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Godin O, Leboyer M, Grillault Laroche D, Aubin V, Belzeaux R, Courtet P, Dubertret C, Gard S, Haffen E, Olie E, Polosan M, Roux P, Samalin L, Schwan R, Bellivier F, Etain B. Childhood maltreatment contributes to the medical morbidity of individuals with bipolar disorders. Psychol Med 2023; 53:7341-7349. [PMID: 37185275 DOI: 10.1017/s0033291723000922] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND Individuals with bipolar disorders (BD) are at risk of premature death, mainly due to medical comorbidities. Childhood maltreatment might contribute to this medical morbidity, which remains underexplored in the literature. METHODS We assessed 2891 outpatients with BD (according to DSM-IV criteria). Childhood maltreatment was assessed using the Childhood Trauma Questionnaire. Lifetime diagnoses for medical disorders were retrospectively assessed using a systematic interview and checked against medical notes. Medical morbidity was defined by the sum of medical disorders. We investigated associations between childhood maltreatment (neglect and abuse) and medical morbidity while adjusting for potential confounders. RESULTS One quarter of individuals had no medical comorbidities, while almost half of them had at least two. Multivariable regression showed that childhood maltreatment (mainly abuse, but also sexual abuse) was associated with a higher medical morbidity. Medical morbidity was also associated with sex, age, body mass index, sleep disturbances, lifetime anxiety disorders and lifetime density of mood episodes. Childhood maltreatment was associated with an increased prevalence of four (i.e. migraine/headache, drug eruption, duodenal ulcer, and thyroid diseases) of the fifteen most frequent medical disorders, however with no difference in terms of age at onset. CONCLUSIONS This large cross-sectional study confirmed a high medical morbidity in BD and its association with childhood maltreatment. The assessment of childhood maltreatment in individuals with BD should be systematically included in routine care and the potential impact on physical health of psycho-social interventions targeting childhood maltreatment and its consequences should be evaluated.
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Affiliation(s)
- Ophélia Godin
- Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Marion Leboyer
- Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory, Créteil, France
- Fondation FondaMental, Créteil, France
- Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMUIMPACT), AP-HP, Hôpitaux Universitaires Henri Mondor, FédérationHospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France
| | - Diane Grillault Laroche
- Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Paris, France
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
| | - Valérie Aubin
- Fondation FondaMental, Créteil, France
- Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco, France
| | - Raoul Belzeaux
- Fondation FondaMental, Créteil, France
- Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France
- INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - Philippe Courtet
- Fondation FondaMental, Créteil, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France
- AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France
- Université de Paris, Inserm UMR1266, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Sébastien Gard
- Fondation FondaMental, Créteil, France
- Centre Hospitalier Charles Perrens, Laboratoire NutriNeuro (UMR INRA 1286), Université de Bordeaux, Bordeaux, France
| | - Emmanuel Haffen
- Fondation FondaMental, Créteil, France
- Service de Psychiatrie de l'Adulte, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, UFC, UBFC, Besançon, France
| | - Emilie Olie
- Fondation FondaMental, Créteil, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - Mircea Polosan
- Fondation FondaMental, Créteil, France
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Paul Roux
- Fondation FondaMental, Créteil, France
- Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie d'Adulte et d'Addictologie, Le Chesnay, France
- Equipe DisAP-PsyDev, CESP, Université Versailles Saint- Quentin-en-Yvelines - Paris-Saclay, Inserm, Villejuif, France
| | - Ludovic Samalin
- Fondation FondaMental, Créteil, France
- Département de Psychiatrie, Centre Hospitalier et Universitaire, Clermont-Ferrand, France
- Université d'Auvergne, EA 7280, Clermont-Ferrand, France
| | - Raymund Schwan
- Fondation FondaMental, Créteil, France
- Université de Lorraine, Centre Psychothérapique de Nancy, Inserm U1254, Nancy, France
| | - Frank Bellivier
- Fondation FondaMental, Créteil, France
- Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Paris, France
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
| | - Bruno Etain
- Fondation FondaMental, Créteil, France
- Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Paris, France
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
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Li J, Jin Y, Xu S, Luo X, Wilson A, Li H, Wang X, Sun X, Wang Y. Anxiety and Depression Symptoms among Youth Survivors of Childhood Sexual Abuse: A Network Analysis. BMC Psychol 2023; 11:278. [PMID: 37717011 PMCID: PMC10504753 DOI: 10.1186/s40359-023-01275-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 08/08/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Previous studies have frequently reported a high prevalence of co-occurring anxiety and depression among people who experienced stressful events in childhood. However, few have noted the symptomatic relationship of this comorbidity among childhood sexual abuse (CSA) survivors. Therefore, this study's objectives were as follows: (1) to examine the relationship across symptoms between anxiety and depression among CSA survivors; (2) to compare differences between male and female network structures among CSA survivors. METHODS A total of 63 Universities and Colleges in Jilin Province, China, covered 96,218 participants in this study, a sub-set data of which met the criteria of CSA was analyzed with the network analysis. The Childhood Trauma Questionnaire-Short Form (CTQ-SF), measured CSA. Anxiety was measured by the seven-item Generalized Anxiety Disorder Scale (GAD-7), and depression was measured by the Patient Health Questionnaire (PHQ-9). The sex difference between anxiety and depression among CSA survivors was compared. RESULTS 3,479 college students reported the experience of CSA (CTQ-SF total scores ≥ 8), with a prevalence of 3.62% (95% CI: 3.50-3.73%). Among CSA survivors, control worry, sad mood, and energy were central and bridge symptoms of the anxiety and depression network. Meanwhile, male CSA survivors appeared to have a stronger correlation between guilt and suicide, but female CSA survivors seemed to have a stronger correlation between control worry and suicide. Moreover, the edge of control worry-relax-afraid was stronger in the male network, while the edge of restless-relax was stronger in the female network. CONCLUSION Control worry, sad mood, and energy are crucial to offer targeted treatment and to relieve anxiety and depression symptoms for CSA survivors. Guilt needs more attention for male CSA survivors, while control worry remains more important for female CSA survivors to reduce suicidal ideation and suicide attempts.
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Affiliation(s)
- Jiaqi Li
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yu Jin
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, China.
- Department of Population, Resources, and Environment, Northeast Asian Studies College, Jilin University, Changchun, China.
- China Center for Aging Studies and Social-Economic Development, Jilin University, Changchun, China.
| | - Xianyu Luo
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Hui Li
- School of Public Health, Jilin University, Changchun, China
| | - Xiaofeng Wang
- Northeast Asian Research Center, Jilin University, Changchun, China
| | - Xi Sun
- Department of Population, Resources, and Environment, Northeast Asian Studies College, Jilin University, Changchun, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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3
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Reingold OH, Goldner L. "It was wrapped in a kind of normalcy": The lived experience and consequences in adulthood of survivors of female child sexual abuse. Child Abuse Negl 2023; 139:106125. [PMID: 36870267 DOI: 10.1016/j.chiabu.2023.106125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 02/14/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Survivors' surveys on the frequency of sexual offenses committed by women indicated a prevalence rate of 9.9 % to 11.6 %. Nevertheless, only a few studies have explored the long-term consequences of abuse on survivors. OBJECTIVES Examine the lived experiences and the long-term consequences of child sexual abuse committed by women. PARTICIPANTS Fifteen adult participants who experienced child sexual abuse conducted by female offenders participated in the study. METHODS The Interpretive Phenomenological Approach was applied to semi-structured interviews. RESULTS Three central themes emerged: types of abuse, characteristics of the perpetrator, and consequences of abuse. Most survivors experienced direct or indirect forms of sexual abuse committed by their mothers. In most cases, the offenders masked their abuse in caregiving, disciplinary or playful behavior. The survivors perceived their mothers as narcissistic, controlling, hostile, and having tremendous difficulties with separation. The survivors reported the need to engage in extensive negative long-lasting psychopathologies, which they attributed partly to having been invalidated and silenced by society. Many participants expressed fears of re-enacting the survivor or perpetrator role, which has led to difficulties in various relationships. They described an altered perception of their bodies as shameful and repulsive, manifesting in self-harm, eating disorders, and the elimination of signs of femininity. CONCLUSION This complex form of sexual abuse hampers the internalization and the construction of positive feminine, masculine, and parental identities.
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Affiliation(s)
- Ortal Herzig Reingold
- School of Creative Arts Therapies, Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel
| | - Limor Goldner
- School of Creative Arts Therapies, Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.
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D'Elia ATD, Juruena MF, Coimbra BM, Mello MF, Mello AF. Increased immuno-inflammatory mediators in women with post-traumatic stress disorder after sexual assault: 1-Year follow-up. J Psychiatr Res 2022; 155:241-251. [PMID: 36113394 DOI: 10.1016/j.jpsychires.2022.08.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 03/27/2022] [Revised: 08/21/2022] [Accepted: 08/31/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Sexual violence is a traumatic event that can trigger post-traumatic stress disorder (PTSD) and generate biological responses to stress characterized by inhibiting the hypothalamic-pituitary axis (HPA), altering immune activity, and changing the structure and function of the brain. PTSD is associated with increased levels of inflammatory markers. This study aimed to measure differences in inflammatory markers and HPA hormone levels between women with PTSD due to sexual violence and controls at baseline and after 1-year follow-up. METHODS Fifty-eight women with PTSD resulting from sexual assault occurring up to 6 months prior were compared to 41 female controls. The patients were followed for 1 year. At baseline (T1), we measured inflammatory biomarkers. We also applied the Mini International Neuropsychiatric Interview (MINI), the Clinician-Administered Post-Traumatic Stress Disorder Scale-5, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Childhood Trauma Questionnaire. The patients were randomized to receive treatment with sertraline or interpersonal psychotherapy for 14 weeks (T2) and then continued the usual treatment if deemed necessary for 1 year. The same interviews and examinations were repeated after 1 year (T3). RESULTS At baseline, the patients had significantly higher adrenocorticotropic hormone levels, compared to controls; however, there was no baseline difference in inflammatory markers or cortisol. After 1 year, there were significantly higher levels of interleukin-1β (p < 0.0001), monocyte chemoattractant protein-1 (p < 0.0001), tumor necrosis factor-α (p < 0.0001), c-reactive protein (p < 0.0001), and cortisol (p = 0.046) in the patient group. In addition to PTSD, 56 patients presented with a major depressive episode at T1 (according to the MINI). At the end of 1 year, there was a significant improvement in depressive (p < 0.001), anxiety (p = 0.03), and PTSD symptoms (p < 0.001) regardless of the treatment received. DISCUSSION The increase of the inflammatory markers after 1 year, even with symptomatic improvement, may indicate that PTSD following sexual violence is associated with high depressive symptoms. This association may have a different pattern of immunoendocrine alterations than PTSD only. Furthermore, these alterations may persist in the long term, even with the improvement of the symptoms, probably generating an immunological imprint that can lead to future clinical consequences. This study adds to the current knowledge of PTSD neurobiology and contributes to broadening approaches to this disorder.
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Affiliation(s)
- Ana Teresa D D'Elia
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
| | - Mario F Juruena
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, Kings College London, London, United Kingdom
| | - Bruno M Coimbra
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Amsterdam UMC, location University of Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam, the Netherlands
| | - Marcelo F Mello
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Andrea F Mello
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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Cruz A, Vieira M, Mesquita AR, Sampaio A, Mendes-Pinto I, Soares I, Freitas PP. Non-invasive diagnosis and monitoring tool of children’s mental health: A point-of-care immunosensor for IL-6 quantification in saliva samples. Front Neurosci 2022; 16:919551. [PMID: 36225733 PMCID: PMC9549322 DOI: 10.3389/fnins.2022.919551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/13/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
Mental disorders are commonly featured as chronic conditions with often onset during childhood. In this context, inflammation has been associated with a higher risk of developing physical and mental health problems. Interleukin (IL)-6 is a key mediator of inflammatory responses and plays a pivotal role in immune and nervous system interaction. High levels of IL-6 during childhood are associated with mental problems, indicating that the IL-6 molecular pathway may represent a new target for monitoring and treating these conditions. Here, we report the detection of IL-6 in saliva samples from children (N = 118, mean age 4.4 years old) with behavioral problems using an immunosensor based on electrochemical impedance spectroscopy. This work demonstrates that the proposed immunosensor requires smaller sample volumes and is significantly faster and more sensitive than conventional ELISA while maintaining comparable levels of specificity and reproducibility. The point-of care immunosensor for detection of IL-6 in saliva samples presented herewith is, therefore, an attractive solution to the clinical practice as a rapid non-invasive, high-sensitive monitoring tool of mental health problems, especially in vulnerable patient populations such as children.
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Affiliation(s)
- Andrea Cruz
- ProChild CoLAB Against Child Poverty and Social Exclusion, Portuguese Foundation for Science and Technology (FCT) Collaborative Laboratory, Guimarães, Portugal
- *Correspondence: Andrea Cruz, ,
| | - Maria Vieira
- International Iberian Nanotechnology Laboratory, Braga, Portugal
| | - Ana R. Mesquita
- CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Adriana Sampaio
- CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | | | - Isabel Soares
- CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Paulo P. Freitas
- International Iberian Nanotechnology Laboratory, Braga, Portugal
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Waters RC, Gould E. Early Life Adversity and Neuropsychiatric Disease: Differential Outcomes and Translational Relevance of Rodent Models. Front Syst Neurosci 2022; 16:860847. [PMID: 35813268 PMCID: PMC9259886 DOI: 10.3389/fnsys.2022.860847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/19/2022] [Indexed: 12/02/2022] Open
Abstract
It is now well-established that early life adversity (ELA) predisposes individuals to develop several neuropsychiatric conditions, including anxiety disorders, and major depressive disorder. However, ELA is a very broad term, encompassing multiple types of negative childhood experiences, including physical, sexual and emotional abuse, physical and emotional neglect, as well as trauma associated with chronic illness, family separation, natural disasters, accidents, and witnessing a violent crime. Emerging literature suggests that in humans, different types of adverse experiences are more or less likely to produce susceptibilities to certain conditions that involve affective dysfunction. To investigate the driving mechanisms underlying the connection between experience and subsequent disease, neuroscientists have developed several rodent models of ELA, including pain exposure, maternal deprivation, and limited resources. These studies have also shown that different types of ELA paradigms produce different but somewhat overlapping behavioral phenotypes. In this review, we first investigate the types of ELA that may be driving different neuropsychiatric outcomes and brain changes in humans. We next evaluate whether rodent models of ELA can provide translationally relevant information regarding links between specific types of experience and changes in neural circuits underlying dysfunction.
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7
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Kim YJ, Levantsevych OM, Elon L, Lewis TT, Suglia SF, Bremner JD, Quyyumi AA, Pearce B, Raggi P, Vaccarino V, Shah AJ. Early life stress and autonomic response to acute mental stress in individuals with coronary heart disease. J Trauma Stress 2022; 35:521-532. [PMID: 35032417 PMCID: PMC9109683 DOI: 10.1002/jts.22766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/02/2021] [Revised: 07/20/2021] [Accepted: 08/27/2021] [Indexed: 11/06/2022]
Abstract
Early life stress (ELS) has been associated with an increased risk of cardiovascular disease. We examined whether ELS was associated with autonomic function and stress reactivity among individuals with coronary heart disease (CHD). We included patients with stable CHD from two parallel studies, the Mental Stress Ischemia Prognosis Study (MIPS) and the Myocardial Infarction and Mental Stress Study 2 (MIMS2), and assessed ELS using the Early Trauma Inventory-Self-Report-Short Form. Participants underwent a laboratory-based mental stress task while undergoing ambulatory electrocardiographic monitoring. We used multivariate linear regression models to estimate the associations between ELS and heart rate variability (HRV; low frequency [LF], high frequency [HF], and LF and HF [LH] ratio). The analytic sample included 405 MIPS and 284 MIMS2 participants. Most participants endorsed at least one experience of ELS (92.2%). Although we did not observe associations between ELS and HRV outcomes in the overall sample, ELS was associated with lower LH ratio HRV during recovery in the posttraumatic stress disorder (PTSD) subgroup, ELS x PTSD interaction, p = .041. In the MIMS2 subgroup, ELS was associated with lower resting period LF HRV, B ̂ $ \widehat{B} $ = -0.16 ln ms2 ; 95% CI [-0.31, -0.02]. Exposure to physical trauma was associated with decreased HF HRV overall reactivity only among participants with high to moderate depressive symptoms, B ̂ $ \widehat{B} $ = -0.52 ln ms2 vs. B ̂ $ \widehat{B} $ = 0.01 ln ms2 , p = .013. Overall, heterogeneous associations between ELS and HRV emerged, suggesting the need for additional research regarding longer-term ambulatory HRV.
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Affiliation(s)
- Ye Ji Kim
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | | | - Lisa Elon
- Department of Biostatistics, Rollins School of Public Health, Emory University Atlanta, Georgia, USA
| | - Tené T. Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Shakira F. Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - J. Douglas Bremner
- Departments of Psychiatry and Radiology and Center for Positron Emission Tomography, Emory University School of Medicine Atlanta, Georgia, USA
| | - Arshed A. Quyyumi
- Department of Medicine, Division of Cardiology, Emory University, Atlanta, Georgia, USA
| | - Bradley Pearce
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Paolo Raggi
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA, Department of Medicine, Division of Cardiology, Emory University, Atlanta, Georgia, USA
| | - Amit J. Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA, Department of Medicine, Division of Cardiology, Emory University, Atlanta, Georgia, USA
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Duong A, Jeong H, El Sabbagh DES, Andreazza AC. Systemic inflammatory biomarkers in DSM-5 defined disorders and COVID-19: Evidence from published meta-analyses. Biological Psychiatry Global Open Science 2022; 3:197-203. [PMID: 35103256 PMCID: PMC8793110 DOI: 10.1016/j.bpsgos.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/03/2022] [Accepted: 01/03/2022] [Indexed: 10/27/2022] Open
Abstract
On March 11, 2020, the World Health Organization declared the outbreak of the novel SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) as a global pandemic. At the center of SARS-CoV-2 is the activation of inflammatory markers; remarkably, interleukin 6 and C-reactive protein seem to be consistently elevated in patients with SARS-CoV-2. Here, we showed that increased systemic C-reactive protein and interleukin 6 are common biomarkers of both severe COVID-19 and DSM-5-defined disorders. However, it is not known whether patients with psychiatric disorders with preexisting increased interleukin 6 and C-reactive protein are more vulnerable to severe complications of COVID-19 because of the additive inflammatory processes.
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Lo Iacono L, Trentini C, Carola V. Psychobiological Consequences of Childhood Sexual Abuse: Current Knowledge and Clinical Implications. Front Neurosci 2021; 15:771511. [PMID: 34924938 PMCID: PMC8678607 DOI: 10.3389/fnins.2021.771511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/12/2021] [Indexed: 01/18/2023] Open
Abstract
A large body of research has documented the long-term harms of childhood sexual abuse (CSA) on an individual’s emotional-adaptive function and mental health. Recent studies have also provided evidence of the biological impact of CSA, implicating specific alterations in many systems, including the endocrine and immune systems, and in DNA and chromatin, in the pathogenesis of medical disorders. Although the effects of CSA are often examined with regard to the general impact of early-life traumatic experiences, the study of CSA per sè, as a trigger of specific pathogenic pathways, would be more appropriate to understand their long-term implications and develop tailored diagnostic and therapeutic strategies. Based on these premises, this narrative minireview summarizes the research on the short-term and long-term sequelae of CSA, focusing on dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, the effects on the immune system, and the changes to DNA through altered methylation. Also, we discuss the literature that examines dysfunctional DNA telomere erosion and oxidative stress markers as a sign of CSA. Finally, recent evidence of the intergenerational transmission of the effects of CSA is reported. The impact of CSA on brain connectivity and functions is out of the scope of this review, thus brain imaging studies are not included. The results of this minireview are discussed, considering their implications for prevention and clinical practice.
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Affiliation(s)
- Luisa Lo Iacono
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy.,IRCCS Santa Lucia Foundation, Rome, Italy
| | - Cristina Trentini
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Valeria Carola
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy.,IRCCS Santa Lucia Foundation, Rome, Italy
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Pan Y, Lin X, Liu J, Zhang S, Zeng X, Chen F, Wu J. Prevalence of Childhood Sexual Abuse Among Women Using the Childhood Trauma Questionnaire: A Worldwide Meta-Analysis. Trauma Violence Abuse 2021; 22:1181-1191. [PMID: 32207395 DOI: 10.1177/1524838020912867] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Childhood sexual abuse (CSA) is a common form of childhood maltreatment. Several studies have shown that CSA adversely affects the physical and mental health. Numerous studies have evaluated the prevalence of CSA among females using various instruments. In this meta-analysis, we estimated the rate of CSA among women using the short form of the Childhood Trauma Questionnaire for the first time. Four databases (PsycINFO, PubMed, Cochrane Library, and Embase) were systematically searched for studies published as of April 2, 2018. Forty-eight articles (53 groups of samples) covering 22,224 individuals, including women, from 16 countries were selected. Using the random-effects model, the pooled overall rate of CSA was 24% (95% confidence interval [21%, 27%]). On subgroup analyses, the rate of female CSA in people with mental illness was higher than that in the general group; this result showed variability among different geographical regions.
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Affiliation(s)
- Yuli Pan
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
- * Authors have contributed equally to this work
| | - Xiujin Lin
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
- * Authors have contributed equally to this work
| | - Jianbo Liu
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, School of Mental Health, Shenzhen University, China
- * Authors have contributed equally to this work
| | - Shengjie Zhang
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Xuan Zeng
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Fenglan Chen
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Junduan Wu
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
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Abstract
Substantial evidence from various studies suggests a preeminent role for early adverse experiences in the development of psychopathology. The most recent studies reviewed here suggest that early life stressors are associated with an increased risk for anxiety disorders in adulthood. Early life stress predisposes individuals to develop a number of psychiatric syndromes, particularly affective disorders, including anxiety disorders, and is therefore a significant health problem.This review examines the emerging literature on the relationship between stress, hypothalamic-pituitary-adrenal (HPA) axis function, and generalized anxiety disorder (GAD), panic disorder, and phobias and the role of early life stress as an important risk factor for HPA axis dysfunction.The most consistent findings in the literature show increased activity of the HPA axis in depression associated with hypercortisolemia and reduced inhibitory feedback. In addition to melancholic depression, a spectrum of other conditions may be associated with increased and prolonged activation of the HPA axis, including panic, GAD, phobias and anxiety. Moreover, HPA axis changes appear to be state-dependent, tending to improve upon resolution of the anxiety syndrome. Interestingly, persistent HPA hyperactivity has been associated with higher rates of relapse. These studies suggest that an evaluation of the HPA axis during treatment may help identify patients who are at a higher risk for relapse. These findings suggest that this dysfunction of the HPA axis is partially attributable to an imbalance between glucocorticoid and mineralocorticoid receptors. Evidence has consistently demonstrated that glucocorticoid receptor function is impaired in anxiety disorders. Moreover, normal basal cortisol levels and hyper-responsiveness of the adrenal cortex during a psychosocial stressor are observed in social phobics. Finally, abnormal HPA axis activity has also been observed in generalized anxiety disordered patients. Early stressful life events may provoke alterations of the stress response and thus of the HPA axis that can endure during adulthood, predisposing individuals to develop psychopathology.
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Affiliation(s)
- Mario F Juruena
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience-King's College London, London, UK.
| | - Filip Eror
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience-King's College London, London, UK
| | - Anthony J Cleare
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience-King's College London, London, UK
| | - Allan H Young
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience-King's College London, London, UK
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Morris G, Berk M, Maes M, Carvalho AF, Puri BK. Socioeconomic Deprivation, Adverse Childhood Experiences and Medical Disorders in Adulthood: Mechanisms and Associations. Mol Neurobiol 2019; 56:5866-5890. [PMID: 30685844 PMCID: PMC6614134 DOI: 10.1007/s12035-019-1498-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [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: 11/10/2018] [Accepted: 01/15/2019] [Indexed: 12/30/2022]
Abstract
Severe socioeconomic deprivation (SED) and adverse childhood experiences (ACE) are significantly associated with the development in adulthood of (i) enhanced inflammatory status and/or hypothalamic-pituitary-adrenal (HPA) axis dysfunction and (ii) neurological, neuroprogressive, inflammatory and autoimmune diseases. The mechanisms by which these associations take place are detailed. The two sets of consequences are themselves strongly associated, with the first set likely contributing to the second. Mechanisms enabling bidirectional communication between the immune system and the brain are described, including complex signalling pathways facilitated by factors at the level of immune cells. Also detailed are mechanisms underpinning the association between SED, ACE and the genesis of peripheral inflammation, including epigenetic changes to immune system-related gene expression. The duration and magnitude of inflammatory responses can be influenced by genetic factors, including single nucleotide polymorphisms, and by epigenetic factors, whereby pro-inflammatory cytokines, reactive oxygen species, reactive nitrogen species and nuclear factor-κB affect gene DNA methylation and histone acetylation and also induce several microRNAs including miR-155, miR-181b-1 and miR-146a. Adult HPA axis activity is regulated by (i) genetic factors, such as glucocorticoid receptor polymorphisms; (ii) epigenetic factors affecting glucocorticoid receptor function or expression, including the methylation status of alternative promoter regions of NR3C1 and the methylation of FKBP5 and HSD11β2; (iii) chronic inflammation and chronic nitrosative and oxidative stress. Finally, it is shown how severe psychological stress adversely affects mitochondrial structure and functioning and is associated with changes in brain mitochondrial DNA copy number and transcription; mitochondria can act as couriers of childhood stress into adulthood.
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Affiliation(s)
- Gerwyn Morris
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong, Victoria, Australia
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong, Victoria, Australia
- Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Kenneth Myer Building, 30 Royal Parade, Parkville, Victoria, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, Victoria, Australia
| | - Michael Maes
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong, Victoria, Australia
- Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand
| | - André F Carvalho
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada
| | - Basant K Puri
- Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK.
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