Early parental death: relation to electrodermal orienting response and gender in schizophrenia

Grief as a Risk Factor for Psychosis: A Systematic Review

PURPOSE OF REVIEW

The assessment of the risk of triggering psychosis upon exposure to grief is a challenge in clinical practice. Adequate diagnosis and early prevention are essential and may be helpful in the evolution of normal grief. We aimed to identify studies exploring grief as a risk factor for developing psychosis.

RECENT FINDINGS

A systematic review of 3 databases (PubMed, EMBASE, and Cochrane Library) was conducted.

RESULTS

In the first approach 618 studies were identified. After the selection process, 15 studies were included in the review. The association between grief and the risk of developing psychosis occurred at younger ages (before 18 years of age) in a first-degree relative and as a consequence of suicide or accidental death. We found that risk factors such as comorbidity, mental problems, unemployment, economic difficulties, and close ties with the deceased have a negative impact on health causing greater vulnerability to psychosis with a risk of developing complicated grief, with statistically significant results regarding the associations between early parental death and the probability of developing psychosis in adulthood.

Epigenetic epidemiology in psychiatry: A translational neuroscience perspective

Accumulating evidence from the field of neuroscience indicates a crucial role for epigenetic regulation of gene expression in development and aging of nervous system and suggests that aberrations in the epigenetic machinery are involved in the etiology of psychiatric disorders. Epidemiologic evidence on epigenetics in psychiatry, however, is currently very sparsely available, but is consistent with a mediating role for epigenetic mechanisms in bringing together inherited and acquired risk factors into a neurodevelopmental etiological model of psychiatric disorders. Here, we review evidence from the epidemiological and neuroscience literature, and aim to converge the evidence into an etiological model of psychiatric disorders that encompasses environmental, genetic and epigenetic contributions. Given the dynamic nature of the epigenetic machinery and the potential reversibility of epigenetic modifications, future well-designed interdisciplinary and translational studies will be of key importance in order to identify new targets for prevention and therapeutic strategies.

Attachment and loss experiences during childhood are associated with adult hostility, depression, and social support

OBJECTIVES

This study examined developmental antecedents to psychosocial traits in adulthood that have been linked in prior studies to increased risk of heart disease. The hypothesis was tested that early parental loss coupled with poor-quality family relationships (FR) during childhood would be associated with increased hostility and depression, and lower social support in adulthood.

METHODS

Participants included 30 university students who experienced the death of one parent before the age of 16, and 31 control participants. Questionnaires were completed measuring current social support, hostility, depression, and the quality of FR.

RESULTS

Multivariate analysis of variance (MANOVA) supported the hypothesis of maladaptive psychosocial characteristics in loss participants reporting poorer-quality FR. Significant interactions of loss and FR were found for individual variables of depressive symptoms, social support, and hostility.

CONCLUSION

These results provide evidence that parental loss in childhood is associated with health-damaging psychosocial characteristics in adulthood only if the quality of the surviving FR is poor.

Childhood attachment and loss experiences affect adult cardiovascular and cortisol function

OBJECTIVE

This study proposes to test the hypothesis that early loss of a parent, coupled with poor quality family relationships, would result in long-term increased cardiovascular and cortisol reactivity to stress.

METHODS

Subjects included 30 university students who lost one parent before age 16, and 31 control subjects. Blood pressure (BP) was measured continuously during 5-minute baseline and recovery periods, and during each of 2 tasks--viewing a 7-minute video clip depicting the death of a parent, and giving a 3-minute impromptu speech (1-hour rest between tasks). Salivary cortisol samples were collected immediately before each task, and at 5 and 20 minutes posttask. Quality of family relationships (FR) was measured using the Moos Family Environment Scale.

RESULTS

Repeated-measures analysis of covariance revealed significant main effects on BP of both parental loss and FR for both tasks (all p values < .05) such that subjects who lost a parent or reported poor quality FR showed higher BP across all periods. The loss by FR by period interaction was not significant. An FR by period interaction was found for cortisol during the movie, in which poor quality FR subjects showed increased cortisol, whereas all others showed decreases. A loss by period interaction was found for cortisol during the speech, in which cortisol increased in loss subjects and decreased in non-loss subjects.

CONCLUSIONS

These findings indicate that both childhood loss of a parent and poor quality of caretaking are associated with long-term increases in BP and altered neurohormonal responses to stress.