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Alves VA, Giesta JM, Bosa VL, Goldani HAS. Bioelectrical impedance phase angle and nutritional status in children with intestinal failure on prolonged parenteral nutrition. J Pediatr (Rio J) 2024:S0021-7557(24)00039-1. [PMID: 38614136 DOI: 10.1016/j.jped.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 12/12/2023] [Accepted: 12/16/2023] [Indexed: 04/15/2024] Open
Abstract
OBJECTIVE To compare the phase angle (PhA) through bioelectrical impedance (BIA) of children with intestinal failure (IF) using prolonged parenteral nutrition (PN) followed by an Intestinal Rehabilitation Program, with a control group. METHODS Children under 10 years of age with IF using prolonged PN for >60 days (study group) were included. The control group consisted of healthy children without chronic pathologies, matched by sex and age. Anthropometric parameters evaluated were: weight, height, weight/age z-score (W/A), height/age z-score (H/A), BMI, BMI/A z-score, arm circumference, triceps skinfold, subscapular skinfold, mid-arm muscle circumference. BIA parameters were resistance (R), reactance (Xc), and phase angle (PhA). RESULTS Twenty-eight children were included in the study group, median (IQR) age was 11 (8-27) months, 53.6 % were male. In the control group, 28 children were included, median (IQR) age was 12.5 (8-24.7) months, 50 % were male. Children from the study group had W/A z-scores and H/A z-scores significantly lower than controls. There was no significant difference between PhA in the study group and controls, [median (IQR) 4.3° (3.8;4.6) vs 4.0° (3.8;5.4) respectively, p = 0.980]. Prematurity was significantly higher in the study group than in the controls, but there was no significant correlation between gestational age at birth and PhA of the children from the study group. CONCLUSION Children with IF using prolonged PN showed lower W/A and H/A compared to the control group, but without significant difference between the PhA of children with IF compared to controls.
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Affiliation(s)
- Victória A Alves
- Post-Graduate Program of Child and Adolescent Health, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Juliana M Giesta
- Post-Graduate Program of Child and Adolescent Health, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Vera L Bosa
- Department of Nutrition, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Helena A S Goldani
- Post-Graduate Program of Child and Adolescent Health, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Dalle Molle R, de Mendonça Filho EJ, Minuzzi L, Machado TD, Reis RS, Rodrigues DM, Mucellini AB, Franco AR, Buchweitz A, Toazza R, Bortoluzzi A, Salum GA, Boscenco S, Meaney MJ, Levitan RD, Manfro GG, Silveira PP. Thrifty-Eating Behavior Phenotype at the Food Court - Programming Goes Beyond Food Preferences. Front Endocrinol (Lausanne) 2022; 13:882532. [PMID: 35677721 PMCID: PMC9168906 DOI: 10.3389/fendo.2022.882532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/14/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Prenatal growth impairment leads to higher preference for palatable foods in comparison to normal prenatal growth subjects, which can contribute to increased body fat mass and a higher risk for developing chronic diseases in small-for-gestational-age (SGA) individuals throughout life. This study aimed to investigate the effect of SGA on feeding behavior in children and adolescents, as well as resting-state connectivity between areas related to reward, self-control, and value determination, such as orbitofrontal cortex (OFC), dorsolateral prefrontal cortex (DL-PFC), amygdala and dorsal striatum (DS). METHODS Caregivers and their offspring were recruited from two independent cohorts in Brazil (PROTAIA) and Canada (MAVAN). Both cohorts included anthropometric measurements, food choice tasks, and resting-state functional magnetic resonance imaging (fMRI) data. RESULTS In the Brazilian sample (17 ± 0.28 years, n=70), 21.4% of adolescents were classified as SGA. They exhibited lower monetary-related expenditure to buy a snack compared to controls in the food choice test. Decreased functional connectivity (n=40) between left OFC and left DL-PFC; and between right OFC and: left amygdala, right DS, and left DS were observed in the Brazilian SGA participants. Canadian SGA participants (14.9%) had non-significant differences in comparison with controls in a food choice task at 4 years old ( ± 0.01, n=315). At a follow-up brain scan visit (10.21 ± 0.140 years, n=49), SGA participants (28.6%) exhibited higher connectivity between the left OFC and left DL-PFC, also higher connectivity between the left OFC and right DL-PFC. We did not observe significant anthropometric neither nutrients' intake differences between groups in both samples. CONCLUSIONS Resting-state fMRI results showed that SGA individuals had altered connectivity between areas involved in encoding the subjective value for available goods and decision-making in both samples, which can pose them in disadvantage when facing food options daily. Over the years, the cumulative exposure to particular food cues together with the altered behavior towards food, such as food purchasing, as seen in the adolescent cohort, can play a role in the long-term risk for developing chronic non-communicable diseases.
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Affiliation(s)
- Roberta Dalle Molle
- Programa de Pós-Graduação em Ciências da Nutrição, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Center, Montreal, QC, Canada
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Euclides José de Mendonça Filho
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Center, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Luciano Minuzzi
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Tania Diniz Machado
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Roberta Sena Reis
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Faculdade de Nutrição, Universidade Federal de Goiás, Goiânia, Brazil
| | - Danitsa Marcos Rodrigues
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Amanda Brondani Mucellini
- Programa de Pós-Graduação em Ciências Médicas: Psiquiatria, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alexandre Rosa Franco
- Instituto do Cérebro (InsCer), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
- Faculdade de Medicina, Programa de Pós-Graduação em Medicina e Ciências da Saúde, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
- Faculdade de Engenharia, Programa de Pós-Graduação em Engenharia Elétrica, PUCRS, Porto Alegre, Brazil
| | - Augusto Buchweitz
- Instituto do Cérebro (InsCer), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
- Faculdade de Medicina, Programa de Pós-Graduação em Medicina e Ciências da Saúde, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
- Faculdade de Letras, Programa de Pós-Graduação em Letras, Linguística, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Rudineia Toazza
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Andressa Bortoluzzi
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Giovanni Abrahão Salum
- Programa de Pós-Graduação em Ciências Médicas: Psiquiatria, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sonia Boscenco
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Michael J. Meaney
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | - Robert D. Levitan
- Department of Psychiatry, University of Toronto and Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Gisele Gus Manfro
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Programa de Pós-Graduação em Ciências Médicas: Psiquiatria, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Patricia Pelufo Silveira
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Center, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- *Correspondence: Patricia Pelufo Silveira,
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Bas‐Hoogendam JM, Groenewold NA, Aghajani M, Freitag GF, Harrewijn A, Hilbert K, Jahanshad N, Thomopoulos SI, Thompson PM, Veltman DJ, Winkler AM, Lueken U, Pine DS, Wee NJA, Stein DJ, Agosta F, Åhs F, An I, Alberton BAV, Andreescu C, Asami T, Assaf M, Avery SN, Nicholas L, Balderston, Barber JP, Battaglia M, Bayram A, Beesdo‐Baum K, Benedetti F, Berta R, Björkstrand J, Blackford JU, Blair JR, Karina S, Blair, Boehme S, Brambilla P, Burkhouse K, Cano M, Canu E, Cardinale EM, Cardoner N, Clauss JA, Cividini C, Critchley HD, Udo, Dannlowski, Deckert J, Demiralp T, Diefenbach GJ, Domschke K, Doruyter A, Dresler T, Erhardt A, Fallgatter AJ, Fañanás L, Brandee, Feola, Filippi CA, Filippi M, Fonzo GA, Forbes EE, Fox NA, Fredrikson M, Furmark T, Ge T, Gerber AJ, Gosnell SN, Grabe HJ, Grotegerd D, Gur RE, Gur RC, Harmer CJ, Harper J, Heeren A, Hettema J, Hofmann D, Hofmann SG, Jackowski AP, Andreas, Jansen, Kaczkurkin AN, Kingsley E, Kircher T, Kosti c M, Kreifelts B, Krug A, Larsen B, Lee S, Leehr EJ, Leibenluft E, Lochner C, Maggioni E, Makovac E, Mancini M, Manfro GG, Månsson KNT, Meeten F, Michałowski J, Milrod BL, Mühlberger A, Lilianne R, Mujica‐Parodi, Munjiza A, Mwangi B, Myers M, Igor Nenadi C, Neufang S, Nielsen JA, Oh H, Ottaviani C, Pan PM, Pantazatos SP, Martin P, Paulus, Perez‐Edgar K, Peñate W, Perino MT, Peterburs J, Pfleiderer B, Phan KL, Poletti S, Porta‐Casteràs D, Price RB, Pujol J, Andrea, Reinecke, Rivero F, Roelofs K, Rosso I, Saemann P, Salas R, Salum GA, Satterthwaite TD, Schneier F, Schruers KRJ, Schulz SM, Schwarzmeier H, Seeger FR, Smoller JW, Soares JC, Stark R, Stein MB, Straube B, Straube T, Strawn JR, Suarez‐Jimenez B, Boris, Suchan, Sylvester CM, Talati A, Tamburo E, Tükel R, Heuvel OA, Van der Auwera S, Nieuwenhuizen H, Tol M, van Velzen LS, Bort CV, Vermeiren RRJM, Visser RM, Volman I, Wannemüller A, Wendt J, Werwath KE, Westenberg PM, Wiemer J, Katharina, Wittfeld, Wu M, Yang Y, Zilverstand A, Zugman A, Zwiebel HL. ENIGMA-anxiety working group: Rationale for and organization of large-scale neuroimaging studies of anxiety disorders. Hum Brain Mapp 2022; 43:83-112. [PMID: 32618421 PMCID: PMC8805695 DOI: 10.1002/hbm.25100] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/09/2020] [Accepted: 06/08/2020] [Indexed: 12/11/2022] Open
Abstract
Anxiety disorders are highly prevalent and disabling but seem particularly tractable to investigation with translational neuroscience methodologies. Neuroimaging has informed our understanding of the neurobiology of anxiety disorders, but research has been limited by small sample sizes and low statistical power, as well as heterogenous imaging methodology. The ENIGMA-Anxiety Working Group has brought together researchers from around the world, in a harmonized and coordinated effort to address these challenges and generate more robust and reproducible findings. This paper elaborates on the concepts and methods informing the work of the working group to date, and describes the initial approach of the four subgroups studying generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobia. At present, the ENIGMA-Anxiety database contains information about more than 100 unique samples, from 16 countries and 59 institutes. Future directions include examining additional imaging modalities, integrating imaging and genetic data, and collaborating with other ENIGMA working groups. The ENIGMA consortium creates synergy at the intersection of global mental health and clinical neuroscience, and the ENIGMA-Anxiety Working Group extends the promise of this approach to neuroimaging research on anxiety disorders.
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Affiliation(s)
- Janna Marie Bas‐Hoogendam
- Department of Developmental and Educational PsychologyLeiden University, Institute of Psychology Leiden The Netherlands
- Department of PsychiatryLeiden University Medical Center Leiden The Netherlands
- Leiden Institute for Brain and Cognition Leiden The Netherlands
| | - Nynke A. Groenewold
- Department of Psychiatry & Mental HealthUniversity of Cape Town Cape Town South Africa
| | - Moji Aghajani
- Department of PsychiatryAmsterdam UMC / VUMC Amsterdam The Netherlands
- Department of Research & InnovationGGZ inGeest Amsterdam The Netherlands
| | - Gabrielle F. Freitag
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Anita Harrewijn
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Kevin Hilbert
- Department of PsychologyHumboldt‐Universität zu Berlin Berlin Germany
| | - Neda Jahanshad
- University of Southern California Keck School of MedicineImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute Los Angeles California USA
| | - Sophia I. Thomopoulos
- University of Southern California Keck School of MedicineImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute Los Angeles California USA
| | - Paul M. Thompson
- University of Southern California Keck School of MedicineImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute Los Angeles California USA
| | - Dick J. Veltman
- Department of PsychiatryAmsterdam UMC / VUMC Amsterdam The Netherlands
| | - Anderson M. Winkler
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Ulrike Lueken
- Department of PsychologyHumboldt‐Universität zu Berlin Berlin Germany
| | - Daniel S. Pine
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Nic J. A. Wee
- Department of PsychiatryLeiden University Medical Center Leiden The Netherlands
- Leiden Institute for Brain and Cognition Leiden The Netherlands
| | - Dan J. Stein
- Department of Psychiatry & Mental HealthUniversity of Cape Town Cape Town South Africa
- University of Cape TownSouth African MRC Unit on Risk & Resilience in Mental Disorders Cape Town South Africa
- University of Cape TownNeuroscience Institute Cape Town South Africa
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Mucellini AB, Miguel PM, Dalle Molle R, Rodrigues DM, Machado TD, Reis RS, Toazza R, Salum GA, Bortoluzzi A, Franco AR, Buchweitz A, Barth B, Agranonik M, Nassim M, Meaney MJ, Manfro GG, Silveira PP. Diminished insulin sensitivity is associated with altered brain activation to food cues and with risk for obesity - Implications for individuals born small for gestational age. Appetite 2021; 169:105799. [PMID: 34767841 DOI: 10.1016/j.appet.2021.105799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 10/14/2021] [Accepted: 11/05/2021] [Indexed: 11/02/2022]
Abstract
While classically linked to memory, the hippocampus is also a feeding behavior modulator due to its multiple interconnected pathways with other brain regions and expression of receptors for metabolic hormones. Here we tested whether variations in insulin sensitivity would be correlated with differential brain activation following exposure to palatable food cues, as well as with variations in implicit food memory in a cohort of healthy adolescents, some of whom were born small for gestational age (SGA). Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was positively correlated with activation in the cuneus, and negatively correlated with activation in the middle frontal lobe, superior frontal gyrus and precuneus when presented with palatable food images versus non-food images in healthy adolescents. Additionally, HOMA-IR and insulinemia were higher in participants with impaired food memory. SGA individuals had higher snack caloric density and greater chance for impaired food memory. There was also an interaction between the HOMA-IR and birth weight ratio influencing external eating behavior. We suggest that diminished insulin sensitivity correlates with activation in visual attention areas and inactivation in inhibitory control areas in healthy adolescents. Insulin resistance also associated with less consistency in implicit memory for a consumed meal, which may suggest lower ability to establish a dietary pattern, and can contribute to obesity. Differences in feeding behavior in SGA individuals were associated with insulin sensitivity and hippocampal alterations, suggesting that cognition and hormonal regulation are important components involved in their food intake modifications throughout life.
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Affiliation(s)
- Amanda B Mucellini
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Patrícia M Miguel
- Graduate Program in Neuroscience, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Roberta Dalle Molle
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Danitsa M Rodrigues
- Graduate Program in Neuroscience, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Tania D Machado
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Roberta S Reis
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rudinéia Toazza
- Graduate Program in Neuroscience, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Giovanni A Salum
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Andressa Bortoluzzi
- Graduate Program in Neuroscience, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Alexandre R Franco
- Brain Institute of Rio Grande do Sul, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Augusto Buchweitz
- Brain Institute of Rio Grande do Sul, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Barbara Barth
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Integrated Program in Neurosciences, McGill University, Montreal, QC, Canada
| | - Marilyn Agranonik
- Fundação de Economia e Estatística Siegfried Emanuel Heuser, Porto Alegre, Brazil
| | - Marouane Nassim
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Michael J Meaney
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Translational Neuroscience Programme, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Gisele G Manfro
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Graduate Program in Neuroscience, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Patrícia P Silveira
- Graduate Program in Neuroscience, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
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5
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Harrewijn A, Cardinale EM, Groenewold NA, Bas-Hoogendam JM, Aghajani M, Hilbert K, Cardoner N, Porta-Casteràs D, Gosnell S, Salas R, Jackowski AP, Pan PM, Salum GA, Blair KS, Blair JR, Hammoud MZ, Milad MR, Burkhouse KL, Phan KL, Schroeder HK, Strawn JR, Beesdo-Baum K, Jahanshad N, Thomopoulos SI, Buckner R, Nielsen JA, Smoller JW, Soares JC, Mwangi B, Wu MJ, Zunta-Soares GB, Assaf M, Diefenbach GJ, Brambilla P, Maggioni E, Hofmann D, Straube T, Andreescu C, Berta R, Tamburo E, Price RB, Manfro GG, Agosta F, Canu E, Cividini C, Filippi M, Kostić M, Munjiza Jovanovic A, Alberton BAV, Benson B, Freitag GF, Filippi CA, Gold AL, Leibenluft E, Ringlein GV, Werwath KE, Zwiebel H, Zugman A, Grabe HJ, Van der Auwera S, Wittfeld K, Völzke H, Bülow R, Balderston NL, Ernst M, Grillon C, Mujica-Parodi LR, van Nieuwenhuizen H, Critchley HD, Makovac E, Mancini M, Meeten F, Ottaviani C, Ball TM, Fonzo GA, Paulus MP, Stein MB, Gur RE, Gur RC, Kaczkurkin AN, Larsen B, Satterthwaite TD, Harper J, Myers M, Perino MT, Sylvester CM, Yu Q, Lueken U, Veltman DJ, Thompson PM, Stein DJ, Van der Wee NJA, Winkler AM, Pine DS. Cortical and subcortical brain structure in generalized anxiety disorder: findings from 28 research sites in the ENIGMA-Anxiety Working Group. Transl Psychiatry 2021; 11:502. [PMID: 34599145 PMCID: PMC8486763 DOI: 10.1038/s41398-021-01622-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/02/2021] [Accepted: 09/14/2021] [Indexed: 12/22/2022] Open
Abstract
The goal of this study was to compare brain structure between individuals with generalized anxiety disorder (GAD) and healthy controls. Previous studies have generated inconsistent findings, possibly due to small sample sizes, or clinical/analytic heterogeneity. To address these concerns, we combined data from 28 research sites worldwide through the ENIGMA-Anxiety Working Group, using a single, pre-registered mega-analysis. Structural magnetic resonance imaging data from children and adults (5-90 years) were processed using FreeSurfer. The main analysis included the regional and vertex-wise cortical thickness, cortical surface area, and subcortical volume as dependent variables, and GAD, age, age-squared, sex, and their interactions as independent variables. Nuisance variables included IQ, years of education, medication use, comorbidities, and global brain measures. The main analysis (1020 individuals with GAD and 2999 healthy controls) included random slopes per site and random intercepts per scanner. A secondary analysis (1112 individuals with GAD and 3282 healthy controls) included fixed slopes and random intercepts per scanner with the same variables. The main analysis showed no effect of GAD on brain structure, nor interactions involving GAD, age, or sex. The secondary analysis showed increased volume in the right ventral diencephalon in male individuals with GAD compared to male healthy controls, whereas female individuals with GAD did not differ from female healthy controls. This mega-analysis combining worldwide data showed that differences in brain structure related to GAD are small, possibly reflecting heterogeneity or those structural alterations are not a major component of its pathophysiology.
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Affiliation(s)
- Anita Harrewijn
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA.
| | - Elise M Cardinale
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Nynke A Groenewold
- Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Janna Marie Bas-Hoogendam
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Department of Developmental and Educational Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Moji Aghajani
- Department of Psychiatry, Amsterdam UMC, location VUMC, Amsterdam, The Netherlands
- Department of Research & Innovation, GGZ InGeest, Amsterdam, The Netherlands
| | - Kevin Hilbert
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Narcis Cardoner
- Department of Mental Health, University Hospital Parc Taulí-I3PT, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain
| | - Daniel Porta-Casteràs
- Department of Mental Health, University Hospital Parc Taulí-I3PT, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain
| | - Savannah Gosnell
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Ramiro Salas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Andrea P Jackowski
- LiNC, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Pedro M Pan
- LiNC, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Giovanni A Salum
- Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - James R Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Mira Z Hammoud
- Department of Psychiatry, NYU School of Medicine, New York University, New York, NY, USA
| | - Mohammed R Milad
- Department of Psychiatry, NYU School of Medicine, New York University, New York, NY, USA
| | - Katie L Burkhouse
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - K Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Heidi K Schroeder
- Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Jeffrey R Strawn
- Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Randy Buckner
- Center for Brain Science & Department of Psychology, Harvard University, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Jared A Nielsen
- Center for Brain Science & Department of Psychology, Harvard University, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Psychology Department & Neuroscience Center, Brigham Young University, Provo, USA
| | - Jordan W Smoller
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Jair C Soares
- Center Of Excellence On Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Benson Mwangi
- Center Of Excellence On Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Mon-Ju Wu
- Center Of Excellence On Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Giovana B Zunta-Soares
- Center Of Excellence On Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Michal Assaf
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Gretchen J Diefenbach
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Anxiety Disorders Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - David Hofmann
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Muenster, Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Muenster, Germany
| | - Carmen Andreescu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rachel Berta
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erica Tamburo
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rebecca B Price
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Gisele G Manfro
- Anxiety Disorder Program, Hospital de Clínicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Elisa Canu
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Camilla Cividini
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Milutin Kostić
- Institute of Mental Health, University of Belgrade, Belgrade, Serbia
- Department of Psychiatry, School of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Bianca A V Alberton
- Graduate Program in Electrical and Computer Engineering, Universidade Tecnológica Federal do Paraná, Curitiba, Puerto Rico, Brazil
| | - Brenda Benson
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Gabrielle F Freitag
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Courtney A Filippi
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Andrea L Gold
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Grace V Ringlein
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Kathryn E Werwath
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Hannah Zwiebel
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - André Zugman
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Sandra Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Robin Bülow
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Nicholas L Balderston
- Center for Neuromodulation in Depression and Stress, University of Pennsylvania, Philadelphia, PA, USA
| | - Monique Ernst
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
| | - Christian Grillon
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, Bethesda, MD, USA
| | | | | | - Hugo D Critchley
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Elena Makovac
- Centre for Neuroimaging Science, Kings College London, London, UK
| | - Matteo Mancini
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Frances Meeten
- School of Psychology, University of Sussex, Brighton, UK
| | - Cristina Ottaviani
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia Foundation, Rome, Italy
| | - Tali M Ball
- Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Gregory A Fonzo
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | | | - Murray B Stein
- Department of Psychiatry, School of Medicine and Herbert Wertheim School of Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Bart Larsen
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Jennifer Harper
- Department of Psychiatry, Washington University, St. Louis, MO, USA
| | - Michael Myers
- Department of Psychiatry, Washington University, St. Louis, MO, USA
| | - Michael T Perino
- Department of Psychiatry, Washington University, St. Louis, MO, USA
| | - Chad M Sylvester
- Department of Psychiatry, Washington University, St. Louis, MO, USA
| | - Qiongru Yu
- Department of Psychiatry, Washington University, St. Louis, MO, USA
| | - Ulrike Lueken
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam UMC, location VUMC, Amsterdam, The Netherlands
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Dan J Stein
- South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Nic J A Van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Anderson M Winkler
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
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6
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Cerveira de Baumont A, Hoffmann MS, Bortoluzzi A, Fries GR, Lavandoski P, Grun LK, Guimarães LSP, Guma FTCR, Salum GA, Barbé-Tuana FM, Manfro GG. Telomere length and epigenetic age acceleration in adolescents with anxiety disorders. Sci Rep 2021; 11:7716. [PMID: 33833304 PMCID: PMC8032711 DOI: 10.1038/s41598-021-87045-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 03/16/2021] [Indexed: 02/01/2023] Open
Abstract
Evidence on the relationship between genetics and mental health are flourishing. However, few studies are evaluating early biomarkers that might link genes, environment, and psychopathology. We aimed to study telomere length (TL) and epigenetic age acceleration (AA) in a cohort of adolescents with and without anxiety disorders (N = 234). We evaluated a representative subsample of participants at baseline and after 5 years (n = 76) and categorized them according to their anxiety disorder diagnosis at both time points: (1) control group (no anxiety disorder, n = 18), (2) variable group (anxiety disorder in one evaluation, n = 38), and (3) persistent group (anxiety disorder at both time points, n = 20). We assessed relative mean TL by real-time quantitative PCR and DNA methylation by Infinium HumanMethylation450 BeadChip. We calculated AA using the Horvath age estimation algorithm and analyzed differences among groups using generalized linear mixed models. The persistent group of anxiety disorder did not change TL over time (p = 0.495). The variable group had higher baseline TL (p = 0.003) but no accelerated TL erosion in comparison to the non-anxiety control group (p = 0.053). Furthermore, there were no differences in AA among groups over time. Our findings suggest that adolescents with chronic anxiety did not change telomere length over time, which could be related to a delay in neuronal development in this period of life.
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Affiliation(s)
- Angelica Cerveira de Baumont
- Anxiety Disorders Outpatient Program for Children and Adolescents, Protaia, Federal University of Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil.
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.
- Basic Research and Advanced Investigations in Neurosciences, BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil.
- Serviço de Psiquiatria, Hospital de Clínicas de Porto Alegre, HCPA, Rua Ramiro Barcelos, 2350-sala 400N, Rio Branco, Porto Alegre, RS, 90035-903, Brazil.
| | - Mauricio Scopel Hoffmann
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
- Departamento de Neuropsiquiatria, Universidade Federal de Santa Maria, Avenida Roraima 1000, Santa Maria, 97105-900, Brazil
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Porto Alegre, RS, Brazil
| | - Andressa Bortoluzzi
- Anxiety Disorders Outpatient Program for Children and Adolescents, Protaia, Federal University of Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
- Graduate Program in Neuroscience, Institute of Basic Sciences/Health, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
- Basic Research and Advanced Investigations in Neurosciences, BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | - Gabriel R Fries
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, (UTHealth), Houston, TX, USA
| | - Patrícia Lavandoski
- Graduate Program in Biochemistry, Laboratoy of Molecular Biology and Bioinformatics, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Lucas K Grun
- Group of Inflammation and Cellular Senescence, Graduate Program in Cellular and Molecular Biology, School of Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Luciano S P Guimarães
- Unit of Epidemiology and Biostatistics, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | - Fátima T C R Guma
- Graduate Program in Biochemistry, Laboratoy of Molecular Biology and Bioinformatics, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Giovanni Abrahão Salum
- Anxiety Disorders Outpatient Program for Children and Adolescents, Protaia, Federal University of Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Porto Alegre, RS, Brazil
| | - Florencia M Barbé-Tuana
- Graduate Program in Biochemistry, Laboratoy of Molecular Biology and Bioinformatics, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
- Group of Inflammation and Cellular Senescence, Graduate Program in Cellular and Molecular Biology, School of Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Gisele G Manfro
- Anxiety Disorders Outpatient Program for Children and Adolescents, Protaia, Federal University of Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
- Graduate Program in Neuroscience, Institute of Basic Sciences/Health, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
- Basic Research and Advanced Investigations in Neurosciences, BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Porto Alegre, RS, Brazil
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Orio L, Alen F, Ballesta A, Martin R, Gomez de Heras R. Antianhedonic and Antidepressant Effects of Affron ®, a Standardized Saffron ( Crocus Sativus L.) Extract. Molecules 2020; 25:molecules25143207. [PMID: 32679643 PMCID: PMC7397008 DOI: 10.3390/molecules25143207] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 12/14/2022] Open
Abstract
Anxiety and depression have high prevalence in the general population, affecting millions of people worldwide, but there is still a need for effective and safe treatments. Nutritional supplements have recently received a lot of attention, particularly saffron. Thus, several pre-clinical studies support a beneficial role for bioactive compounds, such as saffron, in anxiety and depression. Here we used an animal model of depression based on social isolation to assess the effects of affron®, a standardized saffron extract containing ≥3.5% of total bioactive compounds safranal and crocin isomers. Affron® was administered both through the oral and the intraperitoneal routes, and several tasks related to anxiety and depression, such as the elevated plus maze, the forced swimming test or the sucrose preference test, were assessed. These tasks model key features of depressive states and anxious states relating to fear, behavioral despair or anhedonia, the lack of motivation and/or pleasure from everyday activities, respectively. Animals receiving oral affron® displayed behaviors congruent with improvements in their anxious/depressive state, showing the enhanced consumption of a sweet solution, as well as an increase in certain escape responses in the forced swimming test. Our data support a beneficial role for oral saffron in anxious/depressive states.
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de Baumont A, Bortoluzzi A, Wollenhaupt de Aguiar B, Scotton E, Pinto Guimarães LS, Kapczinski F, Belem da Silva CT, Manfro GG. Anxiety disorders in childhood are associated with youth IL-6 levels: A mediation study including metabolic stress and childhood traumatic events. J Psychiatr Res 2019; 115:43-50. [PMID: 31103845 DOI: 10.1016/j.jpsychires.2019.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/20/2019] [Accepted: 05/09/2019] [Indexed: 12/26/2022]
Abstract
Anxiety disorders (ADs) are chronic conditions that often have their onset in childhood and adolescence. Inflammation and oxidative stress markers have been associated with the vulnerability to ADs, however it is not known if ADs in childhood can influence these biomarkers levels longitudinally. This study aims to investigate a possible association between ADs and serum levels of IL-10, IL-6, IL-1β, TNF-α, BDNF, and protein carbonyl content, assessed after 5 years of follow-up. Moreover, we studied possible mediators for these associations, including physical activity, metabolic markers and childhood trauma. From 240 individuals evaluated at baseline, 73 were re-evaluated in the follow-up. Psychiatric diagnoses were assessed with the K-SADS or the MINI and child trauma questionnaire (CTQ) to evaluate presence of trauma. We searched serum levels of IL-10, IL-6, IL-1β and TNF-α (flow cytometry), BDNF (sandwich-ELISA) and carbonyl content in proteins (PCC method). We found a significant direct association between ADs at baseline and log IL-6 (B = 0.34, S.E. = 0.11, p = 0.002) and between AD and log BDNF (B = -0.10, S.E. = 0.05, p = 0.033) five years later. Searching for possible mediators of these association, we found that levels of HDL-cholesterol (ΔB = -0.148) partially mediated the association between ADs and IL-6. No significant mediators were found in the association between ADs and BDNF. Moreover, this association is no longer significant after controlling for the presence of depression. Our results demonstrated that previous AD diagnosis was associated with higher levels of IL-6 in the follow-up evaluation, suggesting that the presence of anxiety in childhood could influence altered inflammatory markers.
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Affiliation(s)
- Angelica de Baumont
- Anxiety Disorders Outpatient Program for Children and Adolescents, Protaia, Federal University of Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil; Post Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil; Basic Research and Advanced Investigations in Neurosciences, BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | - Andressa Bortoluzzi
- Anxiety Disorders Outpatient Program for Children and Adolescents, Protaia, Federal University of Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil; Post Graduate Program in Neuroscience, Institute of Basic Sciences/Health, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil; Basic Research and Advanced Investigations in Neurosciences, BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | - Bianca Wollenhaupt de Aguiar
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil; St. Joseph's Healthcare Hamilton, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Ellen Scotton
- Post Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil; Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | | | - Flavio Kapczinski
- Post Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil; Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | | | - Gisele Gus Manfro
- Anxiety Disorders Outpatient Program for Children and Adolescents, Protaia, Federal University of Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil; Post Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil; Post Graduate Program in Neuroscience, Institute of Basic Sciences/Health, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil; Basic Research and Advanced Investigations in Neurosciences, BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.
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Ergang BC, Molle RD, Reis RS, Rodrigues DM, Mucellini AB, Toazza R, Cunha ACDA, Silveira PP, Manfro GG, Machado TD. Perceived maternal care is associated with emotional eating in young adults. Physiol Behav 2018; 201:91-94. [PMID: 30578893 DOI: 10.1016/j.physbeh.2018.12.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/16/2018] [Accepted: 12/17/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Early life adversity, including the perception of poor quality of maternal care, is associated with long-term metabolic and psychosocial consequences. The negative quality of mother/child relationship is associated with emotional overeating in young children, which is defined by eating in response to emotional arousal states such as fear, anger or anxiety. However, it is not known if this association persists through adolescence. Therefore, we aimed at verifying if maternal care during infancy can influence emotional eating in young adults. METHODS Seventy-five adolescents, residents of Porto Alegre, who participated in the PROTAIA Program (anxiety disorder in childhood and adolescence program), answered the Parental Bonding Instrument (PBI - assessment of perceived maternal care), and the Dutch Eating Behavior Questionnaire (DEBQ). Regression analysis models were built to predict Emotional Eating, a domain of the DEBQ, using maternal care, gender, and anxiety as independent variables. RESULTS The model was statistically significant when adjusted for potential confounders (r2 = 0.272; p < 0.0001). Emotional eating was significantly predicted by levels of maternal care, anxiety and gender (beta = -0.316; p = 0.006). CONCLUSION The results demonstrated a negative association between the quality of maternal care and emotional eating in young adults, suggesting that the early environment could be involved on the development of eating disorders or on the differential eating behavior in adolescents with emotional disorders.
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Affiliation(s)
- Bárbara Cristina Ergang
- Graduação em Nutrição, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2400, CEP 90035-003,Porto Alegre, RS, Brazil.
| | - Roberta Dalle Molle
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Largo Eduardo Zaccaro Faraco, CEP 90035-003 Porto Alegre, RS, Brazil
| | - Roberta Sena Reis
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Largo Eduardo Zaccaro Faraco, CEP 90035-003 Porto Alegre, RS, Brazil
| | - Danitsa Marcos Rodrigues
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Brazil, Rua Sarmento Leite, 500, Sala 107 (Campus Centro), CEP 90046-900 - Porto Alegre, RS, Brazil
| | - Amanda Brondani Mucellini
- Programa de Pós-Graduação em Ciências Médicas: Psiquiatria, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, Santana, CEP 90035-003 Porto Alegre, RS, Brazil
| | - Rudinéia Toazza
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Brazil, Rua Sarmento Leite, 500, Sala 107 (Campus Centro), CEP 90046-900 - Porto Alegre, RS, Brazil
| | - Ana Carla de Araújo Cunha
- Graduação em Nutrição, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2400, CEP 90035-003,Porto Alegre, RS, Brazil
| | - Patrícia Pelufo Silveira
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Largo Eduardo Zaccaro Faraco, CEP 90035-003 Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Brazil, Rua Sarmento Leite, 500, Sala 107 (Campus Centro), CEP 90046-900 - Porto Alegre, RS, Brazil
| | - Gisele Gus Manfro
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Brazil, Rua Sarmento Leite, 500, Sala 107 (Campus Centro), CEP 90046-900 - Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências Médicas: Psiquiatria, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, Santana, CEP 90035-003 Porto Alegre, RS, Brazil
| | - Tania Diniz Machado
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Largo Eduardo Zaccaro Faraco, CEP 90035-003 Porto Alegre, RS, Brazil
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Bortoluzzi A, Salum GA, da Rosa ED, Chagas VDS, Castro MAA, Manfro GG. DNA methylation in adolescents with anxiety disorder: a longitudinal study. Sci Rep 2018; 8:13800. [PMID: 30218003 PMCID: PMC6138655 DOI: 10.1038/s41598-018-32090-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 08/29/2018] [Indexed: 12/18/2022] Open
Abstract
Anxiety disorders (AD) typically manifest in children and adolescents and might persist into adulthood. However, there are still few data concerning epigenetic mechanisms associated with onset, persistence or remission of AD over time. We investigated a cohort of adolescents and young adults at baseline (age; 13.19 ± 2.38) and after 5 years and classified them according to the AD diagnosis and their longitudinal trajectories into 4 groups: (1) Typically Developing Comparisons (TDC; control group, n = 14); (2) Incident (AD in the second evaluation only, n = 11); (3) Persistent (AD in both evaluations, n = 14) and (4) Remittent (AD in the first evaluation only, n = 8). DNA methylation was evaluated with the Infinium HumanMethylation450 BeadChip from saliva samples collected at both evaluations. Gene set enrichment analysis was applied to consider biological pathways. We found decreased DNA methylation in TDC group while the chronic cases of AD presented hypermethylation in central nervous system development pathways. Moreover, we showed that this persistent group also presented hypermethylation while the other three groups were associated with hypomethylation in nervous system development pathway. Incidence and remission groups were associated with increased and decreased methylation in neuron development pathways, respectively. Larger studies are likely to detect specific genes relevant to AD.
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Affiliation(s)
- Andressa Bortoluzzi
- Anxiety Disorders Outpatient Program for Children and Adolescents, Universidade Federal do Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil.
- Post Graduate Program in Neuroscience, Institute of Basic Sciences/Health, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.
- Basic Research and Advanced Investigations in Neurosciences, BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil.
| | - Giovanni Abrahão Salum
- Anxiety Disorders Outpatient Program for Children and Adolescents, Universidade Federal do Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Eduarda Dias da Rosa
- Basic Research and Advanced Investigations in Neurosciences, BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | | | | | - Gisele Gus Manfro
- Anxiety Disorders Outpatient Program for Children and Adolescents, Universidade Federal do Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
- Post Graduate Program in Neuroscience, Institute of Basic Sciences/Health, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
- Basic Research and Advanced Investigations in Neurosciences, BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
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11
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Rodrigues DM, Reis RS, Dalle Molle R, Machado TD, Mucellini AB, Bortoluzzi A, Toazza R, Pérez JA, Salum GA, Agranonik M, Minuzzi L, Levitan RD, Buchweitz A, Franco AR, Manfro GG, Silveira PP. Decreased comfort food intake and allostatic load in adolescents carrying the A3669G variant of the glucocorticoid receptor gene. Appetite 2017; 116:21-8. [DOI: 10.1016/j.appet.2017.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 03/29/2017] [Accepted: 04/05/2017] [Indexed: 11/18/2022]
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Belem da Silva CT, de Abreu Costa M, Kapczinski F, de Aguiar BW, Salum GA, Manfro GG. Inflammation and internalizing disorders in adolescents. Prog Neuropsychopharmacol Biol Psychiatry 2017; 77:133-137. [PMID: 28385493 DOI: 10.1016/j.pnpbp.2017.03.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 03/26/2017] [Accepted: 03/30/2017] [Indexed: 12/28/2022]
Abstract
Serum inflammatory markers have been studied in adults with anxiety and depression, but little is known about cytokine levels in young adolescents with emotional disorders. The objective of this study is to compare serum levels of interleukin-6 (IL-6) and interleukin-10 (IL-10) between adolescents with internalizing disorders and adolescents from the same community without internalizing disorders. A total of 134 non-medicated subjects (n=76 with internalizing disorders) were recruited from a larger sample of 2457 individuals. Serum levels of IL-6 and IL-10 were quantified and psychiatric diagnosis was evaluated using structured clinical interviews. Adolescents with internalizing disorders presented significantly higher levels of IL-6 as compared to youngsters without internalizing disorders. Differences between groups in IL-10 levels were not statistically significant. This study points out that IL-6 levels may be associated with internalizing disorders in youths and suggests that inflammation might be an early biomarker of emotional distress. High levels of cytokines may adversely affect general health in the long-term, which raise broader issues in terms of public health if results are replicated.
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Affiliation(s)
| | - Marianna de Abreu Costa
- Federal University of Rio Grande do Sul (UFRGS), Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Brazil
| | - Flávio Kapczinski
- Federal University of Rio Grande do Sul (UFRGS), Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Brazil; Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia - Translacional em Medicina (INCT), Brazil
| | - Bianca Wollenhaupt de Aguiar
- Federal University of Rio Grande do Sul (UFRGS), Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Brazil; Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia - Translacional em Medicina (INCT), Brazil
| | - Giovanni Abrahão Salum
- Federal University of Rio Grande do Sul (UFRGS), Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Brazil
| | - Gisele Gus Manfro
- Federal University of Rio Grande do Sul (UFRGS), Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Brazil
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Kell G, Rao A, Beccaria G, Clayton P, Inarejos-García AM, Prodanov M. affron ® a novel saffron extract (Crocus sativus L.) improves mood in healthy adults over 4 weeks in a double-blind, parallel, randomized, placebo-controlled clinical trial. Complement Ther Med 2017; 33:58-64. [PMID: 28735826 DOI: 10.1016/j.ctim.2017.06.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/15/2017] [Accepted: 06/04/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND In recent years phytotherapy has been explored as a source for alternative treatments for mood disorders. One potential candidate is saffron (Crocus sativus L.), whose main bioactive components are crocins and safranal. OBJECTIVES The aim of this study was to investigate the efficacy of affron®, a standardised stigmas extract from Crocus sativus L. for improving mood, stress, anxiety and sleep quality in healthy adults. METHODS In this 3 arm study, 128 participants self-reporting low mood but not diagnosed with depression, were given affron® at 28mg/day, 22mg/day, or a placebo treatment in a randomized, double-blind, placebo-controlled trial for 4 weeks. Mood was measured at baseline and at the end of the study, using the POMS (primary outcome measure) and PANAS questionnaires, and the DASS-21 scale. Sleep was monitored using Sleep Quality Index (PSQI). RESULTS Analysis indicated a significant decrease in negative mood and symptoms related to stress and anxiety at a 28mg/day dose (with a significant difference between 28mg/day and placebo on the POMS Total Mood Disturbance scale, p<0.001, d=-1.10), but no treatment effect at the 22mg/day dose. LIMITATIONS The main weaknesses of this investigation were found in the self-reporting nature of both the screening and the testing. CONCLUSIONS affron® increased mood, reduced anxiety and managed stress without side effects, offering a natural alternative to standard treatments.
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14
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Jarros RB, Salum GA, Silva CTBD, Toazza R, Becker N, Agranonik M, Salles JFD, Manfro GG. Attention, memory, visuoconstructive, and executive task performance in adolescents with anxiety disorders: a case-control community study. Trends Psychiatry Psychother 2017; 39:5-11. [DOI: 10.1590/2237-6089-2016-0032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 09/20/2016] [Indexed: 11/22/2022]
Abstract
Abstract Objective: The aim of the present study was to assess children and adolescents with mild and severe anxiety disorders for their performance in attention, verbal episodic memory, working memory, visuoconstructive skills, executive functions, and cognitive global functioning and conduct comparative analyses with the performance of children free from anxiety disorders. Methods: Our sample comprised 68 children and adolescents aged 10 to 17 years (41 with current diagnoses of anxiety disorders and 27 controls) selected from a larger cross-sectional community sample of adolescents. Children and adolescents with anxiety disorders were categorized into two groups on the basis of anxiety severity (mild or severe). All participants underwent a neuropsychological assessment battery to evaluate attention, verbal episodic memory, working memory, visuoconstructive skills, and executive and cognitive functions. Results: No differences were found in any neuropsychological tests, with the single exception that the group with mild anxiety had better performance on the Digit Span backward test compared to subjects with severe anxiety and to controls (p = 0.041; η2 = 0.11). Conclusions: Not only might anxiety disorders spare main cognitive functions during adolescence, they may even enhance certain working memory processes.
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Affiliation(s)
- Rafaela Behs Jarros
- Universidade Federal do Rio Grande do Sul, Brazil; Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, Brazil; UFRGS, Brazil; UFRGS, Brazil
| | - Giovanni Abrahão Salum
- Universidade Federal do Rio Grande do Sul, Brazil; Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, Brazil; UFRGS, Brazil
| | | | - Rudineia Toazza
- Universidade Federal do Rio Grande do Sul, Brazil; UFRGS, Brazil
| | | | | | | | - Gisele Gus Manfro
- Universidade Federal do Rio Grande do Sul, Brazil; Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes, Brazil; UFRGS, Brazil
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15
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Toazza R, Franco AR, Buchweitz A, Molle RD, Rodrigues DM, Reis RS, Mucellini AB, Esper NB, Aguzzoli C, Silveira PP, Salum GA, Manfro GG. Amygdala-based intrinsic functional connectivity and anxiety disorders in adolescents and young adults. Psychiatry Res Neuroimaging 2016; 257:11-16. [PMID: 27716544 DOI: 10.1016/j.pscychresns.2016.09.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 09/20/2016] [Accepted: 09/21/2016] [Indexed: 12/29/2022]
Abstract
Anxiety disorders (AD) are the most prevalent group of psychiatric disorders in adolescents and young adults. Nevertheless, the pathophysiology of anxiety disorders is still poorly understood. This study investigated differences in the functional connectivity of intrinsic amygdala-based networks of participants with and without AD. Resting state fMRI data were obtained from 18 participants with an AD and 19 healthy comparison individuals. Psychiatric diagnosis was assessed using standardized structured interviews. The comparison between groups was carried out using functional connectivity maps from six seed regions defined using probabilistic maps bilaterally within the amygdala (basolateral, superficial and centromedial amygdala). We found significant between-group differences in five clusters, which showed aberrant functional connectivity with the left basolateral amygdala: right precentral gyrus, right cingulate gyrus, bilateral precuneus, and right superior frontal gyrus in subjects with AD as compared with the comparison subjects. For the comparison subjects, the correlations between the amygdala and the five clusters were either non-significant, or negative. The present study suggests there is an intrinsic disruption in the communication between left basolateral amygdala and a network of brain regions involved with emotion regulation, and with the default mode network in adolescents and young adults with anxiety disorders.
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Affiliation(s)
- Rudineia Toazza
- Anxiety Disorders Program for Child and Adolescent Psychiatry (PROTAIA), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Postgraduate Program in Neuroscience, Institute of Basic Sciences/Health (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | - Alexandre Rosa Franco
- PUCRS, Brain Institute of Rio Grande do Sul (BraIns), Porto Alegre, RS, Brazil; PUCRS, Postgraduate Program in Medicine and Health Science, Neuroscience, Porto Alegre, RS, Brazil; PUCRS, Postgraduate Program in Electrical Engineering, Biomedical Engineering, Porto Alegre, RS, Brazil
| | - Augusto Buchweitz
- PUCRS, Brain Institute of Rio Grande do Sul (BraIns), Porto Alegre, RS, Brazil; PUCRS, Postgraduate Program in Electrical Engineering, Biomedical Engineering, Porto Alegre, RS, Brazil
| | - Roberta Dalle Molle
- Postgraduate Program in Child and Adolescent Health, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Brazil
| | - Danitsa Marcos Rodrigues
- Anxiety Disorders Program for Child and Adolescent Psychiatry (PROTAIA), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Postgraduate Program in Neuroscience, Institute of Basic Sciences/Health (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Roberta Sena Reis
- Postgraduate Program in Child and Adolescent Health, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Brazil
| | - Amanda Brondani Mucellini
- Anxiety Disorders Program for Child and Adolescent Psychiatry (PROTAIA), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Postgraduate Program in Child and Adolescent Health, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Brazil
| | - Nathalia Bianchini Esper
- PUCRS, Brain Institute of Rio Grande do Sul (BraIns), Porto Alegre, RS, Brazil; PUCRS, Postgraduate Program in Electrical Engineering, Biomedical Engineering, Porto Alegre, RS, Brazil
| | - Cristiano Aguzzoli
- PUCRS, Brain Institute of Rio Grande do Sul (BraIns), Porto Alegre, RS, Brazil
| | - Patrícia Pelufo Silveira
- Postgraduate Program in Neuroscience, Institute of Basic Sciences/Health (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Postgraduate Program in Child and Adolescent Health, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Brazil
| | - Giovanni Abrahão Salum
- Anxiety Disorders Program for Child and Adolescent Psychiatry (PROTAIA), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Postgraduate Program in Medical Sciences: Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Gisele Gus Manfro
- Anxiety Disorders Program for Child and Adolescent Psychiatry (PROTAIA), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Postgraduate Program in Neuroscience, Institute of Basic Sciences/Health (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Postgraduate Program in Medical Sciences: Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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16
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Machado TD, Dalle Molle R, Reis RS, Rodrigues DM, Mucellini AB, Minuzzi L, Franco AR, Buchweitz A, Toazza R, Ergang BC, Cunha ACDA, Salum GA, Manfro GG, Silveira PP. Interaction between perceived maternal care, anxiety symptoms, and the neurobehavioral response to palatable foods in adolescents. Stress 2016; 19:287-94. [PMID: 27295200 DOI: 10.1080/10253890.2016.1191464] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Studies in rodents have shown that early life trauma leads to anxiety, increased stress responses to threatening situations, and modifies food intake in a new environment. However, these associations are still to be tested in humans. This study aimed to verify complex interactions among anxiety diagnosis, maternal care, and baseline cortisol on food intake in a new environment in humans. A community sample of 32 adolescents and young adults was evaluated for: psychiatric diagnosis using standardized interviews, maternal care using the Parental Bonding Inventory (PBI), caloric consumption in a new environment (meal choice at a snack bar), and salivary cortisol. They also performed a brain fMRI task including the visualization of palatable foods vs. neutral items. The study found a three-way interaction between anxiety diagnosis, maternal care, and baseline cortisol levels on the total calories consumed (snacks) in a new environment. This interaction means that for those with high maternal care, there were no significant associations between cortisol levels and food intake in a new environment. However, for those with low maternal care and who have an anxiety disorder (affected), cortisol was associated with higher food intake; whereas for those with low maternal care and who did not have an anxiety disorder (resilient), cortisol was negatively associated with lower food intake. In addition, higher anxiety symptoms were associated with decreased activation in the superior and middle frontal gyrus when visualizing palatable vs. neutral items in those reporting high maternal care. These results in humans mimic experimental research findings and demonstrate that a combination of anxiety diagnosis and maternal care moderate the relationship between the HPA axis functioning, anxiety, and feeding behavior in adolescents and young adults.
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Affiliation(s)
- Tania Diniz Machado
- a Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Roberta Dalle Molle
- a Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Roberta Sena Reis
- a Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Danitsa Marcos Rodrigues
- b Programa de Pós-Graduação em Neurociências , Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Amanda Brondani Mucellini
- c Programa de Pós-Graduação em Ciências Médicas: Psiquiatria. Faculdade de Medicina , Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Luciano Minuzzi
- d Department of Psychiatry and Behavioural Neurosciences , McMaster University , Hamilton , ON , Canada
| | - Alexandre Rosa Franco
- e PUCRS, Instituto do Cérebro (InsCer), Programa de Pós-Graduação em Medicina e Ciências da Saúde , Porto Alegre , Brazil
- f PUCRS, Faculdade de Medicina , Programa de Pós-Graduação em Medicina e Ciências da Saúde , Porto Alegre , Brazil
- g PUCRS, Faculdade de Engenharia , Programa de Pós-Graduação em Engenharia Elétrica , Porto Alegre , Brazil
| | - Augusto Buchweitz
- e PUCRS, Instituto do Cérebro (InsCer), Programa de Pós-Graduação em Medicina e Ciências da Saúde , Porto Alegre , Brazil
- f PUCRS, Faculdade de Medicina , Programa de Pós-Graduação em Medicina e Ciências da Saúde , Porto Alegre , Brazil
- h PUCRS, Faculdade de Letras , Programa de Pós-Graduação em Letras , Linguística , Porto Alegre , Brazil
| | - Rudineia Toazza
- b Programa de Pós-Graduação em Neurociências , Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Bárbara Cristina Ergang
- i Graduação em Nutrição: Faculdade de Medicina , Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Ana Carla de Araújo Cunha
- i Graduação em Nutrição: Faculdade de Medicina , Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Giovanni Abrahão Salum
- c Programa de Pós-Graduação em Ciências Médicas: Psiquiatria. Faculdade de Medicina , Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Gisele Gus Manfro
- b Programa de Pós-Graduação em Neurociências , Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
- c Programa de Pós-Graduação em Ciências Médicas: Psiquiatria. Faculdade de Medicina , Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Patrícia Pelufo Silveira
- a Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
- b Programa de Pós-Graduação em Neurociências , Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
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17
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Reis RS, Dalle Molle R, Machado TD, Mucellini AB, Rodrigues DM, Bortoluzzi A, Bigonha SM, Toazza R, Salum GA, Minuzzi L, Buchweitz A, Franco AR, Pelúzio MC, Manfro GG, Silveira PP. Impulsivity-based thrifty eating phenotype and the protective role of n-3 PUFAs intake in adolescents. Transl Psychiatry 2016; 6:e755. [PMID: 26978737 DOI: 10.1038/tp.2016.16] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 11/17/2015] [Accepted: 01/19/2016] [Indexed: 02/06/2023] Open
Abstract
The goal of the present study was to investigate whether intrauterine growth restriction (IUGR) affects brain responses to palatable foods and whether docosahexaenoic acid (DHA, an omega-3 fatty acid that is a primary structural component of the human brain) serum levels moderate the association between IUGR and brain and behavioral responses to palatable foods. Brain responses to palatable foods were investigated using a functional magnetic resonance imaging task in which participants were shown palatable foods, neutral foods and non-food items. Serum DHA was quantified in blood samples, and birth weight ratio (BWR) was used as a proxy for IUGR. The Dutch Eating Behavior Questionnaire (DEBQ) was used to evaluate eating behaviors. In the contrast palatable food > neutral items, we found an activation in the right superior frontal gyrus with BWR as the most important predictor; the lower the BWR (indicative of IUGR), the greater the activation of this region involved in impulse control/decision making facing the viewing of palatable food pictures versus neutral items. At the behavioral level, a general linear model predicting external eating using the DEBQ showed a significant interaction between DHA and IUGR status; in IUGR individuals, the higher the serum DHA, the lower is external eating. In conclusion, we suggest that IUGR moderates brain responses when facing stimuli related to palatable foods, activating an area related to impulse control. Moreover, higher intake of n-3 PUFAs can protect IUGR individuals from developing inappropriate eating behaviors, the putative mechanism of protection would involve decreasing intake in response to external food cues in adolescents/young adults.
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Bortoluzzi A, Blaya C, Rosa EDD, Paim M, Rosa V, Leistner-Segal S, Manfro GG. What can HPA axis-linked genes tell us about anxiety disorders in adolescents? Trends Psychiatry Psychother 2015; 37:232-7. [DOI: 10.1590/2237-6089-2015-0035] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Accepted: 07/31/2015] [Indexed: 11/21/2022]
Abstract
Introduction: Anxiety disorders (AD) share features of both anxiety and fear linked to stress response. The hypothalamic-pituitary-adrenal (HPA) axis is considered the core biological pathway of the stress system and it is known that an inappropriate response to environmental stimuli may be related to individual genetic vulnerability in HPA-linked genes. Despite the biological plausibility of a relationship between the HPA axis and AD, few studies have investigated associations between genetic polymorphisms linked to the HPA axis and this complex disorder. Objective: To investigate whether AD are associated with genetic polymorphisms in HPA-linked genes in adolescents. Methods: Our study consisted of a cross-sectional evaluation of a community sample comprising a total of 228 adolescents (131 cases of AD). We extracted DNA from saliva and genotyped polymorphisms in HPA-linked genes (FKBP5: rs3800373, rs9296158, rs1360780, rs9470080 and rs4713916; NR3C1: rs6198; CRHR1: rs878886; and SERPINA6: rs746530) with real time polymerase chain reaction (PCR). The instruments used to diagnose and assess the severity of AD were the Schedule for Affective Disorder and Schizophrenia for School-Age Children - Present and Lifetime (K-SADS-PL) and the Screen for Child and Anxiety related Emotional Disorders (SCARED). Results: We failed to detect any associations between AD and genetic polymorphisms in HPA-linked genes (p > 0.05). Conclusion: To our knowledge, this is the first study evaluating these specific polymorphisms in relation to AD in adolescents, which encourages us to design further research on the subject.
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Affiliation(s)
| | - Carolina Blaya
- Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil
| | | | - Mariana Paim
- Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil
| | - Virgínia Rosa
- Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil
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Machado T, Salum G, Bosa V, Goldani M, Meaney M, Agranonik M, Manfro G, Silveira P. Early life trauma is associated with decreased peripheral levels of thyroid‐hormone T3 in adolescents. Int J Dev Neurosci 2015; 47:304-8. [DOI: 10.1016/j.ijdevneu.2015.10.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 10/13/2015] [Accepted: 10/14/2015] [Indexed: 12/27/2022] Open
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Costa MDA, Salum Junior GA, Isolan LR, Acosta JR, Jarros RB, Blaya C, Diemen LV, Manfro GG. Association between anxiety symptoms and problematic alcohol use in adolescents. Trends Psychiatry Psychother 2015; 35:106-10. [PMID: 25923300 DOI: 10.1590/s2237-60892013000200003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 08/16/2012] [Indexed: 11/22/2022]
Abstract
BACKGROUND Anxiety disorders are highly prevalent, affecting approximately 10% of individuals throughout life; its onset can be detected since early childhood or adolescence. Studies in adults have shown that anxiety disorders are associated with alcohol abuse, but few studies have investigated the association between anxiety symptoms and problematic alcohol use in early ages. OBJECTIVE To evaluate if anxiety symptoms are associated with problematic alcohol use in young subjects. METHODS A total of 239 individuals aged 10-17 years were randomly selected from schools located in the catchment area of Hospital de Clínicas de Porto Alegre. The Screen for Child Anxiety-Related Emotional Disorders (SCARED) was used to evaluate the presence of anxiety symptoms, and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), to evaluate alcohol use. RESULTS One hundred twenty-seven individuals (53.1% ) reported having already used alcohol. Of these, 14 individuals showed problematic alcohol use (5.8% ). There was no association between lifetime use of alcohol and anxiety symptoms, but mean SCARED scores in individuals with problematic alcohol use was higher if compared to those without problematic use, even after adjustment for age and gender (29.9±8.5 vs. 23.7±11.8, p < 0.001). CONCLUSIONS Despite the limitation of a cross-sectional design, our study suggests that anxiety symptoms are associated with problematic alcohol use early in life.
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Affiliation(s)
- Marianna de Abreu Costa
- Anxiety Disorders Program for Child and Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | - Jandira Rahmeier Acosta
- Anxiety Disorders Program for Child and Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | - Lísia Von Diemen
- Center for Drug and Alcohol Research, HCPA, UFRGS, Porto Alegre, RS, Brazil
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Gosmann NP, Salum GA, Schuch F, Silveira PP, Bosa VL, Goldani MZ, Manfro GG. Association between internalizing disorders and day-to-day activities of low energetic expenditure. Child Psychiatry Hum Dev 2015; 46:67-74. [PMID: 24570170 DOI: 10.1007/s10578-014-0450-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The objective of this study is to compare energetic expenditure in day-to-day activities among subjects with internalizing disorders (depression and anxiety), externalizing disorders (attention deficit/hyperactivity disorder and oppositional defiant disorder) and healthy children and adolescents without any psychiatric diagnosis. One hundred and five (n = 105) students from a community sample were evaluated throughout a structured psychiatric interview and categorized into three groups: internalizing (n = 54), externalizing (n = 12) and typically developing controls (TDC, n = 39). Energetic expenditure was evaluated using 3-day physical activity record. Subjects with internalizing disorders performed activities with lower energetic expenditure as compared to those with externalizing disorders and TDC. Participants with externalizing disorders had more energetic expenditure variability. Our study suggests that internalizing disorders are associated with activities of low energetic expenditure in day-to-day activities, extending previous findings with physical exercise. These findings may further contribute to the understanding of the associated morbidity previously described in patients with internalizing disorders.
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Bortoluzzi A, Salum GA, Blaya C, Silveira PP, Grassi-Oliveira R, da Rosa ED, de Aguiar BW, Stertz L, Bosa VL, Schuch I, Goldani M, Kapczinski F, Leistner-Segal S, Manfro GG. Mineralocorticoid receptor genotype moderates the association between physical neglect and serum BDNF. J Psychiatr Res 2014; 59:8-13. [PMID: 25241277 DOI: 10.1016/j.jpsychires.2014.08.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 08/25/2014] [Accepted: 08/28/2014] [Indexed: 01/14/2023]
Abstract
The objective of this study is to investigate if a polymorphism in the NR3C2 gene moderates the association between childhood trauma on serum levels of brain derived neurothrophic factor (sBDNF). sBDNF was used here as a general marker of alteration in brain function. This is a community cross sectional study comprising 90 adolescents (54 with anxiety disorders). DNA was extracted from saliva in order to genotype the MR-2G/C (rs2070951) polymorphism using real time PCR. Blood was collected for sBDNF Elisa immunoassay. The Childhood Trauma Questionnaire (CTQ) was used to evaluate childhood abuse and neglect. Main effects and gene environment interactions were tested using linear regression models. Anxiety disorders were not associated with the MR-2G/C polymorphism or with sBDNF levels, but the number of C alleles of the MR-2G/C polymorphism was significantly associated with higher sBDNF levels (b = 8.008; p-value = 0.001). Subjects with intermediate and high exposure to physical neglect showed higher sBDNF levels if compared to subjects non-exposed (b = 11.955; p = 0.004 and b = 16.186; p = 0.009, respectively). In addition, we detected a significant physical neglect by MR-2G/C C allele interaction on sBDNF levels (p = 0.005), meaning that intermediate and high exposure to childhood neglect were only associated with increased sBDNF levels in subjects with the CC genotype, but not in subjects with other genotypes. Our findings suggest that genetic variants in NR3C2 gene may partially explain plastic brain vulnerability to traumatic events. Further studies are needed to investigate the moderating effects of NR3C2 gene in more specific markers of alteration in brain function.
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Affiliation(s)
- Andressa Bortoluzzi
- Anxiety Disorders Outpatient Program for Children and Adolescents, PROTAIA, Federal University of Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil; Post Graduate Program in Neuroscience, Institute of Basic Sciences/Health, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil; Basic Research and Advanced Investigations in Neurosciences, BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil.
| | - Giovanni Abrahão Salum
- Anxiety Disorders Outpatient Program for Children and Adolescents, PROTAIA, Federal University of Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil; Post Graduate Program in Medical Sciences: Psychiatry, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD/ CNPq), Brazil
| | - Carolina Blaya
- Anxiety Disorders Outpatient Program for Children and Adolescents, PROTAIA, Federal University of Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil; Health Sciences Federal University of Porto Alegre, UFCSPA, Porto Alegre, Brazil
| | - Patrícia Pelufo Silveira
- Post Graduate Program in Neuroscience, Institute of Basic Sciences/Health, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil; Department of Pediatrics, Faculty of Medicine, UFRGS, Porto Alegre, Brazil
| | - Rodrigo Grassi-Oliveira
- Developmental Cognitive Neuroscience Research Group, Post-Graduate Program in Psychology - Human Cognition, Pontifical Catholic University of Rio Grande do Sul, PUCR-RS, Porto Alegre, Brazil
| | - Eduarda Dias da Rosa
- Anxiety Disorders Outpatient Program for Children and Adolescents, PROTAIA, Federal University of Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil; Basic Research and Advanced Investigations in Neurosciences, BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | | | - Laura Stertz
- National Institute of Science and Technology Translational Medicine (INCT/CNPq), Porto Alegre, Brazil
| | - Vera Lúcia Bosa
- Center for Child and Adolescent Health Studies (NESCA), Hospital de Clínicas de Porto Alegre (HCPA), Brazil
| | - Ilaine Schuch
- Center for Child and Adolescent Health Studies (NESCA), Hospital de Clínicas de Porto Alegre (HCPA), Brazil
| | - Marcelo Goldani
- Center for Child and Adolescent Health Studies (NESCA), Hospital de Clínicas de Porto Alegre (HCPA), Brazil
| | - Flavio Kapczinski
- Post Graduate Program in Medical Sciences: Psychiatry, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil; National Institute of Science and Technology Translational Medicine (INCT/CNPq), Porto Alegre, Brazil
| | - Sandra Leistner-Segal
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | - Gisele Gus Manfro
- Anxiety Disorders Outpatient Program for Children and Adolescents, PROTAIA, Federal University of Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil; Post Graduate Program in Neuroscience, Institute of Basic Sciences/Health, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil; Post Graduate Program in Medical Sciences: Psychiatry, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil; Basic Research and Advanced Investigations in Neurosciences, BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD/ CNPq), Brazil.
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DeSousa DA, Zibetti MR, Trentini CM, Koller SH, Manfro GG, Salum GA. Screen for child anxiety related emotional disorders: are subscale scores reliable? A bifactor model analysis. J Anxiety Disord 2014; 28:966-70. [PMID: 25445087 DOI: 10.1016/j.janxdis.2014.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Revised: 10/18/2014] [Accepted: 10/21/2014] [Indexed: 11/30/2022]
Abstract
The aim of this study was to investigate the utility of creating and scoring subscales for the self-report version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) by examining whether subscale scores provide reliable information after accounting for a general anxiety factor in a bifactor model analysis. A total of 2420 children aged 9-18 answered the SCARED in their schools. Results suggested adequate fit of the bifactor model. The SCARED score variance was hardly influenced by the specific domains after controlling for the common variance in the general factor. The explained common variance (ECV) for the general factor was large (63.96%). After accounting for the general total score (ωh=.83), subscale scores provided very little reliable information (ωh ranged from .005 to .04). Practitioners that use the SCARED should be careful when scoring and interpreting the instrument subscales since there is more common variance to them than specific variance.
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Affiliation(s)
- Diogo Araújo DeSousa
- Anxiety Disorders Outpatient Program for Child and Adolescent Psychiatry (PROTAIA), Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul (UFRGS), Brazil; Center for Psychological Studies on At-Risk Populations (CEP-Rua), Institute of Psychology, Federal University of Rio Grande do Sul (UFRGS), Brazil.
| | - Murilo Ricardo Zibetti
- Study Group in Psychopathology and Psychological Assessment, Institute of Psychology, Federal University of Rio Grande do Sul (UFRGS), Brazil.
| | - Clarissa Marceli Trentini
- Study Group in Psychopathology and Psychological Assessment, Institute of Psychology, Federal University of Rio Grande do Sul (UFRGS), Brazil.
| | - Silvia Helena Koller
- Center for Psychological Studies on At-Risk Populations (CEP-Rua), Institute of Psychology, Federal University of Rio Grande do Sul (UFRGS), Brazil.
| | - Gisele Gus Manfro
- Anxiety Disorders Outpatient Program for Child and Adolescent Psychiatry (PROTAIA), Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul (UFRGS), Brazil; National Science and Technology Institute for Child and Adolescent Psychiatry (INPD), Hospital de Clínicas de Porto Alegre (HCPA), Brazil.
| | - Giovanni Abrahão Salum
- Anxiety Disorders Outpatient Program for Child and Adolescent Psychiatry (PROTAIA), Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul (UFRGS), Brazil; National Science and Technology Institute for Child and Adolescent Psychiatry (INPD), Hospital de Clínicas de Porto Alegre (HCPA), Brazil.
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Silva NTD, Schestatsky P, Winckler PB, Salum GA, Petroceli AW, Heldt EPDS. Oppositionality and sympathetic skin response in adolescents: Specific associations with the headstrong/hurtful dimension. Biol Psychol 2014; 103:242-7. [DOI: 10.1016/j.biopsycho.2014.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 09/15/2014] [Accepted: 09/16/2014] [Indexed: 10/24/2022]
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Flores SM, Salum GA, Manfro GG. Dysfunctional family environments and childhood psychopathology: the role of psychiatric comorbidity. Trends Psychiatry Psychother 2014; 36:147-51. [PMID: 27003846 DOI: 10.1590/2237-6089-2014-0003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The study of the association between specific characteristics of family environments and different types of psychopathology may contribute to our understanding of these complex disorders and ultimately inform therapeutics. OBJECTIVE To compare the family characteristics of four groups: typically developing children; children with anxiety disorders only; children with externalizing disorders only; and children with both anxiety and externalizing disorders. METHODS This study enrolled 115 individuals from the community. Child psychiatrists made psychiatric diagnoses using a structured clinical interview. The Family Environment scale was used to evaluate six domains of family function. RESULTS The group with both anxiety and externalizing disorders had higher levels of conflict in family environment and lower levels of organization when compared with typically developing children. In addition, internalizing and externalizing symptoms were positively associated with conflict and negatively with organization. Maternal depressive and anxious symptoms were also associated with higher conflict and lower organization scores. CONCLUSION An important between-group difference in comorbid cases of anxiety and behavioral disorders suggests that children with this comorbidity are potential candidates for family interventions to address family conflicts and organizational aspects.
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Salum GA, DeSousa DA, Bosa VL, Schuch I, Goldani M, Isolan LR, Teche SP, Fleck MP, Rohde LA, Manfro GG. Internalizing disorders and quality of life in adolescence: evidence for independent associations. Rev Bras Psiquiatr 2014; 36:305-12. [DOI: 10.1590/1516-4446-2014-1362] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 02/17/2014] [Indexed: 11/22/2022]
Affiliation(s)
- Giovanni A. Salum
- Hospital de Clínicas de Porto Alegre (HCPA), Brazil; HCPA, Brazil; HCPA, Brazil
| | | | | | | | | | | | | | | | - Luis A. Rohde
- Hospital de Clínicas de Porto Alegre (HCPA), Brazil; HCPA, Brazil
| | - Gisele G. Manfro
- Hospital de Clínicas de Porto Alegre (HCPA), Brazil; HCPA, Brazil; HCPA, Brazil
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Franz AP, Rateke L, Hartmann T, McLaughlin N, Torres AR, do Rosário MC, Filho EC, Ferrão YA. Separation anxiety disorder in adult patients with obsessive-compulsive disorder: prevalence and clinical correlates. Eur Psychiatry 2015; 30:145-51. [PMID: 24908152 DOI: 10.1016/j.eurpsy.2014.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 04/13/2014] [Accepted: 04/21/2014] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Individuals with obsessive-compulsive disorder (OCD) and separation anxiety disorder (SAD) tend to present higher morbidity than do those with OCD alone. However, the relationship between OCD and SAD has yet to be fully explored. METHOD This was a cross-sectional study using multiple logistic regression to identify differences between OCD patients with SAD (OCD+SAD, n=260) and without SAD (OCD, n=695), in terms of clinical and socio-demographic variables. Data were extracted from those collected between 2005 and 2009 via the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders project. RESULTS SAD was currently present in only 42 (4.4%) of the patients, although 260 (27.2%) had a lifetime diagnosis of the disorder. In comparison with the OCD group patients, patients with SAD+OCD showed higher chance to present sensory phenomena, to undergo psychotherapy, and to have more psychiatric comorbidities, mainly bulimia. CONCLUSION In patients with primary OCD, comorbid SAD might be related to greater personal dysfunction and a poorer response to treatment, since sensory phenomena may be a confounding aspect on diagnosis and therapeutics. Patients with OCD+SAD might be more prone to developing specific psychiatric comorbidities, especially bulimia. Our results suggest that SAD symptom assessment should be included in the management and prognostic evaluation of OCD, although the psychobiological role that such symptoms play in OCD merits further investigation.
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Kieling RR, Kieling C, Aguiar AP, Costa AC, Dorneles BV, Rohde LA. Searching for the best approach to assess teachers' perception of inattention and hyperactivity problems at school. Eur Child Adolesc Psychiatry 2014; 23:451-9. [PMID: 23999730 DOI: 10.1007/s00787-013-0466-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 08/13/2013] [Indexed: 10/26/2022]
Abstract
Although major guidelines in the field and current diagnostic criteria clearly demand an assessment of children's attention deficit/hyperactivity disorder (ADHD) symptoms at school, few studies address the fundamental question of which is the best approach for clinicians to get this information from teachers. Three screening strategies for ADHD were applied to teachers of 247 third grade students. They were asked (1) an overt question about potential cases of ADHD in their classroom; (2) to complete a broad-band questionnaire assessing common child mental health problems; (3) to rate ADHD-specific symptoms in a narrow-band questionnaire. Based on the overt question, teachers identified one in five students (21.1 %) as having ADHD; 28 cases (11.3 %) were identified using standard cut-offs for the narrow-band, and 13 (5.3 %) using a standard threshold for the sub-scale of hyperactivity from the broad-band questionnaire. Agreement among strategies was low (k = 0.28). A subsample of students, clinically assessed to confirm screenings, showed modest agreement with final diagnosis. The narrow-band questionnaire had the best diagnostic performance. Multivariate analysis indicated that the presence of a comorbid externalizing disorder was the only variable associated with teachers' ascertainment of ADHD caseness or non-caseness. Choice of screening strategy significantly affects how teachers report on ADHD symptoms at school. The halo effect of externalizing behaviors impacts the correct identification of true cases of ADHD in the school setting. Clinicians can rely on narrow-band instruments like the SNAP-IV to get information on ADHD symptoms at school from teachers.
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Toazza R, Salum GA, Flores SM, Jarros RB, Pine DS, de Salles JF, Manfro GG. Phonemic verbal fluency is associated with pediatric anxiety disorders: evidence from a community study. J Child Adolesc Psychopharmacol 2014; 24:149-57. [PMID: 24725199 DOI: 10.1089/cap.2013.0086] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Anxiety disorders typically begin in childhood and adolescence and predict risk for many problems throughout life. Although some neuropsychological correlates have been described, more research is needed, particularly in adolescents. This study compares neurocognitive characteristics of anxious adolescents with and without comorbidity to externalizing disorders to those of typically developing comparison (TDC) adolescents and adolescents with externalizing disorders alone. METHODS The study included 57 adolescents 12-18 years of age (TDC, n=23; anxiety, n=16; externalizing, n=11; comorbid, n=7). We used a neuropsychological battery to assess eight domains: Orientation, attention, visual perception, memory, arithmetic, language, praxis, and executive function. RESULTS Multivariate analysis of variance revealed a main effect of group in the neurocognitive domains evaluated (F8,48=2.32, p=0.034, ηp(2)=0.279). Post-hoc analysis revealed that executive functions score differed among groups, specifically in the task of verbal fluency (F[df=3]=5.01, p=0.004, ηp(2)=0.221), with both the anxious groups (anxiety and comorbid) presenting a lower score than the TDC and externalizing groups. This effect was independent of age, intelligence, and levels of education. CONCLUSIONS Verbal fluency is specifically impaired in adolescents with anxiety disorders. This extends results from neuroimaging research implicating prefrontal areas in pediatric anxiety disorder neurobiology, and has potential implications to new therapeutics.
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Affiliation(s)
- Rudineia Toazza
- 1 Anxiety Disorders Program for Child and Adolescent Psychiatry (PROTAIA), Department of Developmental and Personality Psychology, Institute of Psychology, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre, RS, Brazil
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Ferreira CF, Bernardi JR, Bosa VL, Schuch I, Goldani MZ, Kapczinski F, Salum GA, Dalmaz C, Manfro GG, Silveira PP. Correlation between n-3 polyunsaturated fatty acids consumption and BDNF peripheral levels in adolescents. Lipids Health Dis 2014; 13:44. [PMID: 24593295 PMCID: PMC3974009 DOI: 10.1186/1476-511x-13-44] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 02/20/2014] [Indexed: 12/21/2022] Open
Abstract
Background Although several studies have reported an association between mental disorders and serum levels of brain-derived neurotrophic factor (BDNF), this association is still poorly understood. The study of factors associated with both BDNF levels and mental disorders, such as n-3 polyunsaturated fatty acids (n-3 PUFAs), may help to elucidate the mechanisms mediating the relationship between the two variables. Therefore, the present study aimed to evaluate whether the intake n-3 PUFAs correlates with serum levels of BDNF. Findings This study involved 137 adolescents drawn from a community sample, including a group with high levels of anxiety, assessed using the Screen for Children and Anxiety Related Emotional Disorders. Blood samples were collected and serum BDNF levels were measured. n-3 PUFAs were estimated using a food frequency questionnaire for adolescents. Correlations were performed to assess the association between n-3 PUFAs intake and BDNF levels. Effects of potential confounders (total fat consumption, age, gender and anxiety) were examined using linear regression models. There was a direct correlation between n-3 PUFAs consumption and serum BDNF levels, which remained significant even after accounting for potential confounders. Conclusions We were able to detect a correlation between n-3 PUFAs intake and peripheral BDNF levels. Our study was limited by its small sample size, and our external validity may be restricted by the oversampling of anxious adolescents. Our findings may help determine the nature of the association between mental disorders and serum levels of BDNF. However, more studies are needed to elucidate the possible mechanisms by which n-3 PUFAs intake affects BDNF levels, and how this may lead to an increased vulnerability to psychiatric disorders.
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Affiliation(s)
- Charles Francisco Ferreira
- Post Graduate Program in Neuroscience, Institute of Basic Sciences/Health, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
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Salum GA, Desousa DA, do Rosário MC, Pine DS, Manfro GG. Pediatric anxiety disorders: from neuroscience to evidence-based clinical practice. Braz J Psychiatry 2014; 35 Suppl 1:S03-21. [PMID: 24142122 DOI: 10.1590/1516-4446-2013-s108] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective of this narrative review of the literature is to describe the epidemiology, etiology, pathophysiology, diagnosis, and treatment of pediatric anxiety disorders. We aim to guide clinicians in understanding the biology of anxiety disorders and to provide general guidelines for the proper diagnoses and treatment of these conditions early in life. Anxiety disorders are prevalent, associated with a number of negative life outcomes, and currently under-recognized and under-treated. The etiology involves both genes and environmental influences modifying the neural substrate in a complex interplay. Research on pathophysiology is still in its infancy, but some brain regions, such as the amygdala and the prefrontal cortex, have been implicated in fear and anxiety. Current practice is to establish diagnosis based purely on clinical features, derived from clinical interviews with the child, parents, and teachers. Treatment is effective using medication, cognitive behavioral therapy, or a combination of both. An introduction to the neuroscience behind anxiety disorders combined with an evidence-based approach may help clinicians to understand these disorders and treat them properly in childhood.
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Affiliation(s)
- Giovanni Abrahão Salum
- Universidade Federal do Rio Grande do Sul, Anxiety Disorders Outpatient Program for Child and Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre, Porto AlegreRS, Brazil
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Isolan L, Salum GA, Osowski AT, Zottis GH, Manfro GG. Victims and bully-victims but not bullies are groups associated with anxiety symptomatology among Brazilian children and adolescents. Eur Child Adolesc Psychiatry 2013; 22:641-8. [PMID: 23553573 DOI: 10.1007/s00787-013-0412-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 03/23/2013] [Indexed: 11/29/2022]
Abstract
School bullying is frequent and is associated with a broad spectrum of psychiatric problems. The aims of this study were to examine the prevalence of bullying behaviors in a large sample of Brazilian children and adolescents and to investigate the association between bullying behaviors and DSM-IV anxiety symptomatology. This cross-sectional study involved completion of a questionnaire about bullying behaviors and their frequency and the Screen for Child Anxiety-Related Emotional Disorders (SCARED) that is a self-report screening tool for childhood anxiety disorders by 2,355 students. A total of 22.9 % of the sample reported frequent involvement in bullying, as a bully (7.6 %), as a victim (5.7 %), or as a bully-victim (9.6 %). In general, our findings showed that students involved in bullying behaviors, as victims or bully-victims, were more likely to have higher scores in SCARED total and its subscales than bullies and than uninvolved students. The prevalence of bullying behaviors among Brazilian youth is about average when compared with previous samples described in the literature. Victims and bully-victims, but no bullies, are groups associated with higher anxiety symptomatology.
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Affiliation(s)
- Luciano Isolan
- Anxiety Disorders Program for Children and Adolescents, Hospital de Clínicas de Porto Alegre (HCPA), Ramiro Barcelos, 2350, Room: 2202, Porto Alegre, CEP 90035-003, Brazil,
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Masi G, Mucci M, Pfanner C, Berloffa S, Liboni F, Perugi G. Pediatric generalized anxiety disorder: predictors of outcome after selective serotonin reuptake inhibitor monotherapy. J Clin Psychopharmacol 2013; 33:577-9. [PMID: 23775050 DOI: 10.1097/JCP.0b013e31829465cb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Desousa DA, Salum GA, Isolan LR, Manfro GG. Sensitivity and specificity of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a community-based study. Child Psychiatry Hum Dev 2013; 44:391-9. [PMID: 22961135 DOI: 10.1007/s10578-012-0333-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this cross-sectional community-based study was to examine the sensitivity and specificity of the Screen for Child Anxiety Related Emotional Disorders (SCARED) to the diagnosis of anxiety disorders (AD). Participants were 119 students aged 9-18. Psychiatric diagnoses were assessed by a psychiatrist throughout a structural clinical interview (K-SADS-PL). Forty-four participants had positive diagnosis for at least one AD. The total score of the SCARED significantly differentiated anxious from non-anxious children with an optimal cutoff point of 22 (sensitivity = 81.8 %; specificity = 52.0 %). SCARED subscales of social phobia and separation anxiety disorder, but not generalized anxiety disorder, revealed better discrimination proprieties than total scores to screen for that specific disorder (p < .05). Both total and specific SCARED scores presented moderate sensitivity and specificity for detecting AD in a community sample. Investigators interested in screening for specific AD, rather than the group of AD, may benefit from using the specific subscales.
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Affiliation(s)
- Diogo Araújo Desousa
- Center for Psychological Studies on At Risk Populations (CEP-Rua), Postgraduate Program in Psychology, Institute of Psychology, Universidade Federal do Rio Grande do Sul, 2600 Ramiro Barcelos, Room 104, Porto Alegre, RS, 90035-003, Brazil.
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de Souza MA, Salum GA, Jarros RB, Isolan L, Davis R, Knijnik D, Manfro GG, Heldt E. Cognitive-behavioral group therapy for youths with anxiety disorders in the community: effectiveness in low and middle income countries. Behav Cogn Psychother 2013; 41:255-64. [PMID: 23438373 DOI: 10.1017/S1352465813000015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Although cognitive-behavioral therapy (CBT) is established as a first line treatment for anxiety disorders in children and adolescents, there is little evidence about the effectiveness of CBT protocols in cases identified in the community in low and middle income countries (LaMICs). AIMS To evaluate the effectiveness of group CBT protocol for youths with anxiety disorders identified in a community sample in LaMICs. METHOD A total of 14 sessions of group CBT for youths and 2 concurrent sessions for parents based on Kendall's Coping Cat program were offered. Participants were selected from a cross-sectional community study; 45 subjects fulfilled inclusion criteria and 28 agreed to participate in the open clinical trial. Treatment effectiveness was evaluated with standard clinical, self- and parent-rated measures of anxiety, depression, externalizing symptoms and quality of life (QoL). RESULTS Twenty youths completed the protocol. All scales showed an improvement of anxiety and reduction in externalizing symptoms over time, with a moderate to large effect size (d = 0.59 to 2.06; p < .05), but not in depressive symptoms or QoL. CONCLUSIONS Consistent with previous evidence, group CBT is effective in treating anxiety disorders in youths. Results encourage further randomized clinical trials using CBT protocols adapted and developed to be used in LaMICs.
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Dalle Molle R, Portella AK, Goldani MZ, Kapczinski FP, Leistner-Segal S, Salum GA, Manfro GG, Silveira PP. Associations between parenting behavior and anxiety in a rodent model and a clinical sample: relationship to peripheral BDNF levels. Transl Psychiatry 2012; 2:e195. [PMID: 23168995 DOI: 10.1038/tp.2012.126] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Adverse early-life environment is associated with anxiety-like behaviors and disorders. Brain-derived neurotrophic factor (BDNF) is sensitive to this environment and could be a marker of underlying brain changes. We aimed at evaluating the development of anxiety-like behaviors in a rat model of early adversity, as well as the possible association with BDNF levels. Similar associations were investigated in a sample of adolescent humans. For the rat study, Wistar rat litters were divided into: early-life stress (ELS, limited access to nesting material) and control groups. Maternal behavior was observed from days 1 to 9 of life and, as adults, rats were subjected to behavioral testing and BDNF measurements in plasma, hippocampus, amygdala and periaqueductal gray. For the human study, 129 adolescents were evaluated for anxiety symptoms and perceived parental care. Serum BDNF levels and the Val66Met polymorphism of the BDNF gene were investigated. We found that ELS dams showed more pure contact, that is, contact with low care and high control, toward pups, and their adult offspring demonstrated higher anxiety-like behaviors and plasma BDNF. Also the pure contact correlated positively with adult peripheral BDNF. Similarly in humans, there was a positive correlation between maternal overprotection and serum BDNF only in Met carriers. We also found negative correlations between maternal warmth and separation anxiety, social phobia and school phobia. Finally, our translational approach revealed that ELS, mediated through variations in maternal care, is associated with anxiety in both rats and humans and increased peripheral BDNF may be marking these phenomena.
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Jarros RB, Salum GA, Belem da Silva CT, Toazza R, de Abreu Costa M, Fumagalli de Salles J, Manfro GG. Anxiety disorders in adolescence are associated with impaired facial expression recognition to negative valence. J Psychiatr Res 2012; 46:147-51. [PMID: 22018638 DOI: 10.1016/j.jpsychires.2011.09.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 09/12/2011] [Accepted: 09/29/2011] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim of the present study was to test the ability of adolescents with a current anxiety diagnosis to recognize facial affective expressions, compared to those without an anxiety disorder. METHODS Forty cases and 27 controls were selected from a larger cross sectional community sample of adolescents, aged from 10 to 17 years old. Adolescent's facial recognition of six human emotions (sadness, anger, disgust, happy, surprise and fear) and neutral faces was assessed through a facial labeling test using Ekman's Pictures of Facial Affect (POFA). RESULTS Adolescents with anxiety disorders had a higher mean number of errors in angry faces as compared to controls: 3.1 (SD=1.13) vs. 2.5 (SD=2.5), OR=1.72 (CI95% 1.02 to 2.89; p=0.040). However, they named neutral faces more accurately than adolescents without anxiety diagnosis: 15% of cases vs. 37.1% of controls presented at least one error in neutral faces, OR=3.46 (CI95% 1.02 to 11.7; p=0.047). No differences were found considering other human emotions or on the distribution of errors in each emotional face between the groups. CONCLUSION Our findings support an anxiety-mediated influence on the recognition of facial expressions in adolescence. These difficulty in recognizing angry faces and more accuracy in naming neutral faces may lead to misinterpretation of social clues and can explain some aspects of the impairment in social interactions in adolescents with anxiety disorders.
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Isolan L, Salum G, Flores SM, Carvalho HWD, Manfro GG. Reliability and convergent validity of the Childhood Anxiety Sensitivity Index in children and adolescents. J bras psiquiatr 2012. [DOI: 10.1590/s0047-20852012000400001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: The purpose of this study was to examine the reliability and the convergent validity of the Children Anxiety Sensitivity Index (CASI) with DSM-IV anxiety disorder symptoms, by comparison with the Screen for Child Anxiety Related Emotional Disorders (SCARED), in a community sample of Brazilian children and adolescents. METHODS: Children and adolescents from five schools were selected from a larger study that aimed to assess different aspects of childhood anxiety disorders. All participants completed the CASI and the SCARED. RESULTS: This study supported the reliability of the CASI total score. Girls reported higher total anxiety sensitivity scores than boys and there were no differences in total anxiety sensitivity scores between children and adolescents. This study showed moderate to high correlations between the CASI scores with SCARED scores, all correlations coefficients being positive and significant. CONCLUSIONS: Our findings demonstrate an appropriate reliability and evidence of convergent validity in the CASI in a sample of Brazilian children and adolescents.
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Affiliation(s)
- Luciano Isolan
- Hospital de Clínicas de Porto Alegre, Brazil; Universidade Federal do Rio Grande do Sul, Brazil
| | - Giovanni Salum
- Hospital de Clínicas de Porto Alegre, Brazil; Universidade Federal do Rio Grande do Sul, Brazil; Institute of Developmental Psychiatry for Children and Adolescent
| | | | | | - Gisele Gus Manfro
- Hospital de Clínicas de Porto Alegre, Brazil; Universidade Federal do Rio Grande do Sul, Brazil; Institute of Developmental Psychiatry for Children and Adolescent
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Tocchetto A, Salum GA, Blaya C, Teche S, Isolan L, Bortoluzzi A, Rebelo e Silva R, Becker JA, Bianchin MM, Rohde LA, Leistner-segal S, Manfro GG. Evidence of association between Val66Met polymorphism at BDNF gene and anxiety disorders in a community sample of children and adolescents. Neurosci Lett 2011; 502:197-200. [DOI: 10.1016/j.neulet.2011.07.044] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Revised: 07/17/2011] [Accepted: 07/26/2011] [Indexed: 01/08/2023]
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