Intergenerational transmission of antisocial personality disorder: Maternal role and its declination

Antisocial personality disorder is a well-established disease which features space from cruelty to lack of empathy and remorse. Its etiology has been deeply analyzed both for genetic and environmental implications. The role of family context has been underlined throughout the whole psychopathology as an explanation to the etiological conflict between nature and nurture. Even if this conflict seems to be apparently solved, it is still possible to ponder about family implications in terms of causes and consequences. In the antisocial field, maternal role may offer interesting and surprising food for thought. Even if it is commonly believed an intergenerational transmission of aberrant behaviors, particularly in terms of learning behaviors and lack of empathy assimilation, it exists a side part of maternal pathological expression that may play a role in the intergenerational transmission and it is extremely difficult to be detected. Female declination of this disorder may be expressed also through somatic implications and complaints, leading to the hypothesis of a self-reflection of the lack of consideration for other's needs, which is distinctive. It is of extreme importance, particularly in terms of prevention, to consider and identify these connotations of the disorder to be able to try to interrupt the cycle of transmission through generations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Abuse During Childhood and Burnout

Background

Childhood maltreatment is the most important risk factor for the onset of psychiatric disorders. Revictimization is really frequent as well as substance or alcohol abuse, often linked to self-treatment. Accordingly, our pilot study aims to analyze possible implication of childhood maltreatment on resilience and burnout.

Methods

Patients admitted to outpatients psychiatric department in a six month period (1st January 2015–30th June 2015) complaining low to moderate anxiety or depression have been administered childhood trauma questionnaire (CTQ) and Maslach burnout inventory.

Results

CTQ results in 71 (87%) Emotional Neglect (EN), 2 (2.4%) Sexual Abuse (SA) and 2 (2.4%) Physical Abuse (PA). Twenty-one showed high emotional exhaustion, 21 high depersonalization, 9 moderate personal accomplishment while 1 showed low personal accomplishment. None of the patients who suffered child sexual abuse shows depersonalization or personal accomplishment difficulties linked to burnout. Patients negative to CTQ show respectively moderate emotional exhaustion (M = 20 ± 20.15), moderate depersonalization (11 ± 9.42) and high personal accomplishment (17 ± 12.38). Patients who suffered emotional neglect show the poorest profile at Maslach, particularly regarding emotional exhaustion. ANOVA reaches statistical significance among the 3 groups of detected abuse (EN, SA, PA) in personal accomplishment (P = 0.013) confirmed at POST HOC between EN and SA (P = 0.0004).

Conclusion

The results obtained in this pilot study highlight two important considerations. First, it seems urgent to stress the huge prevalence of emotional neglect among those referred to psychiatric outpatient department due to moderate anxiety or depression complain. Moreover, emotional neglect appears to be the most compromised factor of burnout, especially if compared to sexual abuse.

Personality Disorders and Perinatal Psychiatry: Food for Thoughts from Perinatal Psychiatric Department Experience

Background

Pregnancy and postpartum are sensitive unique moments in women's life. Perinatal psychiatry is focused on depression and psychosis, but personality issues is often neglected as well as risk factors for personality disorders instead of being considered causative of onset or recrudescence of psychiatric symptoms in perinatal.

Methods

In total, 129 women were referred to perinatal psychiatric department during their pregnancy or postpartum in the last three years. They were administered SCID II, Childhood Trauma Questionnaire (CTQ), Beck Depression and Anxiety Inventories (BDI and BAI), Edinburgh Postnatal Depression Scale (EPDS) and World Health Organization Quality of Life (WHOQOL). Their interaction with babies was monitored at birth and during follow up. Children's behavioral development is under evaluation through structured tests.

Results

BDI and BAI scored moderate or severe in 31 and 27% of women, EPDS was significant in 36%, while SCID II highlighted 24% of borderline, 17% narcissistic, 4% schizoid, 4% paranoid and 9% obsessive/compulsive PD. Nineteen of them suffered physical abuse during childhood, 26 sexual abuse, 89 emotional neglect and only 15 out of 129 were negative to any kind of abuse during childhood.

Conclusion

Personality disorders appears to influence maternal adjustment to pregnancy and motherhood. Abuses suffered during childhood confirm their role as potential risk factor in personality issues which clearly express their effect in adaptation to change in personal role and in emphatic interactions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Roles of PPAR transcription factors in the energetic metabolic switch occurring during adult neurogenesis

PPARs are a class of ligand-activated transcription factors belonging to the superfamily of receptors for steroid and thyroid hormones, retinoids and vitamin D that control the expression of a large number of genes involved in lipid and carbohydrate metabolism and in the regulation of cell proliferation, differentiation and death. The role of PPARs in the CNS has been primarily associated with lipid and glucose metabolism; however, these receptors are also implicated in neural cell differentiation and death, as well as neuronal maturation. Although it has been demonstrated that PPARs play important roles in determining NSCs fate, less is known about their function in regulating NSCs metabolism during differentiation. In order to identify the metabolic events, controlled by PPARs, occurring during neuronal precursor differentiation, the glucose and lipid metabolism was followed in a recognized model of neuronal differentiation in vitro, the SH-SY5Y neuroblastoma cell line. Moreover, PPARs distribution were also followed in situ in adult mouse brains. The concept of adult neurogenesis becomes relevant especially in view of those disorders in which a loss of neurons is described, such as Alzheimer disease, Parkinson disease, brain injuries and other neurological disorders. Elucidating the crucial steps in energetic metabolism and the involvement of PPARγ in NSC neuronal fate (lineage) may be useful for the future design of preventive and/or therapeutic interventions.