Cumulative childhood trauma and complex psychiatric symptoms in pregnant women and expecting men

Background Women and men having been exposed to childhood trauma would be at high risk of various mental health symptoms while awaiting a child. This study aimed to evaluate the association between cumulative childhood trauma and the accumulation of symptoms belonging to different psychiatric problems in pregnant women and expecting men. Methods We first examined prevalence rates of childhood trauma across our samples of 2853 pregnant women and 561 expecting men from the community. Second, we evaluated the association between cumulative childhood trauma and symptom complexity (i.e., the simultaneous presentation of symptoms belonging to multiple psychiatric problems) using subsamples of 1779 pregnant women and 118 expecting men. Participants completed self-reported measures of trauma (Childhood Trauma Questionnaire) and psychiatric symptoms (PTSD Checklist for DSM-5; Kessler Psychological Distress Scale; State-Trait Anger Expression Inventory-2; Self and Interpersonal Functioning Scale). Results Trauma was more frequent in pregnant women than in expecting men and in participants reporting sociodemographic risk factors than in those not reporting any. A dose-response relationship was observed between the number of different traumas reported by pregnant women and expecting men and the complexity of their psychiatric symptoms, even when controlling for the variance explained by other risk factors. Women having been exposed to cumulative childhood trauma were 4.95 times more at risk of presenting comorbid psychiatric problems during pregnancy than non-exposed women. Conclusions Childhood trauma is frequent in the general population of pregnant women and expecting men and is associated with symptom complexity during the antenatal period. These findings call for delivering and evaluating innovative trauma-informed antenatal programs to support mental health and adaptation to parenthood in adults having been exposed to childhood trauma.

How Have Governments and the Entrepreneurial Sector Reacted to the First COVID-19 Lockdown?

At the end of 2019, the pandemic caused by COVID-19 and its different mutations is forcing the world to face a significant economic crisis that will change the business world. To cope with this socio-economic problem, a digitation process has been accelerated in the labor market, and a more vital public-private collaboration has been put into action to solve this situation. Despite these efforts, the world is facing a broader North-South gap, and a new business world has been created for the new generations to come. This chapter aims to analyze how the first lockdown caused by COVID-19 has influenced this changing process. The authors conclude that this lockdown has accelerated both the digitation process and the work-life balance. Also, more efforts are needed to fight the psychiatric problems associated with the lockdown.

Usefulness of the Brief Scale for Psychiatric Problems in Orthopaedic Patients (BS-POP) for Predicting Poor Outcomes in Patients Undergoing Lumbar Decompression Surgery

Background. The Brief Scale for Psychiatric Problems in Orthopaedic Patients (BS-POP) is an original questionnaire that evaluates psychosocial problems in orthopaedic patients. The purpose of this study was to clarify the relationship between BS-POP scores and surgical outcomes in patients with lumbar spinal stenosis (LSS). Methods. From our database, a total of 157 patients with LSS who had undergone decompression surgery and completed a 1-year follow-up were retrospectively observed. The primary outcome was the numerical rating scale (NRS) score for satisfaction with surgery (from 0: not satisfied to 10: completely satisfied). Patients with an NRS score ≥8 were classified into the satisfied group. The secondary outcomes were NRS scores for low back pain, leg pain, and leg numbness and scores on the Roland–Morris Disability Questionnaire (RDQ). BS-POP was used to detect psychiatric problems before surgery. A BS-POP score ≥11 on the physician version or a combination of 10 on the physician version and ≥15 on the patient version was considered to indicate the presence of psychiatric problems. The patients were classified into two groups and compared based on preoperative BS-POP scores at the 1-year follow-up. Results. Preoperatively, 22 and 135 patients showed high and low BS-POP scores, respectively. No significant differences in preoperative symptoms were found between the two groups. At 1 year after surgery, patients with high BS-POP scores showed significantly lower satisfaction with surgery, higher NRS scores for low back pain, leg pain, and leg numbness, and lower RDQ deviation scores than did the low BS-POP group ( p < 0.05 ). The results of the multivariable analysis indicated that preoperative high BS-POP scores were independently associated with low satisfaction with surgery (odds ratio: 5.2, 95% confidence interval: 1.9–15.1). Conclusion. High preoperative BS-POP scores were associated with poor outcomes for decompression surgery in patients with LSS at 1 year after surgery. These results suggest that BS-POP is a useful tool for predicting surgical outcomes in patients with LSS.

Raising children in an technologically advanced world

“The greatest legacy one can pass on to one’s children and grandchildren is not money or other material things accumulated in one’s life, but rather a legacy of character and faith”. Evangelist Billy Graham.Dining together each night my father- in -law converses with us on how he was born and brought up by his parents long back. having his mother alive all hail and hearty, an old lady of 100 makes him recall his childhood each time he sees her. he flips back on how his father gave him valuable advices on lessons of life, and continues to walks on the principals that his father has imbibed on him as a young boy and he carries a strong impression of his fathers teachings, he expects that the coming generation should live a life as they then lived. childhood in itself is a sweet memory for each one of us, we all have our own bunch of memories to share. childhood is even the most correct time to mould a raw person into a fine personality. living in the 21st century world, things have seemed to be changing a lot. parenting, raising children has become a far more different aspect. since parenting is also an ethical and moral issue, perspective may vary according to the culture and civilization for different people belonging to different set ups. as health personals we too come across many cases that arise merely due to maladjustments or psychological impairments that many a times lead to serious psychiatric problems. the third important thing is that parenting as a complete process and according to the changing time parenting is not the same as it used to be in the past. in the previous years we have been undergoing tremendous technological advancement which in terms is a boon for us. our lifestyles have heavily changed, we no more live in an joined family, we all are working parents and our outlook for a settled life has changed the world around us. we all live in the a world that is modernly civilized. leaving our civilization far behind. raising kids in this advanced world is a challenge indeed. since technology has brought curses as well as boons to our lives. we need to balance them both. things may be difficult but not impossible.

Integrating mental health into primary care: Evaluating the Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) pilot project

Background The Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) project trains non-specialist and primary health care workers in Imo State, Nigeria, using the World Health Organization’s Mental Health Gap Action Programme-Intervention Guide (mhGAP-IG) to treat common mental and neurological disorders in the primary care setting. This study evaluates the impact of the HAPPINESS pilot project training on trainees’ beliefs and attitudes about mental disorders and explores the perspectives of trainees, trainers, and health services officials on its implementation using a convergent, mixed-methods approach. Methods Trainees completed a 43-item questionnaire, before and after their 5-day training, to assess perceptions of mental disorders and attitudes towards people with mental illness. Paired-sample t-tests were conducted with respect to four subscales of the questionnaire: acceptance of socializing with people with mental illness, normalizing activities and relationships with people with mental illness, supernatural causation of mental illness, and endorsement of a biopsychosocial approach to mental illness. Semi-structured Key Informant Interviews with trainees, trainers, and local health officials who participated in or supported the HAPPINESS Project were also analyzed. Findings from the questionnaire and interviews were merged using a convergent, mixed method approach. Results Trainees showed significant improvements on socializing, normalizing, and supernatural causation subscales of the stigma questionnaire (p < 0.05). No significant effect was seen on the biopsychosocial subscale; however, evidence of biopsychosocial beliefs was found in interview responses. The HAPPINESS Project enhanced trainees’ diagnostic and treatment abilities, mental health awareness, and empathy towards patients. Misinformation, stigma, inadequate funding and lack of road access to clinics were identified as barriers to mental health care integration into general care in Imo State. Lastly, respondents suggested ways that the HAPPINESS Project could be improved and expanded in the future. Conclusion This study adds to the limited existing evidence on the impact of mhGAP-IG-based training for primary care workers in Nigeria. Notably, it quantitatively evaluates pre and post training change in stigma level among trainees. Future efforts should focus on clinical support, supervision and implementation outcomes as well as scaling up and assessing the cost-effectiveness of the HAPPINESS Project intervention.

Early Life Experiences Moderate the Relationship Between Genetic Risk of Autism and Current and Lifetime Mental Health

Although individuals with autism are at greater risk of mental health challenges than others, we know little about the relationship between the mental health of older adults (50+) and autism because they are less likely to be diagnosed. Identifying the risk and protective factors that are associated with mental health can increase educational awareness, inform clinical practice, and provide information to help diagnose and treat older adults with autism. This study used longitudinal panel data of the 2008–2016 waves of the Health and Retirement Study. It estimated individual random-effect models by interacting a genetic propensity toward autism and early life experiences to test whether the latter has a moderating effect on the relationships between genetics and the Center for Epidemiologic Studies Depression (CES-D) score, self-reported depression, and history of psychiatric problems. Results suggest that individuals with a higher genetic propensity for autism are less likely to develop psychiatric problems if they report a positive maternal relationship early in life. Further, a combined effect of police encounters early in life and genetic risk for autism is associated with higher CES-D scores, increased odds of self-reported depression, and a history of psychiatric problems. Clinical applications of these findings include the need to establish and support high-quality relationships by addressing both child and caregiver needs. Further, these findings support the need to design and implement proactive interventions to teach police and autistic individuals how to successfully navigate these encounters.

Estimated prevalence of Niemann–Pick type C disease in Quebec

Niemann–Pick type C (NP-C) disease is an autosomal recessive disease caused by variants in the NPC1 or NPC2 genes. It has a large range of symptoms depending on age of onset, thus making it difficult to diagnose. In adults, symptoms appear mainly in the form of psychiatric problems. The prevalence varies from 0.35 to 2.2 per 100,000 births depending on the country. The aim of this study is to calculate the estimated prevalence of NP-C in Quebec to determine if it is underdiagnosed in this population. The CARTaGENE database is a unique database that regroups individuals between 40 and 69 years old from metropolitan regions of Quebec. RNA-sequencing data was available for 911 individuals and exome sequencing for 198 individuals. We used a bioinformatic pipeline on those individuals to extract the variants in the NPC1/2 genes. The prevalence in Quebec was estimated assuming Hardy–Weinberg Equilibrium. Two pathogenic variants were used. The variant p.Pro543Leu was found in three heterozygous individuals that share a common haplotype, which suggests a founder French-Canadian pathogenic variant. The variant p.Ile1061Thr was found in two heterozygous individuals. Both variants have previously been reported and are usually associated with infantile onset. The estimated prevalence calculated using those two variants is 0.61:100,000 births. This study represents the first estimate of NP-C in Quebec. The estimated prevalence for NP-C is likely underestimated due to misdiagnosis or missed cases. It is therefore important to diagnose all NP-C patients to initiate early treatment.

Autisme binnen de opvoeding

This study investigates the relationship between the perceived stress of parents with a child with (characteristics of) an autism spectrum disorder (ASD) and the degree of ASD characteristics within parents. Data from 222 children (mean age 7.8 years) and their primary caregivers, previously collected as part of the Social Spectrum Study, were analyzed. Linear regression analyses were used to investigate the association between experienced parenting stress and the influence of parents’ own ASD characteristics, taking into account relevant covariates. This study shows that the experienced parenting stress does not show a significant relationship with the ASD characteristics of parents when relevant covariates (such as own psychiatric problems, ASD characteristics of the child and the partner relationship) are added. This study finds indications that parenting stress in parents of children with ASD appears to be more strongly related to their general perceived psychopathology than to their specific ASD characteristics. Further replication is warranted, and we advise research into interventions for parents that possibly prevent (further) stress associated with raising a child with ASD (characteristics).