inequality refers to the inequitable distribution of social prosperity including the resource of health. The relationship between social inequality and mental health can be established by means of indicators of social inequality throughout all age groups in Germany. There are social gradients of mental health on the population level, i.e. the linear relationship between social classes or status and state of health. Fundamental determinants of health disparity are cultural, social, political, and geographical conditions, which interact with the genetic make-up and epigenetic processes. These determinants also influence the management of developmental tasks during the life course and are of utmost importance for the development of mental disorders. The maladaptation to chronic stress is at the core of health disparity. Interventions at the individual behavioral level should comprise the development of stress management and coping strategies.
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Affiliation(s)
- A Hoell
- Arbeitsgruppe Versorgungsforschung, Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim/Universität Heidelberg, 68159, Mannheim, Deutschland.
| | - H J Salize
- Arbeitsgruppe Versorgungsforschung, Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim/Universität Heidelberg, 68159, Mannheim, Deutschland
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Stubbs K, Merrill BM. Addiction Disorder Considerations for Patients Seeking Psychotherapy. INNOVATIONS IN CLINICAL NEUROSCIENCE 2019; 16:11-15. [PMID: 31214477 PMCID: PMC6538396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Substance use disorders are widespread and cause significant dysfunction. Substance use disorders often co-occur with other psychiatric disorders. Because of this overlap, clinicians commonly encounter patients at risk for substance abuse disorders. This article reviews strategies to aid the practicing clinician in the screening, assessment, intervention, and referral of their parents at risk for substance use disorders.
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Affiliation(s)
- Kimberly Stubbs
- Dr. Stubbs is Clinical Chief Resident, and Dr. Merrill is Assistant Professor and Director of Community Psychiatry at Wright State University Boonshoft School of Medicine in Dayton, Ohio
| | - Brian M Merrill
- Dr. Stubbs is Clinical Chief Resident, and Dr. Merrill is Assistant Professor and Director of Community Psychiatry at Wright State University Boonshoft School of Medicine in Dayton, Ohio
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