The non-specific nature of mental health and structural brain outcomes following childhood trauma

2021 ◽  
pp. 1-10
Author(s):  
Theresa K. Haidl ◽  
Dennis M. Hedderich ◽  
Marlene Rosen ◽  
Nathalie Kaiser ◽  
Mauro Seves ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factor ◽  
Depressive Symptoms ◽  
Childhood Trauma ◽  
Brain Structure ◽  
Mental Health Disorders ◽  
Recent Onset ◽  
Increased Risk ◽  
Health Disorders ◽  
Structural Brain

Abstract Background Childhood trauma (CT) is associated with an increased risk of mental health disorders; however, it is unknown whether this represents a diagnosis-specific risk factor for specific psychopathology mediated by structural brain changes. Our aim was to explore whether (i) a predictive CT pattern for transdiagnostic psychopathology exists, and whether (ii) CT can differentiate between distinct diagnosis-dependent psychopathology. Furthermore, we aimed to identify the association between CT, psychopathology and brain structure. Methods We used multivariate pattern analysis in data from 643 participants of the Personalised Prognostic Tools for Early Psychosis Management study (PRONIA), including healthy controls (HC), recent onset psychosis (ROP), recent onset depression (ROD), and patients clinically at high-risk for psychosis (CHR). Participants completed structured interviews and self-report measures including the Childhood Trauma Questionnaire, SCID diagnostic interview, BDI-II, PANSS, Schizophrenia Proneness Instrument, Structured Interview for Prodromal Symptoms and structural MRI, analyzed by voxel-based morphometry. Results (i) Patients and HC could be distinguished by their CT pattern with a reasonable precision [balanced accuracy of 71.2% (sensitivity = 72.1%, specificity = 70.4%, p ≤ 0.001]. (ii) Subdomains ‘emotional neglect’ and ‘emotional abuse’ were most predictive for CHR and ROP, while in ROD ‘physical abuse’ and ‘sexual abuse’ were most important. The CT pattern was significantly associated with the severity of depressive symptoms in ROD, ROP, and CHR, as well as with the PANSS total and negative domain scores in the CHR patients. No associations between group-separating CT patterns and brain structure were found. Conclusions These results indicate that CT poses a transdiagnostic risk factor for mental health disorders, possibly related to depressive symptoms. While differences in the quality of CT exposure exist, diagnostic differentiation was not possible suggesting a multi-factorial pathogenesis.

scholarly journals Parental Mental Health in Childhood as a Risk Factor for Anxiety and Depression among People Seeking Help for Tinnitus and Hyperacusis

2019 ◽  
Vol 30 (09) ◽  
pp. 772-780 ◽  
Author(s):  
Hashir Aazh ◽  
Ali A. Danesh ◽  
Brian C. J. Moore
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Risk Factor ◽  
Mental Health Disorders ◽  
Anxiety And Depression ◽  
Future Research ◽  
Parental Mental Illness ◽  
Parental Mental Health ◽  
Health Disorders ◽  
The Relationship

AbstractParental mental illness is a risk factor for mental health disorders in the offspring. However, the relationship between parental illness in childhood and mental health disorders in adulthood among patients with tinnitus and/or hyperacusis is not known.The aim was to explore the relationship between parental mental health in childhood and anxiety and depression for patients experiencing tinnitus and/or hyperacusis.This was a retrospective cross-sectional study with a correlational design.Two hundred eighty-seven consecutive patients who attended a Tinnitus and Hyperacusis Therapy Specialist Clinic in the United Kingdom were included. Their average age was 52.5 years.The association was explored between anxiety and depression measured via the Generalized Anxiety Disorder questionnaire (GAD-7) and the Patient Health questionnaire (PHQ-9) and responses to the question “While you were growing up during the first 18 years of life did your parent(s) have depression or mental illness?”Thirty-nine percent of patients (111/287) responded “yes” to the question about their parents’ mental health, which is about double the incidence in the general population. Regression analysis showed that parental mental illness significantly increased the risk of anxiety and depression, with unadjusted odds ratios (ORs) of 2.7 (95% confidence interval [CI]: 1.5–4.9, p = 0.001) for the PHQ-9 and 2.6 (95% CI: 1.4–4.8, p = 0.002) for the GAD-7. However, when the models were adjusted for the effects of age, gender, tinnitus handicap as measured via the Tinnitus Handicap Inventory, hyperacusis handicap as measured via the Hyperacusis questionnaire, uncomfortable loudness levels, GAD-7 scores (for the depression model only), and PHQ-9 scores (for the anxiety model only), parental mental health was only significantly associated with depression, with an OR of 2.7 (95% CI: 1.08–6.7, p = 0.033).Audiologists offering tinnitus and hyperacusis rehabilitation should screen patients for parental mental illness in childhood, especially for those with comorbid depression, and make onward referral to appropriate mental health services when needed. Future research should analyze the breadth and type of adverse childhood experiences among patients with tinnitus and hyperacusis and their relationship with mental problems and treatment efficacy.

scholarly journals Invited commentaries on… Abortion and mental health disorders

2008 ◽  
Vol 193 (6) ◽  
pp. 452-454 ◽  
Author(s):  
Patricia Casey ◽  
Margaret Oates ◽  
Ian Jones ◽  
Roch Cantwell
Keyword(s):  
Mental Health ◽  
Risk Factor ◽  
Mental Health Problems ◽  
Mental Health Disorders ◽  
Induced Abortion ◽  
Evidence Based ◽  
Abortion Debate ◽  
Health Disorders ◽  
And Training ◽  
Psychiatric Issues

SummaryThe finding that induced abortion is a risk factor for subsequent psychiatric disorder in some women raises important clinical and training issues for psychiatrists. It also highlights the necessity for developing evidence-based interventions for these women. P.C. / Evidence suggesting a modest increase in mental health problems after abortion does not support the prominence of psychiatric issues in the abortion debate, which is primarily moral and ethical not psychiatric or scientific. M.O. et al.

scholarly journals Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Systematic Review of Perinatal Pharmacologic Interventions

2021 ◽  
Author(s):  
Meera Viswanathan ◽  
Jennifer Cook Middleton ◽  
Alison Stuebe ◽  
Nancy Berkman ◽  
Alison N. Goulding ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Depressive Symptoms ◽  
Child Outcomes ◽  
Mental Health Disorders ◽  
Postpartum Women ◽  
Third Trimester ◽  
The Third ◽  
Mother And Child ◽  
Health Disorders

Background. Untreated maternal mental health disorders can have devastating sequelae for the mother and child. For women who are currently or planning to become pregnant or are breastfeeding, a critical question is whether the benefits of treating psychiatric illness with pharmacologic interventions outweigh the harms for mother and child. Methods. We conducted a systematic review to assess the benefits and harms of pharmacologic interventions compared with placebo, no treatment, or other pharmacologic interventions for pregnant and postpartum women with mental health disorders. We searched four databases and other sources for evidence available from inception through June 5, 2020 and surveilled the literature through March 2, 2021; dually screened the results; and analyzed eligible studies. We included studies of pregnant, postpartum, or reproductive-age women with a new or preexisting diagnosis of a mental health disorder treated with pharmacotherapy; we excluded psychotherapy. Eligible comparators included women with the disorder but no pharmacotherapy or women who discontinued the pharmacotherapy before pregnancy. Results. A total of 164 studies (168 articles) met eligibility criteria. Brexanolone for depression onset in the third trimester or in the postpartum period probably improves depressive symptoms at 30 days (least square mean difference in the Hamilton Rating Scale for Depression, -2.6; p=0.02; N=209) when compared with placebo. Sertraline for postpartum depression may improve response (calculated relative risk [RR], 2.24; 95% confidence interval [CI], 0.95 to 5.24; N=36), remission (calculated RR, 2.51; 95% CI, 0.94 to 6.70; N=36), and depressive symptoms (p-values ranging from 0.01 to 0.05) when compared with placebo. Discontinuing use of mood stabilizers during pregnancy may increase recurrence (adjusted hazard ratio [AHR], 2.2; 95% CI, 1.2 to 4.2; N=89) and reduce time to recurrence of mood disorders (2 vs. 28 weeks, AHR, 12.1; 95% CI, 1.6 to 91; N=26) for bipolar disorder when compared with continued use. Brexanolone for depression onset in the third trimester or in the postpartum period may increase the risk of sedation or somnolence, leading to dose interruption or reduction when compared with placebo (5% vs. 0%). More than 95 percent of studies reporting on harms were observational in design and unable to fully account for confounding. These studies suggested some associations between benzodiazepine exposure before conception and ectopic pregnancy; between specific antidepressants during pregnancy and adverse maternal outcomes such as postpartum hemorrhage, preeclampsia, and spontaneous abortion, and child outcomes such as respiratory issues, low Apgar scores, persistent pulmonary hypertension of the newborn, depression in children, and autism spectrum disorder; between quetiapine or olanzapine and gestational diabetes; and between benzodiazepine and neonatal intensive care admissions. Causality cannot be inferred from these studies. We found insufficient evidence on benefits and harms from comparative effectiveness studies, with one exception: one study suggested a higher risk of overall congenital anomalies (adjusted RR [ARR], 1.85; 95% CI, 1.23 to 2.78; N=2,608) and cardiac anomalies (ARR, 2.25; 95% CI, 1.17 to 4.34; N=2,608) for lithium compared with lamotrigine during first- trimester exposure. Conclusions. Few studies have been conducted in pregnant and postpartum women on the benefits of pharmacotherapy; many studies report on harms but are of low quality. The limited evidence available is consistent with some benefit, and some studies suggested increased adverse events. However, because these studies could not rule out underlying disease severity as the cause of the association, the causal link between the exposure and adverse events is unclear. Patients and clinicians need to make an informed, collaborative decision on treatment choices.

scholarly journals Management of mental health disorders and central nervous system sequelae in HIV-positive children and adolescents

2014 ◽  
Vol 15 (3) ◽  
pp. 81-96 ◽  
Author(s):  
R Nassen ◽  
K Donald ◽  
K Walker ◽  
S Paruk ◽  
M Vujovic ◽  
...  
Keyword(s):  
Mental Health ◽  
Central Nervous System ◽  
Nervous System ◽  
Mental Disorders ◽  
Children And Adolescents ◽  
Mental Health Disorders ◽  
Hiv Positive ◽  
Increased Risk ◽  
Health Disorders ◽  
The Impact

HIV-positive children and adolescents are at increased risk of both central nervous system (CNS) sequelae and mental disorders owing to a number of factors, including the impact of HIV infection on the brain, social determinants of health (e.g. poverty and orphanhood) and psychosocial stressors related to living with HIV. Every effort should be made to identify perinatally HIV-infected children and initiate them on antiretroviral therapy early in life. HIV clinicians should ideally screen for mental health and neurocognitive problems, as part of the routine monitoring of children attending antiretroviral clinics. This guideline is intended as a reference tool for HIV clinicians to support the early identification, screening and management of mental health disorders and/or CNS impairment in children and adolescents. This guideline covers mental disorders (section 1) and HIV-associated neurocognitive disorders (section 2) among children and adolescents.  

scholarly journals M1. INVESTIGATING THE RELATIONSHIP BETWEEN CHILDHOOD TRAUMA AND PSYCHIATRIC DISEASE USING MACHINE LEARNING TECHNIQUES

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S133-S133
Author(s):  
Theresa Haidl ◽  
Dennis Hedderich ◽  
Marlene Rosen ◽  
Thorsten Lichtenstein ◽  
Nathalie Kaiser ◽  
...  
Keyword(s):  
Childhood Trauma ◽  
Machine Learning Techniques ◽  
Brain Maturation ◽  
Patient Specific ◽  
Psychiatric Disease ◽  
Support Vector ◽  
Recent Onset ◽  
Increased Risk ◽  
Patient Groups ◽  
Structural Brain

Abstract Background Childhood trauma (CT) is associated with an increased risk for psychiatric disorders like major depression and psychosis. However, the pathophysiological relationship between CT, psychiatric disease and structural brain alterations is still unknown. Methods PRONIA (‘Personalized Prognostic Tools for Early Psychosis Mangement’) is a prospective collaboration project funded by the European Union under the 7th Framework Programme (grant agreement n° 602152). Considering a broad set of variables (sMRI, rsMRI, DTI, psychopathological, life event related and sociobiographic data, neurocognition, genomics and other blood derived parameters) as well as advanced statistical methods, PRONIA aims at developing an innovative multivariate prognostic tool enabling an individualized prediction of illness trajectories and outcome. Seven clinical centers in five European countries and in Australia participate in the evaluation of three clinical groups (subjects clinically at high risk of developing a psychosis (CHR), patients with a recent onset psychosis (ROP) and patients with a recent onset depression (ROD)) as well as healthy controls (HC). To investigate the high-dimensional patterns of CT experience, measured by the childhood trauma questionnaire (CTQ), in HC and our three patient groups (PAT) (n=643), we used a Support Vector Machine (SVM). Furthermore, we tested whether patient-specific CT exposure is associated with structural brain changes by VBM analyses. Results We found that patients and HC could be separated very well by their CTQ pattern, whereas the different patient groups showed no specific CTQ pattern. Furthermore, an association with extensive grey matter changes suggests an impact on brain maturation which may put individuals at increased risk for mental disease. Discussion We have demonstrated in this large multi-center cohort that adverse experiences in childhood contribute transdiagnostically to the riskr for developing a psychiatric disease. The observed association between CTQ scores and structural changes suggests an impact of adverse childhood experiences on brain development. Resulting alterations may add to a neurobiological vulnerability for depression and psychosis. A role of both features for other mental disorders could be assumed and warrants further investigation.

scholarly journals Clinical characteristics of adolescents referred for treatment of depressive disorders

2018 ◽  
Keyword(s):  
Mental Health ◽  
Low Income ◽  
Suicidal Behaviour ◽  
Clinical Characteristics ◽  
Depressive Disorders ◽  
Mental Health Disorders ◽  
Low Mood ◽  
Increased Risk ◽  
Health Disorders

Low mood and depression often emerge during adolescence and are associated with long-term difficulties including increased risk of developing other mental health disorders, educational underachievement, low income/unemployment, and risk of suicidal behaviour.

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